Worried again, watery and less semen, and high psa

User

Posted 23 Apr 2025 at 20:04

Back again. I have been out for several years, but here again.

This is my updated full story until today:

I started controls at 45 y/o due to yearly medical checking at work. The first psa was 6,19, but then the following years they were around 2-2 and a half (normal acording to the doctor).

2019, april: psa 4,2 ultrasound, everything normal excepting enlarged prostate 40 cc, one month later psa 2,55. Doctor said control next year, but he thinks it is only a matter of prostate size.

2020 July: psa 4.93, free 15.42% . September 5,90. Underwent an mpMRI in October, which showed inflammation. Urologist said it was prostatitis, and not to worry.

December 2020: Fever and blood in semen. Culture negative, but received a round of antibiotics (ampicillin).

April 2021: psa 3.64, free 16.48%. Doctor said "told you, it was prostatitis", if next psa is below 4, then control as normal population once a year

October 2021: psa 3.59 free 23.96% Doctor said "told you, you don't have anything", control in a year

April 2022: psa 4.28 free 20.79% (medical checking at work, urologist p****d off for not waiting the full year)

October 2022: psa 4.52 free 24.34% (may be the doctor was wrong)

April 2023: psa 4.63, free 20.02% (he said to wait 6 more months)

November 2023: psa 4.36 free 22.94% (doctor says that it is prostatitis again)

April 2024: psa 5.32 free 18.98%

November 2024: psa 4.89 free 23.52%

April 2025: psa 6.15 free 18.37%

There seems to be a steady increase although fluctuating

Tomorrow I have an appointment with my urologist, and I intend to ask for a new mpMRI.

What concerns me now is that in recent months, I’ve noticed my semen is more watery and there's significantly less volume. I'm currently 55 years old.

Honestly, I'm a bit scared. I've never had semen this watery and in such small amounts.

Thanks in advance for your thoughts.

Edited by member 15 Nov 2025 at 10:54 | Reason: Not specified

User

Posted 26 Apr 2025 at 22:34

Hi Chema.

SVI means the cancer has spread to the seminal vesicles (invasion).

User

Posted 27 Apr 2025 at 22:56

A change in semen is something that needs checking.

The watery part of the semen (which is mainly PSA) comes from the prostate. The thick white part comes from the seminal vesicles, via the ejaculatory ducts in the prostate, which can get blocked by prostatitis or cancer.

User

Posted 15 May 2025 at 20:37

Hi chema, I would hope you have a biopsy next. We have had people with pirads 5 lesions getting the all clear. Until you get the biopsy results it is unknown whether you have cancer.

Dave

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User

Posted 25 Apr 2025 at 11:00

I don't think you can read much into the consistency of your semen, it may suggest a prostate problem, and the PSA readings do warrant investigation. The urologist is going to be able to help better than us. However do keep us updated as this may help the next person posting on here with watery semen.

Dave

User

Posted 25 Apr 2025 at 11:21

Thx.

Yesterday I had a consultation with the urologist. He told me that he firmly believes that the PSA and the watery semen and everything is due to chronic prostatitis. He did a DRE and told me he didn't found anything suspicious (enlarged prostate grade II, which we already knew) but nothing other than that.

Nevertheless, taking into account that the previous mpMRI has been done more than 4 1/2 years ago, he agrees with me in the need for a new one. Foreseen for 14th of may.

I'll update as soon as I have more info.

Thx again.

Edited by member 25 Apr 2025 at 11:27 | Reason: Not specified

User

Posted 25 Apr 2025 at 14:23

Hi Chema

I was also diagnosed with prostatitis at the age of 55, but with different set of symptoms from you. My only concern would be the rate of rise of your PSA for the past 9 years, particularly since 2019. My reaction is entirely based on my own experience. I had noticed that my PSA over 4 years rose quite steeply which I thought was suspicious. My two GPs ignored my concern telling me that I worry too much, which I do! I consulted a urologist privately who also thought the same as me, he carried out an MRI guided biopsy, confirmed early stage well contained cancer, performed robot assisted surgery within three weeks when I was 72. That was 14 years ago and I am still cancer free.

I hasten to add that we are all different, so please don't jump to any conclusions, be guided by the medics, obtain a second opinion if possible.

I have totally unsubstantiated gut feeling that from the age of 55 to 72 I suffered from a varying degree off prostatitis which may have turned into cancer. That is not a scientifically based opinion for a retired research engineer!

ps: Is your PSA measured at the same laboratory every year because consistency matters?

Good luck

Edited by member 25 Apr 2025 at 14:28 | Reason: Not specified

'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.' Richard Feynman (1918-1988) Nobel Prize laureate

User

Posted 26 Apr 2025 at 00:35

Hi. Thank you.

No, The laboratory in april/may is related to work and changes from time to time. The one that it is always the same is the one in october/november.

I don't know if I have cancer, but I think the prostatitis thing is clear (particularly because of the going down of PSA when I had two rounds in a year of ampiciline). Nevertheless, I know that both things can exist together.

Let's see what the mpMRI shows...

Edited by member 26 Apr 2025 at 00:36 | Reason: Not specified

User

Posted 26 Apr 2025 at 08:53

I had watery semen and was diagnosed G8 T3B N1 M0 PSA 252 SVI

User

Posted 26 Apr 2025 at 22:01

Hi.

Sorry to read that but thx for the answer. What does mean SVI? And the second question if I may... was the watery semen the reason you had been checked?

Thx again.

Edited by member 26 Apr 2025 at 22:04 | Reason: Not specified

User

Posted 26 Apr 2025 at 22:34

Hi Chema.

SVI means the cancer has spread to the seminal vesicles (invasion).

User

Posted 27 Apr 2025 at 13:16

I was checked because of nocturnal bathroom visits, about five times a night.

User

Posted 27 Apr 2025 at 18:58

Ok, thanks.

User

Posted 27 Apr 2025 at 22:56

A change in semen is something that needs checking.

User

Posted 04 May 2025 at 16:24

Hello

Wellcome myself back to the forum. I am 48 and going through very strange symptoms since June 2024. Off and on blood in the semen after sex and weir burning sensation on the tip of the penis the (gland). I had 3 PSA so far and my readings dance between 2.9 and 2.8.

MRI prostate was done, a cytoscopy, blood work urine studies and all forms of STD panels including frequent rectal exams.

The urologist says no worries hang on no need for a biopsy yet...

I'm soo frustrated this never ending burning is off and on like a lid match.

Have anybody with a High PSA had this burning before or with a cancer diagnosis/?

I'm willing to travel to any country if there is a secret drink out there to take.

The dr thinks I'm too sensitive and must regulate my intake and cancel process of elimination drinks or food irritating my bladder. I told him his full of it.

Any thoughts forum I'm 49 this summer in August in Los Angeles Ca.

Man7679

User

Posted 05 May 2025 at 15:17

Pain at the tip of the penis when there's nothing visibly wrong there can be referred pain from the prostate, as a result of prostatitis (inflammation of the prostate). Pain in testicles and rectum can also be referred pain from the prostate. Blood in semen can be caused by prostatitis too (and prostate cancer). I'm a bit concerned your urologist doesn't seem to know this.

User

Posted 15 May 2025 at 17:21

Back from the MPMRI (yesterday), today I have the report. Two lesions pirads 4, of 5 and 4 mm. Next step, I assume biopsy.

Another thing that worries me is that the prostate has grown from 41,73 cc to 76.70 cc in four years and a half. In the report it says "adenomatous".

Actually, it has been a shock. Honestly, having a previous clean one I hoped this time it would be the same...

User

Posted 15 May 2025 at 20:37

Hi chema, I would hope you have a biopsy next. We have had people with pirads 5 lesions getting the all clear. Until you get the biopsy results it is unknown whether you have cancer.

Dave

User

Posted 20 May 2025 at 20:27

Back from the consultation with the urologist, he thinks that the decision is tought, but that he would wait 3 or 4 month more.

The fact that my prostate is so big (76,7 cm) and has grown a lot in 4,5 years makes him worry about the secondary effects of the biopsy (in terms of inflamation and psa rising, etc...). He told me that in the mpmri, there are sequences that might point to inflamation (DCE negative and T2 sequence Pirads 3). Actually, Pirad 4 is choosen due to DWI and DCE (which are suggestive of cspc) but usually in many cspcs DCE is positive and T2 sequences are higher than pirads 3, although is true that applying the protocol 2.1, DWI/ADC positive in peripheral zone means Pirads 4 without any doubt.

He told me that is true that going now for the biopsy is going to the safe side, but that is not risk free due to the size of my prostate and because of having had prostatitis in the past. On the other hand, he told that in his experience the risk of aggresive cancer in cases like mine is around 1 out of 5, and that the risk of worsening something fot waiting three or four months is not much.

So it was my decision eventually, and I am going to follow his recommendations, new psa at the end of august/september and will see...

Edited by member 15 Nov 2025 at 13:12 | Reason: Not specified

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