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Have urine problem. Had urine test and advised for trus guided biopsy of prostrate.What is this? Can it be done for old people?

My father is 68 yrs old and suffers from frequent urination problem. Urine Report says 20 - 25 RBC/hpf and presence of albumin. PSA level is 6.0. Serum Creatinine is 1.2
Ultra sound reports presence of 2.9 cm calculi in bladder, cystitis and mild hydro nephrosis in left kidney.
We consulted Urologist who has advised TRUS guided biposy of prostrate. Could you kindly explain this test and are there any risks involved in performing the test given his age. Thanks in advance
Asked On : Tue, 16 Apr 2013
Answers:  2 Views:  27
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General & Family Physician 's  Response
A transrectal ultrasound-guided prostate biopsy is a procedure in which small samples of tissue are taken from your prostate gland to look and check for cancer,when your blood tests reveal a raised level of PSA.
PSA is raised in prostate cancer and also in where there is inflammation in prostste.
Side effects of this procedure are..
Blood in urine or stool ,which can last for 10 to 15 days.
Pain rectum
Blood in semen.
Complications of biopsy include..
.....Difficulty in urine because of some blood clot.
.....urine infection because of piercing of rectal wall by biopsy needle. may have to get the procedure repeated because of poor sample obtained.
You must consult your doctor if any complication arises after the biopsy.
Answered: Tue, 16 Apr 2013
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General & Family Physician Dr. Shoaib Khan's  Response
Hello and welcome to HCM.

Thank you for your query.

Let me first explain the root cause as to why your Urologist has advised this test. A test conducted called serum PSA (prostate-specific antigen) is usually conducted in elderly males with an enlarged prostate and is usually elevated in patients with prostate disorders or prostate cancer. The normal range is considered to be 4.0 ng/mL and less. As your serum PSA has returned 6.0 ng/mL, we will have to suspect prostate cancer, and rule this out. For this, we will have to take a tissue sample of your prostate and test it in the laboratory for any cancer cells.

The enlarged prostate can cause stagnation of urine and thus infections, this could be the cause of the cystitis (which is inflammation of the urinary bladder), possibly due to an infection. The obstruction of normal flow of urine due to pressure applied on the ureter by the enlarged prostate can also lead to an infection in the kidneys and accumulation of urine, which explains the hydronephrosis.

In such a scenario, where there are multiple problems being caused by one part, treating and normalizing the problematic part will treat all other problems. In your case, that is the prostate. Which is why your doctor is concentrating entirely on the prostate, and as current investigations are not giving us a healthy picture, a biopsy at this stage would be the best.

TRUS is a transrectal (through the rectum) ultrasonography guided biopsy of the prostate. This is safe, and can easily be performed even in elderly males. Do not worry. His age should not be a concern. Please go ahead with this as it is the best option right now.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you.

Best wishes.
Answered: Tue, 16 Apr 2013
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