Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Urinary Retention And UTI
Question: He recently saw a urologist for urinary retention and was diagnosed as having a lower track UTI, upon the DRE he noted that the right lobe was bigger than the left lobe,he is going to order an MRI before doing a biopsy. The question I have is the prostate symptoms of starting stopping, very little flow.urinating was painful. He gave me an alpha blocker and the symptoms improved within eight hours.of course I feel fine but I am very concerned that these symptoms point to late stage prostate cancer.
Brief Answer:
Could be benign prostatic hyperplasia
Detailed Answer:
Hi
Since your symptoms improved with alpha blocker and you are not having blood in urine or semen and difficulty in having an erection i do not think you are having late stage prostate cancer.
The right lobe was bigger than left lobe in DRE and your other symptoms could be due to a condition called enlarged prostate which is also called benign prostatic hyperplasia and is very common in people at your age.
It is a benign condition and can easily be manged by oral medications.
I would advise you to do a prostate specific antigen (PSA) blood test to rule out prostate cancer.
If the PSA level comes to more than 4.0 ng/mL then you need to do a MRI of lower abdomen followed by a biopsy test.
Wishing you good health.
Regards
Dr De
Could be benign prostatic hyperplasia
Detailed Answer:
Hi
Since your symptoms improved with alpha blocker and you are not having blood in urine or semen and difficulty in having an erection i do not think you are having late stage prostate cancer.
The right lobe was bigger than left lobe in DRE and your other symptoms could be due to a condition called enlarged prostate which is also called benign prostatic hyperplasia and is very common in people at your age.
It is a benign condition and can easily be manged by oral medications.
I would advise you to do a prostate specific antigen (PSA) blood test to rule out prostate cancer.
If the PSA level comes to more than 4.0 ng/mL then you need to do a MRI of lower abdomen followed by a biopsy test.
Wishing you good health.
Regards
Dr De
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
ED been a problem last 5 years loss of Libdo. Been on testosteroNe for last 4 years
wAS WORKING ON i PAD ,NOW ON DESKTOP.I do have ED problems for at least 5 years,been on testosterone,every 10 days IMfor 3-4 Years.My testosterone was at low end I think around 200 far as I can remember.I have the following readings
11/26/12-- 6.52
1/07/13 ---6.57 freePSA 21%
5/09/13----8.54
04/28/14--5.90
-6/02/14---5.10 free psa-22%
Had prostate MRI on 01/09/13 results negative
biopsy following -no pathology
The symptoms can on gradually ,peaked about 1 week ago
Saw urologist -Cipro 1 tab bid for 5 days
Rapaflow 1/day
As stated urine flow back to normal within 5hrs of Rapaflow
I had read that if DRE detect abnormality it won't be early stage.(worry)
So your opinion which I understand ,needs to be unalarming.I wish the internet didn't exist.I have read enough to petrify me.
11/26/12-- 6.52
1/07/13 ---6.57 freePSA 21%
5/09/13----8.54
04/28/14--5.90
-6/02/14---5.10 free psa-22%
Had prostate MRI on 01/09/13 results negative
biopsy following -no pathology
The symptoms can on gradually ,peaked about 1 week ago
Saw urologist -Cipro 1 tab bid for 5 days
Rapaflow 1/day
As stated urine flow back to normal within 5hrs of Rapaflow
I had read that if DRE detect abnormality it won't be early stage.(worry)
So your opinion which I understand ,needs to be unalarming.I wish the internet didn't exist.I have read enough to petrify me.
Sorry the testosterone injections started after blood test showed levels in low 200"s. Then the readings listed by date are PSA scores .I don't remember having a PSA lower than 4 for many years before 2012. Just wanted to clarify
Brief Answer:
Transrectal ultrasound guided prostate biopsy recommended in abnormal DRE
Detailed Answer:
Hi
Almost 50% of men diagnosed with prostate cancer will have an abnormal DRE.
You need to do a fresh PSA test as your last test was done in XXXXXXX 2014.
In my opinion in patients with an abnormal DRE or PSA level above 7 ng/mL an MRI prostate followed by transrectal ultrasound guided prostate biopsy should be done to rule out late stage prostate cancer.
If the PSA level comes between 4 ng/mL and 7 ng/mL you can observe for few weeks and repeat a PSA test 4 weeks later.
Prior to repeating the PSA test you must abstain from ejaculation and bike riding for at least 48 hours.
If the repeat PSA level comes above 4 ng/mL you should do a transrectal ultrasound guided prostate biopsy.
Regards
DR DE
Transrectal ultrasound guided prostate biopsy recommended in abnormal DRE
Detailed Answer:
Hi
Almost 50% of men diagnosed with prostate cancer will have an abnormal DRE.
You need to do a fresh PSA test as your last test was done in XXXXXXX 2014.
In my opinion in patients with an abnormal DRE or PSA level above 7 ng/mL an MRI prostate followed by transrectal ultrasound guided prostate biopsy should be done to rule out late stage prostate cancer.
If the PSA level comes between 4 ng/mL and 7 ng/mL you can observe for few weeks and repeat a PSA test 4 weeks later.
Prior to repeating the PSA test you must abstain from ejaculation and bike riding for at least 48 hours.
If the repeat PSA level comes above 4 ng/mL you should do a transrectal ultrasound guided prostate biopsy.
Regards
DR DE
Above answer was peer-reviewed by :
Dr. Prasad
Thank you,that's what I was afraid of , late stage.Can late stage occurs with slow growing orr is it usuall more aggresive
What is your protocol in treatment planing late stage ,metastaic cancer.So if I understood you ,since I have a DRE and it's positve ,most certain late stage ,can late stage be T3 or just T4
Is there any validity ,that a ketogenic diet helps slow cancer,by reducing available gloucose in blood
Last if MY prostate enlarged in one year does that relate to aggresive nature of PCa.
are thier any new treatments for stage 4 PCa,if I am correct,stage 4 has survival
rate of 30 %
sorry but the last set of questions from one hour ago don't appeae to have answers
What is your protocol in treatment planing late stage ,metastaic cancer.So if I understood you ,since I have a DRE and it's positve ,most certain late stage ,can late stage be T3 or just T4
Is there any validity ,that a ketogenic diet helps slow cancer,by reducing available gloucose in blood
Last if MY prostate enlarged in one year does that relate to aggresive nature of PCa.
are thier any new treatments for stage 4 PCa,if I am correct,stage 4 has survival
rate of 30 %
sorry but the last set of questions from one hour ago don't appeae to have answers
Brief Answer:
Docetaxel 3 cycles at 21 days interval.
Detailed Answer:
Hi
Late stage cancer is more aggressive in nature.
Late stage is T4 and treatment options for late stage metastatic prostate cancer is chemotherapy docetaxel 3 cycles at 21 days interval with repeat PSA test and imaging tests to see the response of chemotherapy to the disease .The drug has a response rate of 55%.
There is no scientific evidence that ketogenic diet helps slow cancer by reducing available glucose in blood.
If your prostate enlarged in one year it may indicate aggressive nature of prostate cancer.
Newer treatment options are a drug called Cabazitaxel which has response rate of 50 %.
Stage 4 has survival rate of around 40%.
Regards
DR DE
Docetaxel 3 cycles at 21 days interval.
Detailed Answer:
Hi
Late stage cancer is more aggressive in nature.
Late stage is T4 and treatment options for late stage metastatic prostate cancer is chemotherapy docetaxel 3 cycles at 21 days interval with repeat PSA test and imaging tests to see the response of chemotherapy to the disease .The drug has a response rate of 55%.
There is no scientific evidence that ketogenic diet helps slow cancer by reducing available glucose in blood.
If your prostate enlarged in one year it may indicate aggressive nature of prostate cancer.
Newer treatment options are a drug called Cabazitaxel which has response rate of 50 %.
Stage 4 has survival rate of around 40%.
Regards
DR DE
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
