No diagnosis yet. Worried that it is cancer instead of BPH or Prostatitis.

Edited , 11 users are following.

Hi;

59 years old, otherwise healthy. I have had increasing nocturia, reduced flow, for the last couple of years, but nothing very life-impacting. I had a DRE last year and my doctor said my prostate was "supple", or something like that and nothing further needed to be evaluated. No mention of its size but I am sure if it was large he would have commented.

9 days ago (Saturday) I developed what looks to have been a severe UTI; pain on urinating, frequency, restricted flow, cloudy urine, fever, malaise, etc.. I received a prescription for Cipro Monday and because of a screw up in emailing the requisition for labs, I did not provide a sample until Wed morning - after 2 days of Cipro treatment. Results came back showing no bacteria or blood - I was already feeling much better - but some abnormal white blood cell counts. Urinary flow and frequency is all back to my pre-episode level, so it looks like it was a UTI, now better. It would not have been a sexually transmitted case of prostatitis.

I also developed constipation right alongside the UTI symptoms and the frequency urge seemed as bad as the one to void which I had not experienced with the relatively few other incidents of constipation in my life. The constipation is still with me, although the urge is less, seemingly because the need to void is less.

What it really feels like is that I have a regular, even "soft" stool that I just can't get out. This is not a hard stool. I have used laxatives and it is still taking effort to get out soft broken stools.

However, my PSA was 30. I have a phone consultation with a urologist tomorrow - Coronavirus is getting in the way of diagnosing and that worries me.

My concern is that my prostate is pressing on my rectum affecting my bowels and the fact that that has not resolved, post-UTI, as my urinary flow has. That makes me think my prostate is still very enlarged and that is worrisome.

So, the ongoing constipation, whether that means I have a suddenly enlarged prostate, and what that means in light of a PSA of 30 are my concerns.

I would appreciate any shared experience or insight - the anxiety level keeps creeping higher, especially around concerns for getting diagnosed and treated, surgically, if needed.

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11 Replies

  • Posted

    You have a double problem. Besides seeing a urologist you should also consult a gastroenterologist.

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  • Posted

    I'd not worry so much your bph is a little elevated at 30 but it can happen if your prostate is enlarged.

    if its a uti that could explain the

    uti symptoms urge, burning and nocturna.

    if its your prostate id switch your diet around a little,I have a enlarged prostate at 37 do to talking testosterone for 6 years.

    best thing to do is switch up your diet No red meat.

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  • Posted

    close to 60, all you describe are possibilities. For your peace of mind you need to rule out the potential problems. I would ask to take a 3 T MRI. That should give you answers about the size of the prostate, if a median lobe is obstructing eventually and if there is any indication of cancer. With that you can take new decisions. Best of luck!

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  • Edited

    I went through a similar thing. I had already been diagnosed with BPH and told my prostate was very large but they never measured it. When my PSA slowly rose to a 4.8, I had a biopsy, that was negative (85% probability, not cancer). Then, my PSA shot up to 9.5 very quickly. Following that, I had side pain, radiating to the front AND super constipation. Sounds like yours, a bit, Went to Urgent Care and they did both blood and urine labs "stat" and told me the issue was an infection". So, they sent me to the E.R. where I had a ct scan and they said I was actually passing a stone. So, got meds for pain and infection. Few days later, could not pee from November 1, 2019 through end of January 2020, effectively. Was on Foley catheters the entire time. With different pain issues, I was in and out of the E.R. almost every day for weeks. Had a lot of CIPRO (yes, I know it is a nasty drug but I never had an issue with it) because, every time they checked, I had an infection and I finally found the bacteria was really bad: enterobacter cloacae. The next PSA test that was done, my PSA level had dropped to 3.5 and the urologist was certain the sudden rise to 9.5 was due to the infection. Issue was resolved by TURP surgery towards the end of January. Had final urine culture after the last catheter was out and I was clean. For the constipation that stayed around for a while, I was using OTC stuff: fiber capsules and laxatives (they prescribed colace, and a couple others). Also, some metamucil. Also found out I have a 10.5 cm cyst in my right kidney. They ran x-rays to make sure that the kidney stone actually did pass and the cystoscopy was what determines that my prostate needed the TURP. The material removed during the TURP was sent to the lab and there was no cancer found.

    My advise is to keep up with a urologist. These times are rough for "elective" anything and the CoronaVirus seems to shut everything else down but that may be changing. Every time you can, get a urine culture along with your other urine tests. White blood cell count can imply you have or just had an infection. Culture will determine the name of the bacteria. Most of my infections were catheter-related, according to the urologist. They were required to remove me from a catheter once per month (replace it). Why the constipation (and it lasted a long time)? Nobody seemed interested in finding that out so I can only guess it was somehow related to the UTI or my kidney(s) reacting to the kidney stone affecting water retention? Even today, I still have some of those Metamucil cookies but no constipation. By the way, I always had urgent urination and that did NOT stop with the Foley catheters. My system "tried" to urinate anyway, even with the catheters in me, causing some urine to spray all over the place and I still have those urges post-TURP. So, probably related to bladder spasms. By the way, some of the drugs for bladder issues can cause constipation and that is why they didn't give me those. You may want to check any of the side-effects of drugs you were taking to see if constipation was an issue.

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  • Posted

    get a 3TMRI of prostate, will address a lot of your questions

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  • Posted

    Not a doctor...not even close. And this is strictly from personal experience. In no particular order:

    1. Constipation. I have suffered prostatitis and do suffer periodically. Perhaps once each year. Bactrim -- sulfameth -- has worked for me. And relief is just about immediate with the first two dosages. HOWEVAH -- the drug always comes with a doc warning that a probiotic should be taken with med as the drug kills the bad bacteria along with the good bacteria -- possibly disturbing regularity.

    So-- you might try a probiotic if you are still on the med -- or even if you are not -- 'til regularity returns. Available at Walgreen's. Assuming a probiotic works, you've perhaps resolved your fear about your prostate pressing on your bowel.

    1. Your 30 score for the PSA is perhaps a better focus at this time. Your doc will know best, but fair questions might be: Is the prostatitis perhaps contributing to a high score? If so, what about another PSA reading when the prostatitis is gone. Also, rarely mentioned is that orgasmic activity can raise a PSA score. Abstaining for a few days prior to the test is typically a good idea. That said, 30 is a rather high score. Your doc will perhaps test again down the road before biopsy or other invasive procedure. Personally, I would insist on it.

    I hope this helps. BPH sufferer for 30 years. Age 74 but with a PSA score supposedly of a 40 yr old. One day at a time.

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  • Posted

    Thanks for all the replies and information.

    is the T3 MRI a pretty standard imaging approach for someone at my stage of complaint? it looks like it (coupled with a DRE) probably provides the most complete picture of what is going on outside a biopsy.

    I don't imagine doctors are to keen on new referrals telling them what level of investigation they would like undertaken.

    I am in Canada, as well, so it's not a case of "my plan covers it so i want it, Doc"

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  • Edited

    MRI of the prostate seems very popular on these pages. But quite expensive without insurance...and perhaps too much too soon? As such, a qualified doc/uro might take a more moderate step approach at least initially. One such approach might be:

    See if the UTI resolves. If it does, and your nighttime frequency abates, then retest the PSA and -- if still high -- get a second opinion. (BTW, was "30" a typo for 3.0? If so, that is a very high number -- at least on the test scales here in the U.S.)

    You have variables going on here (constipation that concerns, personal and perhaps unjustified suspicions of a prostate so enlarged it is causing your constipation). You want very high end testing to rule out calamity.

    A good doc might say "Whoa. We don't kill a mosquito with a howitzer." 1st, the constipation and UTI, then a re-test of the PSA .

    You are perhaps fortunate that this is your first experience with nocturia. Again, I have struggled with it since my 40s and have learned to tolerate while adjusting my fluid intake from the evening meal onward. Yes, those many years ago I was worried about prostate cancer but had a doc who kept me pulling me back to the ground for a more graduated medical protocol. Age 74, still peeing more than I'd like but -- supposedly cancer free from the start. Peace of mind to you and good luck.

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    • Posted

      My PSA "crept" up to 4.8. Then, quickly JUMPED to 9.5. After being diagnosed with a UTI and going on catheters and antibiotics, it dropped down to 3.5. The interesting thing was, after my TURP, I met with my urologist to discuss things and he says that he has seen PSA numbers in the 100's! I can't imagine that. He said that he was pretty confident that my number 9.5 was not a result of cancer. Cancer is too slow to jump the PSA very high in a short time (usually) and I had a negative biopsy just at when it was 4.8. The TURP analysis was negative as well.

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