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Suggest Treatment For Prostatomegaly
Question: Good evening doctor,
My father aged 62 years with diabetic and BP. Last month with blood in urine he consulted a urologist who after scanning told that he had grade1 prostatomegaly. But the next day he consulted another urologist where psa test was done and result was 8.66. He also performed DRE and wrote it as gr2- gr3. What does the DRE test means in this case. Is it BPH?
Thanking you
My father aged 62 years with diabetic and BP. Last month with blood in urine he consulted a urologist who after scanning told that he had grade1 prostatomegaly. But the next day he consulted another urologist where psa test was done and result was 8.66. He also performed DRE and wrote it as gr2- gr3. What does the DRE test means in this case. Is it BPH?
Thanking you
Brief Answer:
DRE means Digital Rectal Examination
Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that your father has Hematuria and was diagnosed to have Enlarged Prostate However there is difference of opinion amongst two Urologist about the size of prostate regarding size of the prostate .
I shall be happy if you can post me few more details to help me in making comments on your problem.
1) What are the dimensions and volume of Prostate reported on Ultrasound Scanning ?
2) What is the Post Void Residual Urine .?
3) Did first Urologist do DRE ?
4) Do any of the both Urologists mentioned about any palpable hard nodule on the surface of prostate in their DRE findings.?
5) Will you upload report of Ultrasound Scanning ?.
DRE is a Digital Rectal Examination where Urologist puts his fingers in the rectum to examines the size ,configuration,and to find whether there is any palpable hard nodule on the surface of prostate which signifies cancer of prostate .It is not a precise test and gives rough idea about the size of the prostate
As regards raised level of PSA 8.66 which is higher than normal value of 4 has to be taken seriously as any level more than 4 is considered to be due to cancer of the prostate .Normally PSA test is to be done before doing DRE as doing DRE gives false reports of raised PSA which is raised due to stimulation of prostate while doing DRE .Hence in your father's case raised level of PSA (8.66) can not be considered to be real reading as blood sample were collected on second day after DRE was being done by first Urologist .Hence I would suggest you to repeat PSA test after a week .
As regards hematuria it is likely to be due to torn superficial vein on the surface of congested enlarged 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.
DRE means Digital Rectal Examination
Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that your father has Hematuria and was diagnosed to have Enlarged Prostate However there is difference of opinion amongst two Urologist about the size of prostate regarding size of the prostate .
I shall be happy if you can post me few more details to help me in making comments on your problem.
1) What are the dimensions and volume of Prostate reported on Ultrasound Scanning ?
2) What is the Post Void Residual Urine .?
3) Did first Urologist do DRE ?
4) Do any of the both Urologists mentioned about any palpable hard nodule on the surface of prostate in their DRE findings.?
5) Will you upload report of Ultrasound Scanning ?.
DRE is a Digital Rectal Examination where Urologist puts his fingers in the rectum to examines the size ,configuration,and to find whether there is any palpable hard nodule on the surface of prostate which signifies cancer of prostate .It is not a precise test and gives rough idea about the size of the prostate
As regards raised level of PSA 8.66 which is higher than normal value of 4 has to be taken seriously as any level more than 4 is considered to be due to cancer of the prostate .Normally PSA test is to be done before doing DRE as doing DRE gives false reports of raised PSA which is raised due to stimulation of prostate while doing DRE .Hence in your father's case raised level of PSA (8.66) can not be considered to be real reading as blood sample were collected on second day after DRE was being done by first Urologist .Hence I would suggest you to repeat PSA test after a week .
As regards hematuria it is likely to be due to torn superficial vein on the surface of congested enlarged 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. Chakravarthy Mazumdar
Thank you for reply sir,
Sir the first Urologist didnt do DRE.
The second Urologist done DRE but he mentioned as
DRE :- gr2-gr3
. ( He said that the gland is much enlarged and the raised PSA may be due to that)
He didnot mentioned abt any palpable or hard nodules.
PSA blood was drawn before DRE.
The first scanning showed 39cc of prostate.
Does DRE the doctor wrote on prescription paper relates to the size of the prostate?
He advised TRUS- Bx.
Sir i would like to add one more point
The post voil urine retention is 1ml .
size is mentioned as 39cc. No dimensions given.
Thankyou sir
Sir the first Urologist didnt do DRE.
The second Urologist done DRE but he mentioned as
DRE :- gr2-gr3
. ( He said that the gland is much enlarged and the raised PSA may be due to that)
He didnot mentioned abt any palpable or hard nodules.
PSA blood was drawn before DRE.
The first scanning showed 39cc of prostate.
Does DRE the doctor wrote on prescription paper relates to the size of the prostate?
He advised TRUS- Bx.
Sir i would like to add one more point
The post voil urine retention is 1ml .
size is mentioned as 39cc. No dimensions given.
Thankyou sir
Brief Answer:
He has moderate enlargement of Prostate
Detailed Answer:
Hello
Thanks for follow up .
Rised PSA could be either of the following reasons
1) Infection of Prostate
2) Benign enlargement of prostate
3) Cancer of the prostate
Give him following medications for 10 days and repeat PSA after 10 days
1) Antibiotic Cefexime twice daily
2) Nitrofurantoin twice daily
3) Tomsulosin and Dutasteride once daily .(Urimax D)
It is general international followed guide line that PSA above 4 should always be suspected to be due to Cancer of prostate unless proved otherwise by biopsy of prostate.
If his PSA remains to be higher than 4 after taking antibiotics we will have to consider for doing Ultrasound guided multi core prostate biopsy .
Thanks and Regards.
Dr.Patil.
He has moderate enlargement of Prostate
Detailed Answer:
Hello
Thanks for follow up .
Rised PSA could be either of the following reasons
1) Infection of Prostate
2) Benign enlargement of prostate
3) Cancer of the prostate
Give him following medications for 10 days and repeat PSA after 10 days
1) Antibiotic Cefexime twice daily
2) Nitrofurantoin twice daily
3) Tomsulosin and Dutasteride once daily .(Urimax D)
It is general international followed guide line that PSA above 4 should always be suspected to be due to Cancer of prostate unless proved otherwise by biopsy of prostate.
If his PSA remains to be higher than 4 after taking antibiotics we will have to consider for doing Ultrasound guided multi core prostate biopsy .
Thanks and Regards.
Dr.Patil.
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. Chakravarthy Mazumdar
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