Partner has high PSA and burning, booked for biopsy.

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My partner (50) has never had any major health issues. Four months ago he began needing to pee frequently and went to gp with a sample expecting antibiotics for UTI. His sample was clear of infection but he was put on antibiotic while it was sent to lab. Symptoms didn't ease and he had burning sensation at tip of penis most of the time. No stds detected. A blood test was taken to check PSA and it came back raised at 7.2. He then went private to a leading urologist who said it could be either enlarged prostate or prostatitis and gave him a different antibiotic. Meanwhile he had a very painful urinary retention and had a catheter for a few days. Four weeks later he had another PSA test and it had gone up to 9.5! Naturally we are worried. The urologist consultant took another test(2 weeks after the 9.5 one). We have not found out the result of that yet but have been told that biopsy is recommended. The burning eased off for weeks but in the past couple of days has increased to a stage now where it has taken over daily life. A urine sample tested at home with professional testing strips showed high levels of white blood cells which I took to mean an infection was present in urinary tract somewhere. However his gp says it is clear, only 2 days later!! I am concerned that if he is biopsied with an infection present it will let the infection into the blood stream and he will end up really ill. I just wondered if anyone here could shed some light on any of this, doesnt sound like Pc me, more like BPH or prostatitis. Think the consultant opted for biopsy route when level rose by 2 points in space of 4/5 weeks. I thought catheter would have been cause of raised levels, he had retained an enormous amount of urine and prostate was bound to have been swollen. He now has a pain inside which he never had before retention. Any help or advice greatly welcomed thanks.

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  • Posted

    With urine infections and Prostatitis you can get a nil reading on a dipstick test of urine, and only when cultured does it show infection.  Just make certain if he has a biopsy that they give him Antibiotics at the time as infection after the procedure can cause Sepsis which is nasty.  Hope all goes well.
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    • Posted

      Thank you, I didn't realise that about urine testing. His GP didn't send it off as he just dipped it and said it was fine. I really think it should have been sent to a lab. It seems the PCA3 test I was looking into isn't available near us so he probably will have to go down the biopsy route. We will definitely make sure he gets given antibiotics, the biopsy is trauma enough without sepsis thrown into the mix!

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    • Posted

      Doctors try to save money on NHS by not sending samples in, I have had urine infections for 2.5 years and have had a few battles with Doctors on this. i am led to believe that your prostate can be infected but it is hard to reach to clear of even the slightest infection.  Not all Consultants deal with Prostatitis so try and get a recommendation to one who does if it is confirmed that that is the problem. Normally it seems from 50 years on you start to find PC being diagnosed .
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    • Posted

      I would hang off on the biopsy for a while as none of his sudden symptoms sound like PC. Infections and prostatitis including non bacterial put PSA up. When I had BPH and prostatitis my PSA was as high as 9.8. I had two negative biopsies one of which caused quite a bleed and I was kept in hospital overnight. A different urologigist doing ward rounds asked why I was there. When I said a biopsy he replied PSA terrorism!  I had  an infection after each although I had antibiotics for one of them.   

      After PVP laser surgery for my BPH and eventually being free of prostatitis for over a year my PSA is now 0.74.    

      Said it could be an enlarged prostate? Did he not do a DRE or a rectal ultrasound scan?

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    • Posted

      he did a DRE and said it felt soft and smooth, the GP said she thought it was a bit enlarged. He has been treated by urologist for prostatitis and at the start was told it could take months as it is hard to get the antibiotics up into the gland. Suddenly he is being sent for biopsy?? Unless the PSA test carried out about 10 days ago has shown that the levels have shot up above 9.5 I don't understand the rush to biopsy without giving the antibiotics more of a chance. This all started one evening back in August, he was fine in the daytime and began running to loo in the evening. We are hoping he will get more information next week, the secretary of urologist said a letter was on it's way so hopefully that will explain things more. No rectal ultrasound has been done. I have read that this could assess size of the gland and maybe explain the PSA levels being as they are. Size of gland in proportion to readings I mean.

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  • Posted

    So long as there is infection I would hold off on the biopsy.
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    • Posted

      My thoughts exactly Joe, I am convinced he has some type of infection in his body. If not the prostate then the urinary tract. The burning and stinging seem to tie in with this. I'm not a doctor but even I can see that this might be something to be 100% sure of before biopsy.

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  • Posted

    If a physician presents you with a treatment plan you think is too agressive, a second opinion is warranted. Yes, I have read that both catherization and acute urinary retention can temporarily raise PSA values. 

    Jim

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  • Posted

    I had similar issues and I was to a point of needing a cath to urinate, but I took Cipro for a month and it did get better. PSA isn't that accurate. I would get a PCA3 test first and not get a biopsy until the results of the PCA3 test were back. If it shows a likelyhood of cancer then I would get a 3T MRI done to locate the growth so that a targeted biopsy could be done. Blind biopsies don't always find the cancer if present. He may need more than one. The steps I listed was my plan of action if things persisted, but I gave it some time and I got better. I am 48 years old and I was not conviced that I needed to have a biopsy done despite being mentioned by my Uro and I am glad I didn't. Everyone is different though and one has to figure out how they feel and if they think it is what they want to do. A  PCA3 test only looks for cancer and it will not respond to BPH or Prostatitis. It is a good test to tell weather a biopsy is needed. 

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  • Posted

    When it comes time to do the biopsy, insist that he get an MRI guided biopsy. That way they look for tumors, and biopsy them. Otherwise the doctor is just shooting in the dark, and might as well biopsy his left big toe. He might well miss an aggressive tumor completely, or find a non aggressive tumor, and think that's all there is. If your doctor won't do that, find one who will.

    Imagine putting a large diameter needle through the non sterile wall of your partner's rectum, teeming with good and bad bacteria, and into his prostate many times. Doesn't that sound like a great way to start an infection in his prostate (prostititus), if he didn't already have one? The doctor may give an antibiotic to minimize infection, but antibiotics have difficulty working in or even entering the prostate since it is a fatty organ. At the very least, it should be minimized by doing it under the guidance of an MRI, and only then if the 3T MRI finds what looks like cancer.

    Many things can increase PSA besides cancer including things like infection, some foods, recent sex, little sex for an extended period and trauma to the prostate, such as a cystoscopy or catheter.

    This needs to be checked out, but it may necessitate going outside the NHS to do it correctly if they won't listen to you.

    Neal

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  • Posted

    Without meaning to cause offence we have had several ladies here who have panicked over similar situations with their parners and rushed them to private consultants and for MRI's and biopsies at great expense on little evidence and in time found all was well.  

    The prostate is a very difficult region to diagnose causes on and in his present situation PSA is totally unreliable. Some Guys have readings in the 30's and even 60's that settle down when infections are eventually cleared. The symptoms are often as baffling to urologists as to the patient.

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    • Posted

      Its the consultant who wants to rush him for biopsy. We thought he just had an infection in the gland and thats how treatment was started. The reason he went private straight away is because his father had great prostate trouble and it took ages for him to be seen on NHS at the time. Apparently the cut off level is 10 and as he is 9.5 he is being directed to biopsy. I wish they would give it another few months of antibiotics and then test levels again but he is scared to wait now.
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  • Posted

    Heck! Looking at your posts on the UTI group I see that you had urinary problems and tests at the end of the summer. Did you tell your husbands Urologist about that ?

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    • Posted

      Hi Derek, yes I had frequent urination in September. GP found no infection but gave me antibiotics anyway. There was blood traces in urine but no further action was taken. It has flared up again but my home urine test has shown infection today. Pain in back as well so thinking likely a kidney infection. We have both had checks for std's as we thought he had urethritis which can be caused by std's. These were clear. We have been together for 10 years and never doubted they would be clear. I'm not sure if he discussed this with urologist or not but will make sure it's mentioned at next meeting.

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    • Posted

      It does seem rather a coincidence in the time scale.

      Another thing is to be very careful about the drugs prescribed Cipro and others containing Fluoroquinolones can as I have found to my cost cause severe tendon problems. 

      This site has a lot of good information that you can read at leisure 

      http://patient.info/search.asp?searchterm=prostatitis&searchcoll=All   ;

      http://patient.info/search.asp?searchterm=uti+in+men&searchcoll=All

       

       

       

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