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Suggest Treatment For Heterogeneous Echotexture Prostate And Urinary Problems

Posted on Sat, 3 Jan 2015

Question: 53 year old male with heterogenous echtexture prostate with normal psa and ratio having mild uriary symptoms

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Could be du tomld Enlarged Prostate.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you could have Benign Enlargement of Prostate(Mild)

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) What are your urinary symptoms?
2)What is the size of the Prostate reported on ultrasound scanning ?
3) What is the post void residue of urine reported on Scanning?

Since your PAS levels are normal there is no possibility of cancer of the prostate.

Mild urinary symptoms can be controlled with drugs like Tomsulosin taking once daily.

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (11 minutes later)

Total psa 2.231 now and was on 20march2.214
Free psa 0.496
Ratio is 22
Mild dysuria and nocturia urgency reccurrent uti dull lower abd pain mild
4.2 ----5.6-----4.7
Post boid is 124 m
Wt 59 gml

Answered by Dr. Dr. P. T. Patil (38 minutes later)

Brief Answer:
You have Grade 2 Enlarged Prostate.

Detailed Answer:
Hello
Thanks for feedback.
You have grade 2 BEP with significant Post Void Residue ,

Taking Darifenacin in the morning and Tomsulosin in the evening (once daily)will help to control urgency and nocturia However this is temporary arrangement till you decide to get operated to remove (resect) enlarged prostate by an endoscopic procedure called Trans Urethra Resection of Prostate (TURP).

This is gold standard procedure to resect enlarged prostate practiced world wide and offers permanent cure from obstructive voiding symptoms.

Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (15 minutes later)

Does this procedure has a risk of urinary incontenince or sexual dysfunctin

Answered by Dr. Dr. P. T. Patil (12 minutes later)

Brief Answer:
No risk of Dysfunction

Detailed Answer:
Hello Thanks for follow up .

There is no risk of Erectile Dysfunction ,However this procedure causes what is termed as Retrograde Ejaculation.

In normal process of ejaculation bladder neck is closed making room for semen to enter forward in urethra and outside the tip of penis but during this surgery since bladder neck is resected along with Prostate bladder neck remains wide open hence semen enters into bladder and one does not ejaculate outside though he gets orgasm.This is what is called as Retrograde Ejaculation .

In experienced hands there is no risk of urinary incontinence .
Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (9 minutes later)

Is there arisk that i have a prostate cancer

Answered by Dr. Dr. P. T. Patil (9 minutes later)

Brief Answer:
You do not have cancer of Prostate.

Detailed Answer:
Thanks for writing again .
Please do not worry ,Since your serum PSA levels are within normal range ,you do not have cancer of the prostate,
Thanks and Regards.
Dr.Patil.

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