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I have now waited 1 hor 40 minutes for an answer!!!! Please

I have now waited 1...

I have now waited 1 hor 40 minutes for an answer!!!!

Please  note that I posted this question OVER AN HOUR AGO!!!! I had to wait 7 hours for your last response...are you on line or not? I was told that I would have real time discussion with you on line if I placed a deposit?

For the last two days only I have had trouble peeing in the morning. However, on both occasions I had had large amounts of water to drink the previous evening. I am also taking painkillers and lorazapan /anti depressants. For most of the time, months if not years, I don't notice any issues with peeing. This morning I peed normally when I woke at 5.50 and then again at 8.30am. I last had an issue with irregular peeing in November 2011. My GP said as its was intermittent and as the Digital Regital Examination at the time was normal he said "forget it". All returned to normal in a few days with my urine behaviour. Yesterday following the second of the two early morning incidents I went to see a private doctor on Sunday morning. I had urine test that was 100% normal. The Doctor then gave me a DRE....His comment was your prostate is ok, its normal for a person of your age...it is slightly enlarged but then so are 90% of people in your age group. There is nothing to worry about and its OK. When I explained that my symptoms were intermittent (ie once every 12 months if that) and not daily the doctor said that was not consistent with prostate. My urine symptoms today seem more normal. I went to the loo at 7.00pm last night and then again at 8.30am with a fairly normal uninterrupted flow. All seems normal again. The doctor said I should have a PSA test at my age, but my symptoms and the nature of the test which seems inconclusive might not be ideal for a person with OCD, which I have got. I have had problems with erectile problems since I was a teenager - so at 56 these are nothing new. I have had an erection several times in the last 6 weeks. What are your thoughts? What are your thoughts?

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Answered in 1 hour by:
5/27/2013
Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3,682
Experience: MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
Verified
Hello,
What exactly was the trouble in peeing - Was there a delay in starting the urine flow or did you have to strain to pass urine ?
Do you have to get up at night to pass urine?
Do you have a sense of incomplete emptying of the bladder after passing urine?
Do you smoke ?
Please let me know.
Dr.Tharun
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Customer reply replied 4 years ago

There was a delay

I do not generally have to strain - it comes naturally but perhaps not as forcefully as it might have done 10 years ago.

Occasionally I feel a slight sense of not emptying the bladder

I don't smoke.

Yesterday I felt normal and peed 7 times in 24 hours.

What are you thoughts?

Customer reply replied 4 years ago

DR THURAM - Could you please respond to my question. I put a lot of effort into constructing the question and you are not providing a good service in terms of timeliness. I want to pay you a bonus, but at present you are simply not responding.

WHERE ARE YOU DR THURAM????

ARE YOU GOING TO RESPOND?????

CAN YOU PLEASE RESPOND - THIS IS MEANT TO BE INTERACTIVE ISN'T IT

There was a delay

I do not generally have to strain - it comes naturally but perhaps not as forcefully as it might have done 10 years ago.

Occasionally I feel a slight sense of not emptying the bladder

I don't smoke.

Yesterday I felt normal and peed 7 times in 24 hours.

What are you thoughts?

I don't normally get up more than 2 times a night if that

I am sorry but I thought this was meant to be interactive.....it is now some time since your response......

HI Jan,

Sorry to have kept you waiting.
Prostate enlargement is a progressive condition.The graph keeps on coming down.It does not present like once in a year.Your doctor was right in saying that these symptoms are not consistent with prostate.

So this once in a year symptom can be easily ignored and not given much importance if the urine tests are negative for any infection.

Gone is the era when PSA was routinely prescribed to all men above 50 years of age.It has lead to lot of over-treatment for prostate cancer.So it is now done as a opportunistic investigation if the doctor finds something suspicious in DRE or the patient demands for it after knowing the pro's and con's of this test.

Rather doing a Uroflowmetry test and PVR study would be more meaningful in your case.Uroflowmetry measures the flow of the urine when you void into transducer pot.It will give a baseline value of your flow rate which can be compared with future values and see if the flow rate is deteriorating or not.

PVR - Post void residue is done to know whether you are emptying your bladder completely or not.It also gives an idea about the function of the bladder whether it is functioning or not.If this is normal there is nothing to worry on the prostate front.

At this point of time given the circumstances and current evidence and the history of OCD, it would be justified in avoiding the PSA till your doctor finds a reason to do it.Till then it can be avoided as a screening test.

I hope this clears your doubt.Let me know if you have any more questions and I would try to be more prompt this time.

Regards

Dr.Tharun
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Customer reply replied 4 years ago

Thank you for a good and very helpful answer.

You are welcome, Jan.
Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3,682
Experience: MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
Verified
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Dr. Tharun
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