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Frequent urination. Have diabetes, prostrate enlargement. Ultrasound showing fatty changes in liver. On Dynapress.

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I am 64 years old and a type 2 diabetic. I have problem of prostate enlargement and it measures 45*58*33 volume = 46cm3 increase in size Parenchymal echo texture is uniform and normal. No focal lesions. No free fluid in abdomen and pelvis. No para-aortic/paracaval lymphademopathy. Ultra sound abdomen suggests fatty changes in liver and grade 2 prostatomegaly. The PSA was 3.82 ng/ml when the test was made on 11-Oct-11. For the last one year I have been using Dynapress 0.4 mg after doctor prescribed. Kindly suggest what to do. My present problem is frequent urination.
Posted Tue, 22 May 2012 in Men's Health
 
 
Answered by Dr. Rajiv goel 1 hour later
Dear,

Thanks for the query.

From your description it is obvious that you have prostatic enlargement which is symptomatic and you are on right treatment with Dynapress (Tamsulosin).

The frequent urination you are experiencing can be there if your diabetes is not well controlled. You need to report back with your postvoid residual urine. I will be in position to suggest to you better once I know the postvoid residual urine.

Hope I answered your query. Please write back with the report of post void residual volume.

Awaiting your response.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Frequent urination. Have diabetes, prostrate enlargement. Ultrasound showing fatty changes in liver. On Dynapress. 1 hour later
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.

But again I underwent ultrasound abdomen on 04-Mar-12 and the prostrate measures are 4.5*5.8*3.3 cms. Volume 46cm3 but there is no mention anywhere about post void residue in the report. Under impressions it is mentioned that prostatomegaly is grade 2.

There seems to be considerable increase in the prostrate measures. Please advise.
 
 
Answered by Dr. Rajiv goel 8 hours later
Dear,

Thanks for your query.

I am not really worried about the prostate size. Abdominal ultrasound is not the right modality to measure the size of the prostate. The right size is measured by transrectal ultrasound or digital rectal examination.

We treat the symptoms of the patient rather than the size of the prostate. Prostate size has no relation to the severity of prostate. One may have prostate smaller than normal sized and still markedly troubled by it where as somebody may have 400 gm prostate within and still does not know that it exists. You need to ask your radiologist about your posvoid residual urine (PVR) on the second ultrasound. Once PVR is available we can be of further help.

Hope I answered all your questions. If you do not have any more queries, please close this discussion.
Above answer was peer-reviewed by
 
Follow-up: Frequent urination. Have diabetes, prostrate enlargement. Ultrasound showing fatty changes in liver. On Dynapress. 2 hours later
Today I went for another round of ultrasound abdomen and in n the report it is mentioned as ultrasound findings suggest the possibility of BPH with PVR of 20ML and the size of the prostrate is 3.5*4*3.6 cms. Volume 26.8ml

Also mentioned that no evidence of any free fluid in territorial cavity, Para-aortic/Para-iliac regions are normal, No lymphademopathy.

Kidneys, Spleen, Liver, Gal Bladder, Urinary Bladder are normal.
 
 
Answered by Dr. Rajiv goel 2 hours later
Dear,

I had mentioned earlier that prostate volume is not accurately measured by abdominal ultrasound, hence the variation in size on ultrasounds.

You can start yourself on solifenacin along with Dynapress under the guidance of urologist for your frequency. These are prescription drugs. Please discuss with your urologist regarding the same. It shall improve significantly with this medication and report back to us after 4 weeks with repeat residual urine assessment.

Hope I answered all your questions. If you do not have any more queries, please close this discussion.

Regards,
Above answer was peer-reviewed by
 
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