Low PSA with PRads 4

User

Posted 08 Apr 2026 at 13:47

Hi All.. First post so i'll provide a bit of information on why i'm here..

Around 14 months ago I started having issues urinating, ie weak flow, increased night wake ups, hot sweats etc, along with ejaculation issues: delayed which could take anywhere from 10 to 30+ mins to come out... While none of these issues were causing dread they were defo starting to concern me.. So after dealing with them for a few months I went to the Dr's, and a Urology referral was made which took 10 months....

At the appt I was told to take a medication to make the urine flow stronger, I never took it as I have an issue taking new meds, and an ultrasound was performed to check bladder storage. I was told I needed another ultra sound as my bladder was quite full... For the next bladder ultrasound I was asked to drink a litre of water an hour before the procedure!!!! Heres where things took a strange turn, during the exam the gent doing it said "Oh I can see you have an issue with your prostate"(I was later told he shouldn't have said anything to me, so I hope he didn't get in trouble) at the time I thought nothing of it but it lingered in my mind, so while waiting for the next Urology appt I had a private MRI of the prostate done. The results said PiRads 4.

Tomorrow I have a multi-parametric MRI scan with contrast and I am having a cystoscopy at the end of April. I have a low Psa count 1.3, which the Urologist says is a positive. My brother-in-laws father had a similar Psa to me and had advanced PC, he unfortunately passed away as his Pc was advanced by the time it was discovered, so I am aware that low Psa results are a good indicator but not a guarantee...

I have found the posts read on here really helpful and the journeys of others inspiring..

User

Posted 08 Apr 2026 at 17:54

Hello, mate.

I'm sorry that you're having possible prostate problems, but welcome to the forum.

Your PSA level is within the normal range, but your pi-rads score indicate that it is likely that you have significant prostate cancer.

Both PSA and pi-rads are only indicators. High pi-rads score can be due to non cancerous prostatitis, which often causes the symptoms you describe.

I'm not medically trained but from what I know about PCa, at this time, I wouldn't be overly concerned.

Best of luck with your next MRI results. It may be, that if the result is the same, you'll be advised to have a biopsy. Only a biopsy can give a clear picture of your exact condition.

Please keep us updated.

Edited by member 08 Apr 2026 at 18:26 | Reason: Typo

User

Posted 08 Apr 2026 at 21:39

Hi. I’ve just had a biopsy today & results will be in 3 weeks. My PSA was 4.73, but have been diagnosed with PIRAD 4. Just have to wait for results i guess. I’ve been up 4 or 5 times at night peeing, but it just dribbles out & it feels like bladder not empty.

User

Posted 08 Apr 2026 at 21:41

The Gleason score will give me more of an idea, but I hope it’s not bad news.

User

Posted 10 Apr 2026 at 16:34

Hi Guys and thanks for the replies.

I had the MRI with contrast yesterday and should get the results in 3 days. So fingers crossed with the low Psa score its nothing to be concerned about..

User

Posted 10 Apr 2026 at 18:28

A sizeable number of men are on Tamsulosin hydrochloride which helps men empty the bladder or have a narrowed spincter which affects urine flow, (like me). I have been on it for about 20 years with no noticeable side effects, although it does affect some men.

It's difficult to put thoughts of PCa out of ones mind and it doesn't help with results often coming through slowly but try to do so. There are many nuances with PCa as well as different types of the disease, some exhibiting little to high PSA. When all the tests/scan have been evaluated, you will be offered one or more appropriate treatment options if you have PCa; appropriate because PCa if confirmed, is an individual disease and treatment differs with how much disease there is, where it is and how advanced. Treatment has advanced greatly in recent years but with most people having one of the forms of radiation or surgery. A good place to get more unbiased information, is the 'Toolkit' published by this charity. https://shop.prostatecanceruk.org/our-publications/all-publications/tool-kit?limit=100&_ga=2.206109653.795867346.1564408880-1013787081.1564408880

Barry

User

Posted 10 Apr 2026 at 20:23

I’m on Tamsulosin hydrochloride. 400 micrograms a day, but up 4 or 5 times a night/early morning. Pee very little & want to go again, but same results. Feeling bladder isn’t empty. Having flow test & bladder scan on18th of May. Waiting for results of prostate biopsy. Diagnosed PIRAD 4 from MRI & PSA was 4.73. Not too optimistic it’s not prostate or related cancer.

User

Posted 13 Apr 2026 at 14:26

Hi Guys..

Got the results of the multi-parametric Mri today, and i'm so pleased to say the Pi-rads has been dropped from 4 to 2 !!!! Meaning its BPH and will be monitored over time.

I still have to have cystoscopy and other tests to determine the cause of urine and ejaculation issues.

Thanks to everyone who offered kind words, and to those going through the diagnosis and treatments for PC I send my hopes for easy treatments and speedy recoveries... x

User

Posted 17 Apr 2026 at 03:17

Great news—that’s a big relief. Pi-RADS 2 is much more reassuring, and BPH fits well with your symptoms. Good call to still go ahead with the cystoscopy to get a full picture. Wishing you all the best with the remaining tests—and hope the symptoms get sorted soon Geometry Dash👍

Notification

Join the online community now.