Doc,
I’ve seen a lot of tv commercials for men who have trouble or a feeling of urgency to urinate. If my PSA is low, what do you think is the most likely cause and what course of action do you suggest?
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A sense of urgency to urinate can be present for a number of reasons. In men this most commonly is due to a benign enlargement of the prostate or sometimes an inflammation of the prostate (prostatitis) An overactive bladder can also be playing a role though more commonly that is seen in women. A low PSA does not really help to sort this out as the PSA is most useful as a screening test for prostate cancer and typically prostate cancer is asymptomatic in its early stages. Rather a visit to the primary care doctor with an examination of the prostate and a simple urinalysis are the next step. If an infection is suspected then a course of antibiotics would be indicated. If a benign enlargement of the prostate is thought to be the reason then medications that relax the muscular coat around the prostate (Flomax, uroxatral, rapaflo and others) or medications to shrink the prostate (proscar or avodart) might be considered. Hope that helps.