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Suggest Treatment For Enlarged Prostrate And Cyst In Kidney
Question: I was diagnosed having enlarged prostrate in 2011 and was for sometime on Flotral D. Recently I had a check up and the prostrate size was 3cm x 4.8 cm x 3.5 cm, volume 27 ml. post void 15 ml. left kidney a simple cyst in upper 1/3rd measuring 1.5 cm. No drug advised. I am 65 years old and generally healthy with no sugar or BP problems. Can I continue Flotral D or any other drug for ensuring that prostrate enlargement is under control. Please suggest a drug available in XXXXXXX
XXXX, XXXXXXX
XXXX, XXXXXXX
Brief Answer:
Please get blood PSA level done, FLOTRAL D not required without symptoms
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. A prostate volume of 27 ml is borderline normal and not a serious concern. Most doctors take a prostate up to 25 ml as normal and few take a prostate of 30 ml as normal. If you have prostate volume of 27 ml then please do not worry.
2. The post void residue 15 ml is acceptable. It is about 3 teaspoons of urine left after you have voided the bladder. At 64 years age this is usual.
3. The simple cyst in upper third of left kidney measuring 1.5 cm in diameter is a small cyst. Cysts are thin walled fluid filled structures and two cysts in each kidney is normal after 60 years age.
4. Flotral D is a medicine containing alfuzosin 10 mg, dutasteride 0.5 mg and is available locally. This medicine should be taken only when required and if you are having significant urinary problems like urgency and increased frequency of urination due to an enlarged prostate.
5. In my opinion there is no urgent need for starting medicine unless you have significant symptoms. In the absence of symptoms, taking medicine is not a good idea.
6. Instead you can get blood PSA level done to know if there is any risk of prostate cancer. It is recommended that men above 60 years get PSA level done annually.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please get blood PSA level done, FLOTRAL D not required without symptoms
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. A prostate volume of 27 ml is borderline normal and not a serious concern. Most doctors take a prostate up to 25 ml as normal and few take a prostate of 30 ml as normal. If you have prostate volume of 27 ml then please do not worry.
2. The post void residue 15 ml is acceptable. It is about 3 teaspoons of urine left after you have voided the bladder. At 64 years age this is usual.
3. The simple cyst in upper third of left kidney measuring 1.5 cm in diameter is a small cyst. Cysts are thin walled fluid filled structures and two cysts in each kidney is normal after 60 years age.
4. Flotral D is a medicine containing alfuzosin 10 mg, dutasteride 0.5 mg and is available locally. This medicine should be taken only when required and if you are having significant urinary problems like urgency and increased frequency of urination due to an enlarged prostate.
5. In my opinion there is no urgent need for starting medicine unless you have significant symptoms. In the absence of symptoms, taking medicine is not a good idea.
6. Instead you can get blood PSA level done to know if there is any risk of prostate cancer. It is recommended that men above 60 years get PSA level done annually.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
At the outset let me thank you. This is first time I have chosen your site for answer and I am delighted. I now would suggest this site to my friends. Any referral bonus for me :-)
my follow up question :
Last PSA test done (ECLIA) on 13/09/14 shows value 1.31 ng/ml (ref 4.1 ng/ml) . Though i have no urgency to urinate I get up 3 to 4 times during night with an urge to urinate (though no urgency) , however during daytime i have no urge and urination is normal.
Trust I can take the next PSA test later. Any other prevention you would like to suggest so that there is no deterioration
my follow up question :
Last PSA test done (ECLIA) on 13/09/14 shows value 1.31 ng/ml (ref 4.1 ng/ml) . Though i have no urgency to urinate I get up 3 to 4 times during night with an urge to urinate (though no urgency) , however during daytime i have no urge and urination is normal.
Trust I can take the next PSA test later. Any other prevention you would like to suggest so that there is no deterioration
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Thanks for your appreciation and choosing our services and referral. I will try to give you the most accurate suggestions.
In continuity with our earlier discussion,
1. Nice to know you have got PSA level done and it is normal. This test can be repeated in September 2015. If at any time you find the level crossing 4 ng/ ml then you need to take further tests like free PSA to check for any cancer risk..
2. As you are not having urgency in the daytime, it looks like the problem is not mainly due to prostate enlargement. In this case I can suggest you to drink adequate water during the day time and avoid taking too much water after 8.00 pm. This can be followed by passing urine once just before you go to bed.
3. An international research says that
"Men at risk for benign prostatic hyperplasia disease can be identified using prostate specific antigen greater than 1.5 ng/ml as a surrogate marker of prostate volume. In men at risk with prostate specific antigen greater than 1.5 ng/ml 5-reductase inhibitors medicine have potential value for benign prostatic hyperplasia disease prevention regardless of symptom status."
For your information dutasteride contained in Flotral D is a 5-reductase inhibitor medicine.
Therefore as your PSA is 1.31 ng/ ml and this is less than 1.5 ng/ ml as described in the above research, I find taking any medication is not recommended in the absence of significant features of urinary retention due to prostate enlargement. If the PSA is more than 1.5 ng/ ml in future then you can decide to start medicine to control prostate enlargement even if there are no symptoms.
4. Benign prostate enlargement is an aging process and at 85 years age more than 95 percent men will have it. The idea is to treat the complications arising due to an enlarged prostate and also remove a significantly enlarged prostate by surgery if required at a later age.
It will be good if you continue to get ultrasound scan and PSA level test done annually and then take measures as required.
5. Eating healthy food and vegetables can help in prevention of benign prostate enlargement.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Thanks for your appreciation and choosing our services and referral. I will try to give you the most accurate suggestions.
In continuity with our earlier discussion,
1. Nice to know you have got PSA level done and it is normal. This test can be repeated in September 2015. If at any time you find the level crossing 4 ng/ ml then you need to take further tests like free PSA to check for any cancer risk..
2. As you are not having urgency in the daytime, it looks like the problem is not mainly due to prostate enlargement. In this case I can suggest you to drink adequate water during the day time and avoid taking too much water after 8.00 pm. This can be followed by passing urine once just before you go to bed.
3. An international research says that
"Men at risk for benign prostatic hyperplasia disease can be identified using prostate specific antigen greater than 1.5 ng/ml as a surrogate marker of prostate volume. In men at risk with prostate specific antigen greater than 1.5 ng/ml 5-reductase inhibitors medicine have potential value for benign prostatic hyperplasia disease prevention regardless of symptom status."
For your information dutasteride contained in Flotral D is a 5-reductase inhibitor medicine.
Therefore as your PSA is 1.31 ng/ ml and this is less than 1.5 ng/ ml as described in the above research, I find taking any medication is not recommended in the absence of significant features of urinary retention due to prostate enlargement. If the PSA is more than 1.5 ng/ ml in future then you can decide to start medicine to control prostate enlargement even if there are no symptoms.
4. Benign prostate enlargement is an aging process and at 85 years age more than 95 percent men will have it. The idea is to treat the complications arising due to an enlarged prostate and also remove a significantly enlarged prostate by surgery if required at a later age.
It will be good if you continue to get ultrasound scan and PSA level test done annually and then take measures as required.
5. Eating healthy food and vegetables can help in prevention of benign prostate enlargement.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much.
Brief Answer:
Welcome
Detailed Answer:
Hi XXXX,
Welcome and thanks for sending your query.
Should you have any more queries and would like me to answer them then please quote query Id 179510 and mention Dr.Vivek Chail in the subject line and the moderators will direct it to me. I will be glad to answer your query at the earliest.
Regards,
Dr.Vivek
Welcome
Detailed Answer:
Hi XXXX,
Welcome and thanks for sending your query.
Should you have any more queries and would like me to answer them then please quote query Id 179510 and mention Dr.Vivek Chail in the subject line and the moderators will direct it to me. I will be glad to answer your query at the earliest.
Regards,
Dr.Vivek
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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