13 doctors weighed in:
What is the best treatment for prostrate enlargement BPH of 140gm & psa 6.73? Catheter insertion for one month & chronic sob, no hypertension. 72years
13 doctors weighed in

6 doctors agree
In brief: Simple Prostatectomy
Given your psa, a biopsy should be considered, though not imperative.
Your only choices are to continue with a catheter indefinitely to see if medications eventually help, or proceed with removal of the obstructing portion of the prostate (a simple prostatectomy). This operation carries a fair amount of morbidity, but it can be done with spinal anesthesia. This would be helpful in light of sob.

In brief: Simple Prostatectomy
Given your psa, a biopsy should be considered, though not imperative.
Your only choices are to continue with a catheter indefinitely to see if medications eventually help, or proceed with removal of the obstructing portion of the prostate (a simple prostatectomy). This operation carries a fair amount of morbidity, but it can be done with spinal anesthesia. This would be helpful in light of sob.
Dr. Robert Donato
Dr. Robert Donato
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Dr. George Klauber
Pediatrics - Urology
5 doctors agree
In brief: Prostatectomy
Your prostate is too large to respond to medical treatment, so you need surgery.
Presumeably you were in urinary retention and hence required a catheter, but, long term catheterization always results in infection. You need to in a center with reliable anesthesia, and with a urologist experienced in "open" surgery. The specimen will be reviewed by a pathologist, especially in view of the psa.

In brief: Prostatectomy
Your prostate is too large to respond to medical treatment, so you need surgery.
Presumeably you were in urinary retention and hence required a catheter, but, long term catheterization always results in infection. You need to in a center with reliable anesthesia, and with a urologist experienced in "open" surgery. The specimen will be reviewed by a pathologist, especially in view of the psa.
Dr. George Klauber
Dr. George Klauber
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2 doctors agree
In brief: Simple prostatectomy
I agree with the first answer, but advocate a robotic simple prostatectomy to decrease blood loss and improve the urethra to bladder reconstruction.

In brief: Simple prostatectomy
I agree with the first answer, but advocate a robotic simple prostatectomy to decrease blood loss and improve the urethra to bladder reconstruction.
Dr. Michael Louie
Dr. Michael Louie
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Dr. Phillip Porch
General Practice
2 doctors agree
In brief: Open prostatectomy
With a prostate that large, an open prostatectomy is probably your best choice but it depends on your surgeon.

In brief: Open prostatectomy
With a prostate that large, an open prostatectomy is probably your best choice but it depends on your surgeon.
Dr. Phillip Porch
Dr. Phillip Porch
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Dr. Rabii Madi
Urology
1 doctor agrees
In brief: Probably surgery
Your prostate is very big, and that might explain the high psa.
Urinary retention and catheter insertion also can rise psa . I agree that the best treatment will be surgical either open or robotic prostatectomy . Your prostate is too big for trans-urethral resection ( turp). If your psa remains high, a prostate biopsy is needed to rule out prostate cancer.

In brief: Probably surgery
Your prostate is very big, and that might explain the high psa.
Urinary retention and catheter insertion also can rise psa . I agree that the best treatment will be surgical either open or robotic prostatectomy . Your prostate is too big for trans-urethral resection ( turp). If your psa remains high, a prostate biopsy is needed to rule out prostate cancer.
Dr. Rabii Madi
Dr. Rabii Madi
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