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What Does This Following Lab Report Indicate?

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Posted on Fri, 18 Nov 2016
Question: Got my report...two simple cysts but the biggest at one pole is 9.7 x 6.6 x 7.3 cm...pretty big...should it be drained or removed in your opinion?

Secondly, I use Flomax and Finsaride both for BPH...my PSA IS 2.5 but only on the finsaride 12 months as it replaced Avodart.

The other findings said Prostate Enlargement with mass effect upon elevation of the bladder. Did not rule out prostate neoplasia. Should this be evaluated further and can it become cancer?

Thanks again Dr

One added point, I understand the finastiride can lower PSA
doctor
Answered by Dr. V. Sasanka (53 minutes later)
Brief Answer:
Treat if symptoms are present

Detailed Answer:
Hi again,
Noted the findings.
Your cysts are definitely large, but having said that, even large simple cysts do not need treatment unless they are so big that they cause pressure effects or if they get infected or if there is bleeding into cysts. Isolated drainage gives only temporary relief, and if the cysts indeed need treatment, laparoscopic drainage and de-roofing of the cysts followed by filling of the empty cysts space using fat from abdomen will ensure the cysts do not form again.
Finasteride is fine to reduce the size of grossly enlarged prostate, and reduces the requirement for prostate surgery. It does reduce PSA and we factor this in, so your actual PSA could be somewhere around 3.5 to 5.5.
Now there is a problem with PSA screening, and it picks up these borderline PSA levels and patients often are worried with the thought that they could be harbouring cancer when the elevated levels could be due to just a benign enlargement. Conversely some patients with cancer can have PSA levels within normal limits. But quite a few of these cancers may not eventually be clinically relevant, and harm could come of treating these which should have been better left alone.
In your case, you might need to get a digital rectal examination to find out if your prostate feels irregular, and your Urologist could recommend biopsy if you are very worried about cancer in view of a strong family history.
Uroflowmetry is a simple test to know if your urine stream appears obstructed, in which case you might restart Flomax.
Hope I have been able to help you.
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. V. Sasanka (2 hours later)
What is the mass from bladder elevation mean?

Thanks doc
doctor
Answered by Dr. V. Sasanka (26 minutes later)
Brief Answer:
Intravesical enlargement of prostate

Detailed Answer:
The prostate when it gets enlarged has a tendency to elevate bladder base. A lobe of prostate called median lobe might give the same appearance, and in fact, role of Finasteride is to reduce the progression of the same.
As I said earlier, Uroflowmetry is a very simple test to tell you if this is causing significant outlet obstruction. If it is indeed appearing to cause obstruction, you might have to add Flomax.
Regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
Answered by
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Dr. V. Sasanka

Urologist

Practicing since :1995

Answered : 529 Questions

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What Does This Following Lab Report Indicate?

Brief Answer: Treat if symptoms are present Detailed Answer: Hi again, Noted the findings. Your cysts are definitely large, but having said that, even large simple cysts do not need treatment unless they are so big that they cause pressure effects or if they get infected or if there is bleeding into cysts. Isolated drainage gives only temporary relief, and if the cysts indeed need treatment, laparoscopic drainage and de-roofing of the cysts followed by filling of the empty cysts space using fat from abdomen will ensure the cysts do not form again. Finasteride is fine to reduce the size of grossly enlarged prostate, and reduces the requirement for prostate surgery. It does reduce PSA and we factor this in, so your actual PSA could be somewhere around 3.5 to 5.5. Now there is a problem with PSA screening, and it picks up these borderline PSA levels and patients often are worried with the thought that they could be harbouring cancer when the elevated levels could be due to just a benign enlargement. Conversely some patients with cancer can have PSA levels within normal limits. But quite a few of these cancers may not eventually be clinically relevant, and harm could come of treating these which should have been better left alone. In your case, you might need to get a digital rectal examination to find out if your prostate feels irregular, and your Urologist could recommend biopsy if you are very worried about cancer in view of a strong family history. Uroflowmetry is a simple test to know if your urine stream appears obstructed, in which case you might restart Flomax. Hope I have been able to help you.