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Suggest Treatment For Enlarged Prostate

Posted on Wed, 8 Jun 2016

Question: My father is diagnosed with enlarged prostate (measure 564 x 51 x 53 mm with a volume of 77.3 cc and PSA - 53.6) and hernia.

Hernia surgery is required as discussed with doctors but for Prostate, different views are coming. Please suggest if prostate removal is required or not.

Answered by Dr. Dr. P. T. Patil (3 hours later)

Brief Answer:
Plan of action should be as follow

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that your 65 years old father has been detected to have Enlarged Prostate with Inguinal Hernia and his PSA is detected to be very high 53.

Though high level of prostate more than 4.5 is suspected to be due Cancer Of the prostate unless proved otherwise by Ultrasound Guided Multicore biopsy of Prostate .However it also gets increased in when prostate is enlarged and there is associated infection .

Hence the plan of action I would suggest is as follow .
1) Start him antibiotics like Cefriaxone with Nitrofurantoin twice daily.
2) Tamsulosin and Dutasteride once daily .

All these drugs have to taken for one month followed by repeat PSA test .

If PSA level gets reduced continue the medications for one more month .

With this treatment if it gets lowered you can consult qualified Urologist for evaluation and get endoscopic surgery for removal of Prostate (TURP) done along with repair of hernia at the same sitting .

Please note that Hernia in such cases is always secondary to Enlarged Prostate hence it is removal of prostate that is more important than hernia surgery .Please do not be in hurry to go for hernia surgery.

However if his PSA levels are still persistently high you may have to go for biopsy of the prostate to rule out Cancer of the prostate .

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. Deepak

Follow up: Dr. Dr. P. T. Patil (43 minutes later)

Thank you so much Dr XXXXXXX

This helps a lot in decision making, I will consult my father's surgeon now for removal of prostate.

Thanks & regards,
XXXX

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

Brief Answer:
Treat him with antibiotics and treatment suggested first.

Detailed Answer:
Hello
Thanks for follow up
.Read my earlier reply carefully You need to treat him with treatment suggested earlier for a month and go for removal of prostate and hernia surgery after PSA drops down to near normal levels.
Thanks nd Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Deepak

Follow up: Dr. Dr. P. T. Patil (40 minutes later)

Hi Dr XXXXXXX

Yes, I got it.
Removal will happen after PSA drops down to normal range.

Sorry my last message created confusion.

Thanks & Regards,
XXXX

Answered by Dr. Dr. P. T. Patil (6 minutes later)

Brief Answer:
O.K bye

Detailed Answer:
Hello
Thanks for follow up .
Go ahead as suggested .
Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Deepak