22 yr old male with enlarged prostate

Thank you peter.

Hi Helen, A few of us replied to you for your son already. In reflection on a 22 year old having severe problems, one bit of advice we all gave was to figure out how large his prostate is. That is probably the starting data point. For example, if it is greater than say 75 grams he is probably headed toward a laser procedure, ie HoLEP. But if it is possibly 30-40 grams or less he may have a completely different problem and/or set of options. I mention this because a close friend has ben having pretty bad prostate problems. He went to the Mayo in Rochester. They did the following tests:

UDS

Flow Study

Ultrasound to determine urine retention in bladder after voiding

Ultrasound to estimate size of bladder

Cystoscopy

I think nearly all of these tests are common urology steps, except perhaps the UDS test. I do not know how many people struggling have this one done (maybe all, maybe a few, I haven't asked the forum yet). In my friends case they concluded he has bladder issues and are taking a different course of action. If you want to know more about UDS, just type "Urology UDS" into search and a few summaries will come up.

Also, I may have said this, but your son could easily have prostatitis. For some reason, Urologists do not seem to isolate this from an enlarged prostate. Prostatitis is a temporarily inflamed prostate. Figuring out what inflemd it and how to avoid it is the trick. I do not recall, but other forum members can advise how often or whether prostatitis can be caused by an infection in the bladder. If yes, a Urologist can examine your son and use a microscope to conclude while in his or her office whether your son has an infection. FYI, Bill

hi ian, thanks for your feedback.

Nobody has mentioned PSA readings. His urine flow was poor, his bladder was still 40% full.

He started with symptoms of urine infection in May this year, was given antibiotics but they didnt work . He went back to the doctors again and thats when he checked his prostate, found it enlarged and perscribed some different meds and a blood test as they wanted to rule out a STI,which came back clear. The meds made him feel awful so he ended up going to A&E where they checked him and his prostate , they said they didnt know what was wrong with him and stop taking the tablets.They told my son they would refer him to a consultant , who he saw for the first time two wks ago. After being checked my son was told he had the prostate of a 80yr old man , large and hard.Since then everythings been rushed through,flow test,ultra sound,camera into his penis,MRI scan and now he's waiting to have a blood test because he could'nt have one for two weeks after the camera! and then the biopsy on tues.

Normally they would do a PSA test and biopsy before doing an MRI scan. Evidently the MRI has not given them an answer otherwise they would have said. They have also seen the prostate during the cystocopy and have a picture of it from the TRUSS.

Surmising does not help and doing a biopsy is like firing 12 or 16 needles into an orange hoping to hit a pip.

Some notes on how a prostate feels:

"The prostate gland is normally rubbery, pliable, and smooth. Because it is next to the rectum, the physician is able to feel its size and consistency with a gloved finger during a rectal exam. If it feels enlarged or hard or there is a hard lump, then this is an indication that the prostate has undergone a change, not necessarily cancer. If it is swollen, sore and soft it may be infected"

 

Hi Helen.

Thanks for answering. With that info, there's not anything more I can add - others have done better than I could. Clearly there's something that needs serious attention, and very careful consideration before any further irriversible operations are done. Anything that puts at risk your son's chances of being a father in the future has to checked and checked again, along with possible sperm preservation if there's any chance of it being compromised.

I'd want at least one other consultation by someone at a specialist centre. If your consultant cannot recommend someone, then I'd check out NHS Choices website; pester his GP to find the best expert; etc.

Sorry I cannot be of more help.

Hi Ian , thank you for your advice . I see what they say on tues after the biopsy . Do you think they will know something that day? Or will we have to wait 2 weeks? 

Biopsy specimens have to be sent to the pathology lab, for specialist guys to prepare (slicing into think sections and put on a slide) and then stare down a microscope to see if they can see abnormal cells. There's thus a time lag to ge to them; to prepare the speciman; and then wait their turn to be checked. I don't know how long it may take in any particular place, but a few days would seem minimum; mine took a couple of weeks (but I wasn't in a hurry). You could ask the doc and/or ask them to speed it up.

Hi Ian and everyone else whose been kind enough to and help me out with their info. Unfortunately we had a meeting with the consultant and my son was diagnosed with a sacoma tumor in his prostate. We were told he will be having chemotherapy soon .

I am so sorry to hear that and hope for an early sucessful outcome.

The prostate cancer UK website has information on all types of prostate cancer and treatments.

The three Royal Marsden Hospitals in London are the best in the country if you can get a referral.

I very much understand what you are going through as our daughter died of cancer when she was 22.

 

Bummer. 

I've been there - stage 4 bladder cancer, no hope, etc. 7 years ago.

Contrary to what some may say, there is much that the patient can do to improve their response to chemo, their body's ability to cope with it, and to recover.

Walking does help; a lot. Maybe walk with him. More is better. It pumps the lymph system - the fluid within the body that fights infections, builds up the immune system. Even a 'bouncer' - mini-trampoline - each day (I do 100 bounces).

I'm assuming your son doesn't smoke; or, if he does, he'll stop.

Eat a Meditteranean diet; preferaby organic. Check out Cancer Active website for good info.

Incidently, I chose whether to accept the medicos advice - that's what it is: advice. Your son does the decision (that's why they get him to sign the forms), not them. I had 5 consultants advise me before I chose - the first 4's advice I didn't like or accept (like: no hope; nothing to do; chemo only palliative; make final preparations; etc).

Best wishes to your son.