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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Cyst In Epididymis, Larger Than Testis. Blood In Urine. How Often Should Biopsises And CAT Be Done?

I am 82 and have have a cyst that was discovered in my epididymis during annual physical by my primary physician over ten years ago. I have had obvious blood in my urine about twice a month for much longer. The cyst has become larger than the testis; I assume that it is a complication of vasectomy at 45 years of age. I also had TURP performed about age 57 for hypertrophy of the prostate. I had surgery for bilateral inguinal hernia when I was 63 and cysts have been found on my kidneys. Biopsy of the prostate four years ago and cystoscopy of the bladder and CAT scan then and once since has been negative for tumors. Repeating these recent procedures seems to be overkill due to risk of injury in procedures and possibility of induction of malignant change during mitosis in healing of tissue. It appears that the vas deferens and prostate empty into the urethra at about the same place. Blood usually appears in the urine at the end of urination but may occur at beginning and throughout particularly if it was present in previous urination. It is more difficult to stop the flow of blood at the end of urination than it is to stop flow of urine. Does this observation give any indication of the source of bleeding? How often should biopsies and CAT scans be done so that risk of procedure is not greater than malignancy? My father lived to 94 and mother to 88. Robert Schaible, Indiana, YYYY@YYYY , 812-876-9884
Tue, 3 Sep 2013
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,
Cyst of the epididymus is abenign lesion.
removal of the cyst is the treatment for the cyst.
More worrisome than the cyst is the blood in the urine.
Blood in urine before onset of urination, along with urination and after urination has different sources and different pathogenesis.
Blood at the end of the urination suggests malignancy of the urinary bladder.
A microscopic examination of the urine sample is required to look for malignant cells is required.
Along with urine microscopic examination, cystoscopic examination of the bladder is also required.
Cystoscopy allows viewing of the inner walls of the urinary bladder and allows biopsy also.
The biopsy is examined microscopically to look for the evidence of infection.
You need to consult an urologist for these investigations.

Thnaks and take care
Dr Shailja P Wahal
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Cyst In Epididymis, Larger Than Testis. Blood In Urine. How Often Should Biopsises And CAT Be Done?

Hello and welcome to HCM, Cyst of the epididymus is abenign lesion. removal of the cyst is the treatment for the cyst. More worrisome than the cyst is the blood in the urine. Blood in urine before onset of urination, along with urination and after urination has different sources and different pathogenesis. Blood at the end of the urination suggests malignancy of the urinary bladder. A microscopic examination of the urine sample is required to look for malignant cells is required. Along with urine microscopic examination, cystoscopic examination of the bladder is also required. Cystoscopy allows viewing of the inner walls of the urinary bladder and allows biopsy also. The biopsy is examined microscopically to look for the evidence of infection. You need to consult an urologist for these investigations. Thnaks and take care Dr Shailja P Wahal