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Enlarged Prostate, Heterogeneous Echotexture And Smooth Outline. Have Diabetes And Lumbar Spondylisis. What Do These Parameters Indicate?

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Posted on Mon, 13 Aug 2012
Question: My husband (61 yrs) and a diabetic has enlarged prostrate ( 3.8x3.9x3.8 cm) with weight of 30 grams &heterogenous echotexture & smooth outline. What do these parameters indicate? He is overweight (102 kg) with sedentary lifestyle. Exercise is restricted by Lumbar spondylisis.
doctor
Answered by Dr. Sourav Ganguly (1 hour later)
Hi,

Thanks for posting your query.

In your husband the prostate size is normal, weight is mildly increase (normal up to 20 gm) and has smooth outline that suggest mild grade of benign hyperplasia of the prostate gland (BPH). But as the echo texture is heterogeneous we need to rule out tumours (as 20%-40% patients with heterogeneous echo texture prove to be a case of malignancy). So it’s tough to comment weather it is a BPH or malignancy by seeing this ultrasonography (USG) report.

So first you have to do a screening test for prostatic cancer called "blood level for prostate specific antigen (PSA)". If PSA level is more than 10 ng/ml then you have to do a trans- rectal biopsy of prostate gland to confirm if it is malignancy or not.

The PSA is very nonspecific test. Its value can rise in so many conditions including BPH. So remember we cannot establish a diagnosis based on this value alone, however if the value is under 10, then it is most like BPH.

Just to remember if your USG scan suggests that there is mild prostatomegaly and biopsy don’t prove malignancy and if you see a noticeable change in your urine flow, then I will advise you to start taking a regular medicine to further decrease the rate of progression of the prostate gland. However operative procedure would be needed at the earliest if biopsy reports suggest otherwise.

Consult your urologist to undergo the aforementioned test for confirmation and treatment.

Hope I have answered your query. If you have any further questions I will be happy to help
If you do not have any clarifications, you can close the discussion and rate the answer and write a review.

Wish your husband a speedy recovery

Regards,
Dr Sourav Ganguly

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sourav Ganguly (8 hours later)
Serum PSA is low - 0.42ng/ml
doctor
Answered by Dr. Sourav Ganguly (56 minutes later)
Hi,
Thanks for your query.
If your PSA level is low then there are almost no possibilities of malignancy in prostate.
The symptoms of BPH are typically worse in people with diabetes. To manage this better, diabetes needs to be controlled better and medication should start for the BPH.
Please get the above mentioned tests done for confirmation and treatment.
Hope I have answered your query. If you have any further questions I will be happy to help
If you do not have any clarifications, you can close the discussion and rate the answer and please write a review.
Best Wishes,

Dr Sourav Ganguly
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Aparna Kohli
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Answered by
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Dr. Sourav Ganguly

General & Family Physician

Practicing since :2007

Answered : 452 Questions

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Enlarged Prostate, Heterogeneous Echotexture And Smooth Outline. Have Diabetes And Lumbar Spondylisis. What Do These Parameters Indicate?

Hi,

Thanks for posting your query.

In your husband the prostate size is normal, weight is mildly increase (normal up to 20 gm) and has smooth outline that suggest mild grade of benign hyperplasia of the prostate gland (BPH). But as the echo texture is heterogeneous we need to rule out tumours (as 20%-40% patients with heterogeneous echo texture prove to be a case of malignancy). So it’s tough to comment weather it is a BPH or malignancy by seeing this ultrasonography (USG) report.

So first you have to do a screening test for prostatic cancer called "blood level for prostate specific antigen (PSA)". If PSA level is more than 10 ng/ml then you have to do a trans- rectal biopsy of prostate gland to confirm if it is malignancy or not.

The PSA is very nonspecific test. Its value can rise in so many conditions including BPH. So remember we cannot establish a diagnosis based on this value alone, however if the value is under 10, then it is most like BPH.

Just to remember if your USG scan suggests that there is mild prostatomegaly and biopsy don’t prove malignancy and if you see a noticeable change in your urine flow, then I will advise you to start taking a regular medicine to further decrease the rate of progression of the prostate gland. However operative procedure would be needed at the earliest if biopsy reports suggest otherwise.

Consult your urologist to undergo the aforementioned test for confirmation and treatment.

Hope I have answered your query. If you have any further questions I will be happy to help
If you do not have any clarifications, you can close the discussion and rate the answer and write a review.

Wish your husband a speedy recovery

Regards,
Dr Sourav Ganguly