I am a physician running one of the largest erectile dysfunction/sexual
dysfunction clinics in the world.  I am sickened by the large numbers
of men who are receiving radical prostatectomies for small low grade
tumors that were not causing any symptoms, but were detected by a small
or minor elevation of the PSA.

In Canada Urologists make a living doing procedures.

So when a man is referred to an urologist even when the prostate is not
enlarged and their are no symptoms the patients are told that to be
safe they should have an ultrasound and a biopsy.

Well most men with prostate cancer never find out that they have it and
die from something else. In fact if you did an autopsy on men 60 years
old, 60% will have microscopic prostate cancer, 70% of men aged 70
years old will have prostate cancer, 80% 0f men over 80 will have
microscopic prostate cancer, and 90% of men aged 90 years old will have
prostate cancer but very few of these men will ever die or have
problems from their cancer.

That is why it is insane to be doing routine biopsies on men with a PSA
below 10.

Because if you are 70 years old you will have up to a 70% chance of
that test showing that you have cancer, even though their is only less
that a 1% chance that that cancer will ever enlarge and cause you
problems.  Only if that PSA goes from below 10 to well over 10 do you
need to have a biopsy.

Most men with a positive biopsy within days or a few weeks are having a
radical prostatectomy, which means they will never ever ejaculate
again; they will never ever have a normal erection without using
intra-penile injections.  More than 50% will be incontinent of urine
and have to wear diapers for the rest of their lives, and perhaps 20%
will have fecal incontinence.

In fact the majority of men I see who have profound sexual dysfunction
from prostate cancer had no symptoms and the only reason they had the
biopsy was because of a minor increase in their PSA.

Even though Urologists are doing 4 times more radical prostatectomy's
their has been no decrease in the death rate from prostate cancer!
Doctors are just doing more un-necessary surgeries on men who would
never have had any problems if they had been left alone.

If you have a PSA test that is less than 10, wait a few months and
repeat it. Only if the PSA is rising, or you have signifcant
enlargement, reduced or blocked urine flow or asymetry or a nodule
should you consider a biopsy if your PSA is below 10.

Remember erectile problems rarely are caused by the prostate, it is the
tests and procedures such as cystoscopies, biopsies and
TURPS/prostatectomies done by urologists that damage the penis that are
going to ruin your sex life, not the postate itself if it is left
alone.