a Bart Simpson ” damned if you do and damned if you don’t” issue..what to do with a high psa and one negative prostate biopsy?

The question to Bart was,”should America have a strong military as a deterrent?”

Prostate Diaries

Recent comment/question on this blog

I recently had a PSA of 17 and so saw a urologist and he ordered antibiotics for a month and another test. Tested the same and so he performed a biopsy with the 12 small cores you mentioned. Biopsy came back negative for cancer. I should mention there have been no symptoms, no urination problems, nothing at all which I have read is very common.

My urologist has recommended another biopsy in 6 months. My thought is to have another PSA check in 6 months and if PSA is the same avoid the second biopsy until and if I ever see an increase from 17. What do you think? From What I have read the biopsy should be avoided unless necessary.


This question comes up often and is troublesome for both the patient and the urologist. Here are some salient points to consider. Also…

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holy bloody mess batman!….the bleeding scrotum capo…i mean caper…tmi?

Read most recent comment! Too funny.

Prostate Diaries

Guitar Capo-Or as my mother used to say, ” Necessity is the mother of invention.”

When I was a urology resident I had to do a research paper on Fournier’s gangrene. I got somehow the original article on the subject by Mr. Fournier himself. It was in French and much to the chagrin of the chairman of the Dept. of Urology, it cost something like 500 dollars to translate it. Fournier’s is an interesting and devastating disease process. Two things are remarkable about it: one it can start as a small scratch on the scrotum and in hours infection can devour tissue from the scrotum and then up onto the abdominal tissue and skin (an infection that gallops) and despite all the destruction, the testicles themselves are spared. Why? The skin of the scrotum and that of the testicles are different so the testicles are unaffected. Think of a forest…

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Trouble voiding after radiation for prostate cancer? Proceed with caution!

Tissue don't heal well if you go a cuttin on it after radiation. Think incontinence and scarring if you do a procedure on a prostate that has been treated with seeds or external beam radiation. You can fix obstructive voiding symptoms before radiation by conventional methods but after radiation treatment is fraught with complications. It …

What should I expect after a prostate biopsy checking for prostate cancer because of an elevated PSA?

Fever after a prostate biopsy is serious business. Notify your urologist at the earliest sign of any temperature change!

Prostate Diaries

  • There will blood places and that is normal. Blood at the tip of your penis, blood when you urinate, blood with bowel movements, and blood in your semen if you are sexually active. Blood is expected and rarely a problem and almost always limited in duration. As a rule, don’t worry about the blood. Urology tip: blood at the beginning of the urinary stream and then clears as you void is prostate in origin a rarely associated with complications or difficulty voiding because of clots. Spotting of blood on your underwear or pajamas in the morning when you awake is expected.
  • If you have trouble voiding to the point that you are uncomfortable, that is something to be concerned about. If you get really full and uncomfortable you need to make your way to an Emergency Room. This usually means you had some underlying early prostate enlargement that has been exacerbated by…

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Jonah’s prayer.

The Blue Whale has a throat the size of a human.
The Sperm Whale could swallow something as large as a human!

Prostate Diaries


I spoke yesterday in Helen, Ga on the prayer of Jonah. What? The Chattahoochee Methodist Church- “I’d Climb The Highest Mountain” was filmed there in 1951. The church was established in 1860. Remember Tarshish?
Piqued your interest? Try Chapter 9 “The Sermon” from Moby Dick.

Jonah’s Prayer

2 Then Jonah prayed to the Lord his God from the belly of the fish, 2 saying,

“I called out to the Lord, out of my distress,
and he answered me;
out of the belly of Sheol I cried,
and you heard my voice.

For you cast me into the deep,
into the heart of the seas,
and the flood surrounded me;
all your waves and your billows
passed over me.

Then I said, ‘I am driven away
from your sight;
yet I shall again look
upon your holy temple.’

The waters closed in over me to take my…

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