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Dr. Andrew Rynne

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Suggest treatment for acute urinary retention while suffering from benign prostatic hyperplasia

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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 9891 Questions

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Posted on Wed, 15 Mar 2017 in Urinary and Bladder Problems
Question: hello I am 62 yrs old and have had to have a foley catheter installed to remedy a blocked urethra. along with starting on flowmax 1/day.
this occurred 7 days ago. I am in generally good health, work as a machinist 40 hrs per week, do exercise. have been on testosterone replacement for 15 yrs and do have an enlarged prostate and slightly elevated psa levels. have been on a watch process for this time.
I do drink coffee 4 to 6 times a day, enjoy 1-2 alcoholic drinks per day as well as daily use of marijuana (about 1/4 oz per month).
I am married (43 yrs) to a partially disabled woman, though we are not having any sex due to her discomfort, and have 3 adult children one of which has a genetic disability.
how do these lifestyle choices affect my prostate and what might be the best changes to take?
doctor
Answered by Dr. P. T. Patil 4 hours later
Brief Answer:
Provide few more details

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you had Acute Retention of Urine due to enlarged prostate 7 back and have been catheterized with indwelling Foley catheter to drain out urine from bladder.

I shall be happy if you can post me few more details to help me in making comments on your problem.
1)Is your Ultrasound Scanning of the abdomen done to assess the size of prostate ?
2) Do you have other urinary symptoms like frequency ,nocturia ,poor urine stream over a period of last few months ?
3) What your PSA levels done very recently?
4) Was your Digital Rectal Examination carried out by concerned Dr? and if so what are the findings ?

Looking at retention of urine that you had developed it s likely you have significantly large enlarged prostate gland which needs to be assessed and treated by an endoscopic surgery called Trans Urethral Resection of Prostate (TURP) to clear the obstructed urethral passage. This will help to improve your quality of life afterwards .

The Urologist on doing Digital Rectal Examination and PSA test will take the decision regarding the need for surgery .

I would state that it is not your life style choices that will affect your prostate but it is the enlarged prostate that will affect your life style choices .

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
doctor
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Follow up: Dr. P. T. Patil 14 hours later
the doctor who prescribed the catheter did a rectal exam and noted the consistent enlargement with regular "nodules"? of the prostate.

it has been enlarged for the past 4-5 years.
I have had testicular hypofunction for the last 15 years.

I have been experiencing weaker flow, difficulty beginning urination sometime and generally awake after 3-5 hrs sleep to urinate.

most recent PSA from october 2016 is 7.95 ref 0-4
Testosterone bioavailable 77.3 ref 110-570
free testosterone 32.1 ref 46-224
testosterone total 309 ref 250-1100

so far no ultrasound or other to accurately assess the prostate size or shape
am scheduled to see a urologist today and would like to report back what I find

are there any changes regarding my consumption of things that may affect the prostates swelling or shrinkage?

post TURP ( if that is what occurs) will I have ability to normally urinate or have sex?
Thank you for the help
doctor
Answered by Dr. P. T. Patil 35 minutes later
Brief Answer:
Do write after your visit to Urologist

Detailed Answer:
Hello
Thanks for follow up ..
You have obstructive voiding symptoms since long time .In my opinon you will need to undergo endoscopic surgery of TIRP .

PSA levels are high and has to be repeated after two weeks of taking antibiotic to decide need for doing Prostate Biopsy to rule out cancer of prostate

There is no specific diet or activities that will reduce size of the prostate .

This will help you to have normal urine flow and will not affect your sexual potency .except there will be a retrograde ejaculation which is known complication of any surgery done to remove enlarged prostate .

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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