The patient: more than 30 years ago, he suffered from acute prostatitis due to male L-operative infection and then chronic prostatitis. more than 20 years ago, he was found to have prostatic hyperplasia, and now he feels discomfort in the perineum, swelling after standing for a long time, thin urine stream, incomplete urination and dripping urine. I’ve been up 3 times during the night. I was treated at Chongqing Hospital. The company has been in the business of prostate surgery for more than 30 years, and has been using antibiotics followed by perineal prostate puncture injections of gentamicin and kanamycin. 20 years ago, prostate hyperplasia was detected. The echogenicity of the inner and outer gland is clear, the echogenicity of the inner gland is thickened, heterogeneous and nodular, the ducts are dilated, and multiple scattered dots of strong echogenicity are seen in the inner gland and at the boundary of the inner and outer gland. PSA 7.9ng/ml, fPSA 2.78ng/ml, fPSA/PSA = 0.35, reference value > 0.16 (2) 2010.10.27. PSA 8.74ng/ml, fPSA 0.8ng/ml, fPSA/PSA = 0.0915 (3) 2011.4.22. 22.PSA 6.273ng/ml, fPSA 1.030ng/ml, fPSA/PSA = 0.164 (4) 2011.4.27.PSA 6.674ng/ml, fPSA 0.708ng/ml, fPSA/PSA = 0.106 (5) 2011.10.21.PSA 6.36ng/ml, fPSA fPSA 1.00ng/ml, fPSA/PSA = 0.157 The right epididymis was removed 5 years ago due to frequent enlargement of the scrotum, and the symptoms improved after removal of the right epididymis. Urodynamic examination: bladder neck R was increased. Some doctors said surgery (electrodesection of the prostate). Some doctors suggest observation (check every six months). 1, based on the above tests do you estimate the likelihood of prostate cancer? I’ve been told that cancer is not usually found in the hyperplasia area, but my ultrasound is nodular in the hyperplasia area, so can I understand that malignancy is less likely? The first thing I need to do is to have a prostate puncture biopsy (do I have an indication for a puncture?). 4. Is a puncture biopsy better via the perineum? Is it better to do it through the perineum or through the rectum? Is it better to have ultrasound guidance? 5. Although surgery cannot solve the problem of cancer, it can solve the problem of cancer of the excised tissue. Also, if it is not cancerous, should the PSA be in the normal range after surgery? Thanks! The actual fact is that you can’t get a lot of money from the internet and you can’t get a lot of money from the internet. There is a prostate symptom scale you can look at, you can observe or puncture, depending on your own mood decision, puncture is like going to about 10 stitches of tissue in an apple, there may be the possibility of false negatives, surgery can not remove the tissue cancer problem, mainly to solve the problem of urinary difficulties, electrodesiccation surgery can not remove the good part of prostate cancer. Now the urodynamics report lying wash teaching to see if you need to take medication? 2, where can I find the prostate scale you mentioned? Can you please pass it to me? 3. Is it dangerous to have a puncture? How effective is it? Is there a high probability of false negatives? Is it possible to have a false positive? 4. Which is more accurate, puncture or MRI? 5. Is it better to have an MRI or not to have a puncture? (The actual fact is that I’ve had numerous perineal puncture prostate injections with gentamicin 30 years ago due to chronic prostatitis, and I’ve never been anesthetized). The main items to observe, if any, are the following How often is it checked? The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. If the urination affects your daily life, you can operate. The actual fact is that there is no danger of a puncture through the perineum or through the rectum. Thanks again! Please excuse me for being a bit shivering! The PSA is more complicated, there are many professional articles, in general, greater than 10 definitely need to puncture, between 4-10 called gray area, depends on many other reference indicators, it is recommended to find a professional doctor to tell you Patient: thank you very much granted! Listen to your first MRI to see. If the total PSA is in the gray zone and the combined one is more, will cancer be suspected? If not, is there any harm if I don’t take any medication? Thank you! Yang Qing, Department of Urological Oncology, Tianjin Cancer Hospital: Let’s find a doctor to explain the problem of PSA and let’s do MRI first Patient: Dr. P: Hello! I went to the hospital today and the doctor suggested surgery, saying that long-term inflammatory stimulation can reach cancer. The following is what the doctor said: “Although the PSA follow-up is not progressively elevated, it is always higher than normal, and in the case of PSA10, the quotient of the free PSA value divided by the total PSA value should be suspected of prostate cancer if it is less than 0.16. Also, your prostate is hard to palpate, so the possibility of prostate cancer cannot be excluded. Many current studies suggest that long-term prostate inflammation may be an important predisposing factor for prostate cancer. Is it better to decide on surgery? Can electrodes be used to remove the inflammatory prostate tissue? If not, will there still be inflammation and irritation? The actual fact is that the actual fact is that the particulars of the actuals are not the same as the actuals of the actuals. The reason for this is that the area removed by electrodes is the prostate migratory zone, while the high incidence of prostate cancer is in the peripheral zone, and electrodes solve the problem of urination rather than diagnosis. The actual fact is that you can find a lot of people who are not able to get a good deal on this. Patient: Dr. Yang:Hello! I have been to several hospitals in Chongqing for my condition, and the statements are very inconsistent. But the final result has come out and it matches your diagnostic judgment perfectly, very admirable! Check PSA is still 6. point more FPAS/TPSA 0.1, MRI did not find occupancy, consider prostate hyperplasia. The prostate puncture pathology diagnosis: benign prostatic hyperplasia. The hematuria after puncture and dark areas on ultrasound. The actual fact is that you can find a lot of people who are not able to get a lot of money from the internet. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. 3, improve the symptoms. 4, PSA should drop after the operation, no longer need to be worried like now. What I don’t understand is that I don’t know how dangerous the surgery is. The most important thing to know is whether the inflammatory prostate tissue in the migratory zone can be dried out as you said. I’d like to know what the complications are after the surgery. I would like to ask Dr. Yang to give me more ideas about the above. Thank you! The actual fact is that you can’t have a lot of trouble urinating and it doesn’t affect your quality of life, so you can’t have surgery. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The actual fact is that there are risks associated with surgery, such as anesthesia, urinary incontinence, urethral stricture, post-operative cardiopulmonary and cerebral accidents, sexual dysfunction, etc. From the viewpoint of urodynamics, suspicious obstruction, and not an absolute indication for surgery. Surgery has risks and should be done with caution. If you ask me to do your surgery, I would definitely be very careful. In my opinion, the indications for surgery are not strong, and the surgery may not achieve the results you expect. Good luck!