Normal Size Prostate with good PSA. Still possible to constrict the urethra ?

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I am a fit 70 year old with recurrent UTIs.

My prostate size is average and my PSA is good.

DRE was unremarkable

Ultrasound showed no abnormalities in the bladder, kidneys and urinary tract in general.

However, 2x u/s tests showed post void retention of 60ml and then 145 ml.

Urologist thinks it could be a urethral stricture of scar and is going to 'stretch' any narrowing with 'sounds'

Question: Could a normal size prostate with a good PSA reading still cause constriction of the urethra ?

Any advice or similar experiences would be very much appreciated.

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  • Edited

    Hey Tim

    What your doctor is telling you is true. A stricture would do it. I have a stricture and will be having it checked at the end of the month. Sometimes it will make the steam slow and thin.

    See what the doctor wants to do. Ken

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    • Posted

      Hello Time

      He found it in 2014. I had a lot of infections that year and also I had Sepsis was in the hospital for 6 days on IV'S and was sent home with a port in my arm Had to have 12 more days of antibiotics. When I first went in they tried to put a catheter in and they could not do it so I had to see a Urologist.

      After seeing him for a few weeks he did a scope on me and when he was inside he found it. It is right before the prostate. It has been okay for the 7 years.

      I have had many catheters and I was suppose to only have a 12 or a 14 fr coude catheter because of it. I made a doctor mad at me. Was not my doctor. This was about 4 years ago. I was bleeding after a surgery and I would not let him do emergency surgery on me unless he signed a paper that my prostate would not be cut or removed for any reason.

      It took me 30 minutes for him to sign it I had 3 blood clogs on my prostate. He had to burn them. I had to have a 3 way flush. He put in a 28 fr straight catheter in to get rid of the blood. That was a good thing. It broke it up and it has been good

      The reason this happen was that I was to to start my blood thinner when I got home and it was to soon.

      I will be seeing my doctor on the 24 th. We will see what is going on. I had Sepsis again and sometimes the flow is thin and slow. I will not have it cut out. There are many treatments for stricture.

      One is a Urethroplasty. Most of the times they go through the perineum. At 66 I do not want anyone to cut into that area. They cut into the muscles to get to the stricture and it takes a long time to heal. There is also dilation of the stricture and they can go in and cut it to open it up. There is also a balloon dilation to.

      I have been reading about a new treatment. It is called Optilume It is a drug coated balloon that is put in and then open up and this drug will coat the stricture and get rid of it. It is just what you want to do

      Good luck....Ken

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    • Posted

      Good Grief ! What a nightmare of a time. It seems that one condition can escalate and cause the most terrifying developments.

      The urologist said that he is going to use the metal 'sounds' to stretch things.

      The trouble is with specialists is that they are so damned difficult to read even when they are pleasant.

      Your experience was horrendous.

      Tim

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    • Edited

      Yes that can happen because it is all connected. Yes most of the time when they use the rods is that they start with smaller ones and go up. It does work

      Good Luck with the procedure....Ken

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  • Edited

    The Urologist might be able to see what is happening with a cystoscopy. Post viod residual of 60ml is not much, even 145 is not that bad. Are you having bothersome urinary symptoms ?

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    • Posted

      Hi TKM Thanks for the response.

      My urologist is going to do a cystoscopy and try some stretching if he finds strictures next week.

      I don't think my stream is that bad but it's hard to make a comparison with the past.

      Never experienced the gross haematuria thing. I don't 'stop start' but my flow starts ok and then trails to extended dribbling. I am now so hyper obsessed with all of this that I think I am adding a layer of anxiety which, of course...affects the bladder.

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  • Posted

    Hi, Many thanks for your response.

    I didn't think that my PVR was that bad either, however I am getting UTIs

    I have never had an episode of visible blood in my urine. I have seen some blood on a couple of occasions but that was at the real peak of a really bad infection.

    My stream isn't bad although the slowing down of the stream compared to former times is hard to be objective about.

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