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Ultrasound Of Prostate Said Increase In Size And Echotexture. Possibility Of BPH. Why Do I Have Frequent Urination?

Posted on Mon, 9 Jul 2012

Question: I am 64 years old and a type 2 diabetic. I have gone for an ultrasound abdomen on 11-Oct-11 and the prostrate measures were 3.3*4.2*3.9 cms. Volume 28.4 cc. Post void residue at that time was 6cc. In October last year, prostatomegaly was grade 1.

Again I underwent ultrasound whole abdomen on 06-Mar-12 and the prostrate measures are 3.5*4*3.6 = 26.8ml. Comments were increase in size and echotexture. Post void residue is 20ml. Also it is mentioned that no evidence of any free fluid in peritoneal cavity, Para-aortic/Para-iliac regions are normal. No lymphademopathy. Kidneys, Spleen, Liver, Gal Bladder, Urinary Bladder are normal in size.

Ultrasound findings suggests the possibility of B.P.H with post void residue of 20ml. Since October I have been using Dynapress 0.4 mg after doctor prescribed. My present problem is frequent urination. There seems to be considerable increase in PVR as well. Please advise.

Answered by Dr. Vineet Malhotra (4 hours later)

Hello,

Thanks for your query

It seems that your main symptom is frequent urination.
I would need to know if you have any other urinary symptoms.

Your ultrasound report for prostate size and residual urine are within the normal ranges though post-void residual urine is always compared to your pre-void capacity of bladder. A post-void residue more than 10% of the bladder capacity (pre-void volume) is usually considered to be significant. In absolute terms, this is usually greater than 50ml.

Diabetics can develop weakness of the bladder muscle which may not allow complete emptying of the bladder and hence it is imperative that you keep your sugar under good control.

You are advised to undergo a uroflowmetry test and let me know the report.

I hope I have answered your query. I will be happy to answer any follow-up queries that you may have

Regards
Dr Vineet Malhotra

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Vineet Malhotra (4 days later)

In April 2010, PSA was 1.45 ng/ml and PVR was 80 ml. Doctor prescribed Dynapress 0.4 mg and after I started using that, I again got PSA verified in November, 2011 and the PSA was 3.8 ng/ml and PVR is 20 ml.

After using Dynapress, PVR got reduced but PSA went up from 1.45 to 3.8 ng/ml.

Please suggest. My problem is frequent urination. What is the normal range of PSA.

Answered by Dr. Vineet Malhotra (25 minutes later)

Hello,
Thanks again

The normal range of PSA is 0-4ng/ml. There are various reasons for rise of PSA including infections, instrumentation and malignancy. It is likely that rise of PSA was related to an infective episode and i would advise you to get a repeat total and free PSA testing done.

I would like to know your urine routine report and your uroflowmetry report.

Dynapres seems to have worked well to reduce the residual urine volume. It has no effect on PSA.

You can consult your local urologist who can suggest a medication for the frequent urination.

I hope i have answered your query.
I will be happy to answer any follow-up queries that you may have.

Wishing you good health
Dr Vineet Malhotra

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vineet Malhotra (44 days later)

I have undergone Uroflowmetry test and I have attached the report. Please let me know how to proceed.

I have used Alfoo 10 mg for one month and went for test. Also used Zydalis md 20 mg for 6 days.

Answered by Dr. Vineet Malhotra (2 hours later)

Hello,

Thanks for your follow-up query.

Your Uroflowmetry report is unreliable as you have voided less than 150 mlurine, which is usually the minimum criteria for validating such a test. However, it appears that your symptoms maybe related to a bladder outlet obstruction.

Please repeat a uroflowmetry test with a full bladder which will help us arrive at an accurate diagnosis. You may also require a retrograde urethrogram( an X XXXXXXX test) which helps in delineating such an obstruction.

You may continue to use zydalis if erectile dysfunction persists.It should not be taken everyday as it has a period of action of 2 days.

I hope i have answered your query
Regards
Dr Vineet Malhotra

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar