Possible Prostatitis but concerned. Advice welcomed.

User

Posted 03 Feb 2018 at 16:32

Hi I have been looking for a forum to voice my concerns and hopefully find kindred spirits so would really appreciate any advice.

I am 49 years old, nearly 50, and for many years, as far back as I can remember I have had bladder issues with regard to regular visits to the loo and at times passing small amounts but frequently. At it's best I could get round the golf course and then pass 4-500 ml in one go, but at it's worst it would be every five minutes passing as little as 10-20 ml and varied day to day. It certainly affected life to extent that jobs were based on if a loo was nearby!!

After years of various tests I went to see another Urologist in 2015 with urinary frequency and nocturia. I had all the usual tests including a DRE which was normal. I was passing normal amounts of urine considering my liquid intake but passing small amounts frequently so an irritable bladder was diagnosed which was fair considering I have suffered with IBS (bowel) for many years. I was placed on a medication Solifecanin (Vesicare) and it was a life changer as my nocturia reduced and daytime symptoms improved so I was discharged.

I was warned that the meds could have less effect as time went on and a few months ago I started to have worsening symptoms again with frequency issues. At about the same time in June 17 I had a blood test for an unrelated problem, type 2 diabetes, and when I rang for results apparently my PSA Total Serum was listed as abnormal at 2.05 ug/l with the guidelines at the surgery set at between 0.00 and 2.00 ug/l. My full blood count was also abnormal with white cells and platelets all over the place so I was called back in for another test. The test two weeks later showed my PSA as normal at 1.9 and my blood count had normalised which obviously was good news.

Back in early December I went back to the GP with my urinary frequency problems and was put on a different med coming off the Vesicare. My GP also suggested another PSA Test and the result came back as normal at 1.61 but she decided to re refer me to a Urologist anyway whom I see late February. Unfortunately the new meds didn't work and I went back on the Vesicare.

This brings us to last week. My frequency issues were becoming a joke with visits every 10 minutes at times and on Monday I was sent home from work with severe frequency issues and pain which seemed to be coming from my urethra. It felt like there was urine permanently in my urethra and the bladder was never empty and whilst the frequency and non empty bladder feeling were not overly new to me although worse than usual the pain and feeling of being unwell was unusual although there was no discomfort in the process of urinating only before and after. I got an emergency appointment and told my GP the symptoms - Frequent urination, Discomfort in urethra before and after urination and after ejaculation (which was also a new finding) along with the feeling that my bladder was not empty, again!

He then performed a DRE and a urine test. He said that my prostate was enlarged, although he didn't say how large and he said he suspected Prostatitis. He basically said it was like turning a hose on but standing on the pipe and that was what is happening with my waterworks. The urine sample came back clear. Obviously I was quite concerned about PC and even though he tried to reassure me that my PSA levels were fine a search with Dr Google (I know, I know) brings up many entries that a normal PSA Level isn't necessarily a green light. Obviously I have had these urine issues for many years so now I am wondering if all along it has been my prostate and now things have take a turn for the worse.

The GP prescribed me Finasteride 5mg one a day but did say that if these tablets didn't work surgery could become an option which obviously gives me concern.

I am back to see the GP in a week or so and see the Urologist in a few weeks so I am just wondering if there are any particular questions I need to ask to make sure that I am doing the right thing?

Many thanks for your help.

User

Posted 04 Feb 2018 at 09:11

Hello Max and welcome to the site.

PSA is only an indication that something needs investigating and you are lucky enough to have a GP who isn't hesitating to do just that.
Your PSA is low and classed as "normal" by your GP but even so, follow up is called for .

The fact that you are referred to a urologist is a good thing. IF, there is anything sinister to find , they will find it.
.

Your situation is obviously serious enough to affect your working life so the fact that you are being taken seriously is a good thing.

The urologist will soon sort you out.

Hopefully somebody will be along to advise you but in the meantime, it really isn't a good idea to do general googling, especially if you end up at foreign sites ie American, as they are not always relevant to treatment in the UK.

Good luck. Be patient. I'm sure somebody will be along to help

Edited by member 04 Feb 2018 at 09:12 | Reason: Not specified

We can't control the winds - but we can adjust our sails

User

Posted 04 Feb 2018 at 11:31

Well jobwise that is very distressing (I was once in probationary period for a job and got carted off to hospital by ambulance for kidney stones and spent a week in there so I know how you feel - they did keep me on though!!)

Your health has to come first though doesn't it and if you have a problem then it has to be sorted, no matter what it is.

You could struggle through at work, putting your future health at risk and still end up with no job.

I know you are still in your probation period but isn't there a rule about being sacked for ill health (or did I wishful think that for you!!)
Did you declare yourself fit and healthy before you took the job or had you mentioned previous issues with frequent urination and back/hip problems ?

I know you said he checked your urine for infection but I am sure there is more than one kind so maybe you need a specific test to rule out infection completely

Edited by member 04 Feb 2018 at 11:34 | Reason: Not specified

We can't control the winds - but we can adjust our sails

User

Posted 04 Feb 2018 at 17:08

Yeah I had a medical so to speak so I was pretty honest on the form and they only picked me up on Diabetes and Vertigo because in the past whilst I went to the loo a lot it certainly wasn't over the top. Not sure about sackings/ill health although I might find out when I go back!! I'll probably go in an just be honest with them because I have checked and can't get an appointment with a GP until next week anyway so no way of getting a Sick Certificate.

Went to the Walk In Clinic and was there for three hours with several visits to the loo. The Dr didn't fill me with confidence especially when he said that it is unusual to see prostate enlargement in someone under 60, which I am sure is not right!! He gave me some painkillers and some antibiotics to take for just three days to see if it makes any difference. He also said that an ultrasound would be useful in distinguishing the size of the prostate but didn't offer that there.

So I guess it's just a case of struggling on until I see the GP a week Monday and then the urologist late February.

***Update re work. Work were really good. I went in but was sent home again and after a long chat with my Line Manager they were quite reassuring about time taken off for a genuine illness in the Probation Period. So whilst no guarantees they might change their minds at least that's one thing I can take off my mind.

Painkillers working to an extent but soon wears off and not sure about the antibiotics but I now seem constipated, One extreme to another!!

Edited by member 05 Feb 2018 at 10:00 | Reason: Not specified

User

Posted 06 Feb 2018 at 10:51

Well saw the Urologist today and he fortunately wasn't concerned about the prostate stating that it was a normal enlargement as you get older. He performed a DRE and an Ultrasound and said that with the fact the prostate felt normal (albeit enlarged) along with a neutral family history (I am adopted) and the PSA scores he wasn't concerned.

I do however have an extremely sensitive bladder which due to years of frequency issues has got worse and inflicted inflammation on the waterworks. So basically when I have 10ml of urine in the bladder it's telling me I need to go whereas in reality I should be holding half a litre I think he said. So new meds and lifestyle changes including eradicating all caffeinated and decaffeinated liquids for at least 3 months and see where we are then,.

Thank you Johsan you were very kind.

Edited by member 08 Feb 2018 at 18:36 | Reason: Not specified

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User

Posted 04 Feb 2018 at 09:11

Hello Max and welcome to the site.

The fact that you are referred to a urologist is a good thing. IF, there is anything sinister to find , they will find it.
.

Your situation is obviously serious enough to affect your working life so the fact that you are being taken seriously is a good thing.

The urologist will soon sort you out.

Good luck. Be patient. I'm sure somebody will be along to help

Edited by member 04 Feb 2018 at 09:12 | Reason: Not specified

We can't control the winds - but we can adjust our sails

User

Posted 04 Feb 2018 at 10:51

Johsan, Many thanks for your reply. I am off to a walk in centre today after calling 111 last night. I tried to have a rare night out with some good friends but after one Jack Daniels I was visiting the bathroom 4 times in a matter of minutes, the urethra pain returned and had a general feeling of malaise and discomfort so left and called 111. What was worrying is that some of the questions she asked like do I have any back or hip pain. No back pain but I have had hip pain since 2012 although I had an XRay for that and it was diagnosed as arthritis. It got worse last year so had another xray and the arthritis hadn't got worse so I was relived but now slightly concerned that the arthritis is the cause of the hip pain after all although it has improved since I started sleeping with a pillow between my knees,.

My other worry (it shouldn't be but it is) is that I started a new job at the start of January and within 3 weeks I am suddenly having a week off with these symptoms which I am sure most employers would tell you that won't go down well. I was due to go back tomorrow but with this big relapse since Friday I now don't know what to do. Struggle through popping to the loo every 5 minutes, get another certificate from the GP and probably get fired when my first probation comes up for lack of attendance or just resign and concentrate on getting well. A worry on top of a worry. I work with SEN Kids and love the job but you have to be switched on at all times and right now I am all over the place!!

User

Posted 04 Feb 2018 at 11:31

Your health has to come first though doesn't it and if you have a problem then it has to be sorted, no matter what it is.

You could struggle through at work, putting your future health at risk and still end up with no job.

I know you said he checked your urine for infection but I am sure there is more than one kind so maybe you need a specific test to rule out infection completely

Edited by member 04 Feb 2018 at 11:34 | Reason: Not specified

We can't control the winds - but we can adjust our sails

User

Posted 04 Feb 2018 at 17:08

So I guess it's just a case of struggling on until I see the GP a week Monday and then the urologist late February.

Painkillers working to an extent but soon wears off and not sure about the antibiotics but I now seem constipated, One extreme to another!!

Edited by member 05 Feb 2018 at 10:00 | Reason: Not specified

User

Posted 06 Feb 2018 at 10:51

Thank you Johsan you were very kind.

Edited by member 08 Feb 2018 at 18:36 | Reason: Not specified

User

Posted 12 Feb 2018 at 18:27

Well I am as confused as ever today. Saw a GP with an update from the urologist and in some ways he was dismissive of the urologist and said he had never heard of him and just sort of shrugged and said "well he is the expert" thus not instilling a lot of confidence in the medical profession from me!! Whilst the GP wasn't dismissive of a sensitive bladder he did say something must be making the bladder sensitive and therefore suggested that the enlarged prostate was the culprit, which to be honest does make sense but why did the urologist dismiss that and who is correct?!

So the GP basically told me to carry on taking the Finasteride even though the urologist told me to stop taking it but to continue as well with the Mirabegron that the urologist prescribed for the bladder,. The GP then just casually suggested a PSA test every year would be fine and sent me on my way.

My bladder symptoms are a bit better so not going every 5 minutes but still not perfect and I still have this irritating discomfort in the urethra. I know both meds take time to work, if at all, but considering the seemingly difference of opinion between urologist and GP I am really not sure what to do. I am also concerned a tad about reading that Finasteride can mask a correct PSA score thus potentially not showing up any possible future rises which of course is not what you want.

So not sure whether to book again with another GP and maybe even another urologist considering these two seem not to be able to agree. The only thing that both seem to agree on is that the prostate is enlarged but both said the DRE didn't show any areas of concern so that's a positive I guess.

Thoughts on what others would do in this situation welcome?

User

Posted 12 Feb 2018 at 18:58

GP stands for General Practitioner. In other words he sees it all but isn't (generally) an expert in any of it which is why a GP refers you on.

The Urologist on the other hand has trained in that specific area and will have enough experience to recognise what he sees and diagnose accordingly.
I cannot understand why a GP would be dismissive of an expert.

I wouldn't say don't trust the GP but they are aren't always right.

I know that for a fact since our GP constantly told my daughter she had IBS which was, in fact aggressive colo-rectal cancer. Had he erred on the side of caution and got her checked she might still have a bowel.

I do think the GP suggesting an annual PSA is a good thing however.

(By the way, you're very welcome :)

We can't control the winds - but we can adjust our sails

User

Posted 12 Feb 2018 at 19:01

I would be a bit p*****d off with the GP to be honest - overactive or over-sensitive bladder is a real thing and you have had tests that show you are emptying at 10ml which cannot possibly be put down to your prostate since it is happening higher up the command chain, so to speak. My husband was diagnosed with overactive bladder (initially caused by a muscle problem) when he was 35 and took meds until he was diagnosed with PCa 15 years later. The tablets were the difference between sleep and no sleep.

GPs are so called because they are general practitioners rather than specialists - urologists have to study for a long time to be acknowledged as having that specialism. If you were my husband, dad or brother I would be making sure you took the meds prescribed by the urologist, stopped taking what you have been told not to take and sending you back to see a different GP for any necessary prescriptions.

PS The halving of PSA on finasteride would not have been a massive issue since you are aware of it - future PSA results would simply need to be doubled to get an idea of the true score.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 12 Feb 2018 at 19:07

Thanks Johsan, that's awful about your daughter by the way I'm so sorry I must come across as worrying about nothing compared to that.

Not sure if to continue with the Finasteride that the GP said though although I have decided to book another appointment with another GP in a couple of weeks time for a second opinion so will take the Finsateride till then.

Thank you LynEyre. I agree the appointment has baffled me considering I was all straight and happy enough prior. I'll give my GP the benefit of the doubt because I couldn't get an appointment later this week when he would have had the urologists report so all he knew today was what I told him that the urologist said. Maybe once he receives the official report later this week he may change his tune and call to say stop taking the Finasteride. I suspect me being on it a week or two will do no harm. He is unfortunately a rather abrupt man and I don't usually see him but unsurprisingly his appointments are the most available so I suspect others have the same view of him.

Sorry to hear about your husband but it did interest me that his sensitive bladder came from a muscle injury. I have had frequency/bladder issues for years and I can remember my first issues were after I ripped both groin muscles riding on a rather large horse in Florida some 20 odd years ago. I was not happy to start with then the bloody thing decided to gallop!!! Ouch!! For the rest of the trip I spent quite a bit of time in Disney and Universals wonderful bathroom facilities and have never really recovered so whilst I'm not saying the new enlarged prostate isn't involved in my recent problems I have had certainly two prior normal DRE's in the past but still plenty of bladder issues.

I will however never ever ride a horse again and bemoan the day that my ex persuaded me to have a go!!!!

Edited by member 12 Feb 2018 at 19:24 | Reason: Not specified

User

Posted 12 Feb 2018 at 21:35

There has to be a solution which will at least improve your situation and this could require referral to a specialist with greater expertise. Infections aside, there can be other circumstances which lead to greater frequency. One of these is physical or emotional stress but this is unlikely to be the case over such a long period. Pouches (Diverticulum) can develop in the bladder which happened to me as was a narrowed sphincter for which I was prescribed Tamsulosin which I take to this day. There must be other reasons why frequency/urgency becomes a problem. A camera was inserted through my penis and nothing more was found at the time. I did attend a special clinic where I was advised to have cranberry juice and not to have normal tea or coffee but if I did have these to have decaff variants. I had to measure and record my intake of fluid each day and try to hold on for as long as I could before giving in to visiting the toilet. This formed part of what they termed 'bladder retraining'. It also meant not having a pee just before I went out 'just in case' if there was no real need. Similarly, I was not to have a pee when I woke in the night 'just in case I might wake up again', unless I was really bursting. This did help, although I do need to get up once each night and sometimes twice despite not drinking anything after 8pm except on rare occasions. Whether any of this affects you I am unable to say.

The exception to this in my case was when I had Radiotherapy, when at worst I had to pee anything up to 8 times a night - very debilitating. The situation gradually improved so that after a couple of months or so after RT finished I was back to my pre RT frequency. Clearly, this is not a reason for your problem but I mention it to show there can be other reasons which can give rise to this problem.

Of course you want a long term fix but depending how strenuous your job is, as an interim measure you could consider doing what I did and get one of the systems where you attach a bag to your leg that holds your urine. This is fed by a tube connected to a replaceable sheath covering your penis. The bag has a valve to facilitate emptying the urine. An addition larger bag can be attached at night. I found that as well as the strap securing the bag, during the day an elastic stocking available in several sizes as part of the system better secured the bag in place but suggest don't go running for a bus if you adopt this suggestion!

Edited by member 13 Feb 2018 at 14:28 | Reason: Not specified

Barry

User

Posted 13 Feb 2018 at 11:24

Thanks Barry. Yeah I had all the tests a few years ago including camera and a flow test. I remember the flow test was a nightmare because there were 10 of us at the hospital who were all holding it in since the night before and only one flow bowl. I had to say to the nurse I was either going to go in the flow bowl or on the floor so was fast tracked pretty quickly!!! All was normal.

Hopefully I won't need a bag. Whilst I have the frequency I haven't had the incontinence and when I get there it's only small amounts and at times I stand and wait so it's not like I would pee into a bag without thinking about it so it's just a case of warning my employers when I get back that I may well have to pop out a few times.

It's fortunately better than it was last week so I am holding better so maybe that's the meds from the urologist although far from perfect. Also bizarrely I have woken up this morning and the discomfort in the urethra has got a lot better for the first time in three weeks which is strange unless starting the Finasteride yesterday has had a miracle effect although I have also cut out the coffee since Friday so once again you never know. It did get better for a day last week but was suffering again in the evening so not holding my breath but hopeful. That's been the main problem this time around it's not so much the bladder feeling full but the discomfort in the urethra makes it feel like there is urine in the urethra so it gives you the urge to go because of that. I don't know if urine tests rule out urethral infection but that's what it has felt like.

***Well the relief didn't last long and was back at the GP this afternoon with awful pain in the urethra which was somewhat strange after such a good start to the day. This GP thinks it could be an urethral infection or inflammation, cause unknown and has given me pain killers and some antibiotics.

Edited by member 13 Feb 2018 at 19:08 | Reason: Not specified

User

Posted 17 Feb 2018 at 12:42

This is a bloody nightmare. One day you think you are improving the next you are running to the loo every 10 minutes. Back at work Monday and it's going to be a disaster with the frequent bathroom trips!!

One thing I have noticed though is that if I sit in front of the TV on my side my urgency issues are better which I suppose makes sense because you aren't putting as much pressure on that area. Unfortunately sitting on your side is not easy long term so I purchased a ring cushion to see if that worked but it's very uncomfortable in other ways.

So I have been looking at prostatitis relief seats and cushions and there are loads online some quite reasonable and some really expensive so was wondering if anyone on here uses one that they are happy with or can advise the best and worst? Worth a try. Thanks.

User

Posted 24 Feb 2018 at 16:05

Well things had settled a bit although far from perfect and until Thursday night time wasn't a total disaster as whilst I would have to get up maybe once or twice a night it was to pass small amounts and I slept fairly well. No nocturia was ever diagnosed due to acceptable/normal amounts being passed at night so have never worried about volume of urine just the frequency. However Thursday night was a nightmare with me waking up every two hours to pass quite a large amount each time. Went to bed Friday night and decided if the same thing happened I would take a note on my frequency chart.

I was shocked. I was up 4 times, every one and a half to two hours and passed on each trip 400ml, 300ml, 275ml and 400ml so a staggering 1375ml over night which bar the night before has never happened. It's usually 100ml tops if I wake every couple of hours. With my daily output of anything from 1500 to 2600 with probably an average of 1900ml 1375 is an incredibly shocking amount for over night so it's been one step forward and two steps back! Nothing different drink wise although ironically I am finding I have less issues drinking diet coke rather than water or milk which seem to be an issue.

So still not sure if it's bladder, prostate, both or even if the kidneys are now getting involved!! Betmiga hasn't made much difference but I read on here that it takes a while to work and it can be taken in combination with something else so may look into that.

Has anyone found a drug that works for urinary frequency issues?

User

Posted 24 Feb 2018 at 17:23

Max, you say nothing different drink wise but how does the output compare with the input.

How much do you actually drink over the course of a day and have you tried cranberry juice as Barry suggested?

Roll on your late February Appointment eh.

PS have you ever mentioned the double groin ripped muscles whenever you have seen anyone about your problem

Edited by member 24 Feb 2018 at 18:32 | Reason: Not specified

We can't control the winds - but we can adjust our sails

User

Posted 24 Feb 2018 at 17:40

Recently reintroduced Vesicare.

Although night time frequency is only slightly reduced I now go back to sleep quickly as almost constant irritation has pretty much gone. Daytime urgency is now rare, frequency far less and voiding more each time. It does come with retention risk so you should have a flow test to ensure you're emptying bladder enough (35ml left in my case). I had choice of 5 or 10mg. Opted for 5 to see how I go.

Was asked to keep off fizzy drinks and tomatoes.

Ray

User

Posted 24 Feb 2018 at 23:10

Well logically, you only pretty well pee what fluid you intake plus fluids that are extracted from the food you eat. Might be worth keeping a record of all you eat and drink and at what times and log when you pee and how much over a couple of weeks. Appreciate this could be difficult when at work but perhaps a Conveen bag system or similar could help. With this information perhaps you could be referred to a specialist urinary clinic as I was.

Barry

User

Posted 25 Feb 2018 at 01:19

Thanks guys. I have several "Frequency Charts" and my output is usually the same as my input but last night was a big difference as I have never had an output like that at night and I didn't drink that much the previous day. I forgot about the Cranberry juice so a visit to Sainsbury on the cards tomorrow so thanks for the reminder. It's really strange that water and milk is worse for me than fizzy pop although I suspect it's because it's easier to drink more water than you can fizzy drinks but milk is a strange one because the urologist says that is fine. BTW yep always mentioned the groin muscles but never had much of a reply about them although Thursday and Friday I was fairly active at work sports wise with the kids so could there be something in that I don't know!!

Vesicare Ray was an absolute godsend and life changer when I went on it back in 2015 but sadly as time went on it's effects stopped working. I tried to up the dose but the side effects were awful with a dreadfully dry mouth and the upped dose didn't really help anyway. Taking just the one with 50mg of Betmiga at the moment but no life changing moments as yet. It's just so frustrating because within minutes of having a pee any movement like a waggle of the hips whilst sitting down there is a feeling of needing to go again. The ultrasound showed my bladder was empty or at the very least had a mere 10ml or so in there but it really does feel like it's just filling up again as soon as it's been emptied. The signals shouldn't kick in until about 250ml is in the bladder but with me it's almost immediate. In a nutshell I almost think that the nerves of the bladder for the first 250ml should be just destroyed in some way so I get no feeling so early but I guess treatment like that doesn't as yet exist,.

Sorry to moan because I know there are people on this site far far worse off with far more serious conditions..

Edited by member 25 Feb 2018 at 01:26 | Reason: Not specified

User

Posted 25 Feb 2018 at 10:02

I previously came of Vesicare due to severe constipation which was worse than peeing frequently. So far I'm managing it but?

Don't read you as moaning as I've some understanding of your frustration. In my case an easy 15 yrs of minimum 3/4 times a night except for 1 night of zero, I remember it well -:) Add on those not infrequent 10 plus times a night, which at present Vesicare is helping, and nights when you wonder where all the waters coming from as it was just a normal day. I've given up trying to work out the logic on those two. I've tried the juice/food/drink routes which seem to work at first but then back to square one. So I'm thinking after all these years my body sees 3/4 times as now normal so will defeat any attempt to change that? Thus I can only advise you push to get it sorted before you get to that stage.

Ray

User

Posted 25 Feb 2018 at 10:59

Max it seems you are a classic example of someone who needs bladder retraining rather than medication. It isnt the nerves of your bladder that are picking up messages too early - it is your brain that is misinterpreting the signals.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 26 Feb 2018 at 17:31

LynEyre I would be inclined to agree but the problem I seem to have is that there are two types of feelings. The first is in the bladder higher up where you feel that you could go to the bathroom but because in my case it's a "bladder" feeling then I can quite happily hold for a while sometimes a few hours. The feeling that gets me every time though is the urethra feeling which is far lower down, almost like a chill which you just can't hold and when you can end up going every ten minutes for hours or every ten minutes two or three times then you are fine for a bit. That's the feeling that I would say would be very difficult to retrain.

User

Posted 21 Apr 2018 at 09:39

Hi all, Sorry to be back but not quite sure where else to go as it seems most other forums re bladder and urinary issues are mainly regarding women's symptoms.

Saw my urologist again last week because the meds haven't worked a great deal and my bathrooms visits are still quite frequent, so much so that I am trying to get an excusal from Jury Duty due to the fact I would have to put my hand up every 15 minutes!! There is still discomfort in the urethra as well from time to time which as explained above makes retention more difficult.

The urologist has sent a letter to my GP regarding "urgency and discomfort around suprapubic region" and he is forwarding me for a flexible cystoscopy and has advised me on possible botox injections into the bladder as a possible treatment considering the fact I am on the highest meds available although as many will know on here no surgery is without risks.

The thing is I am still not convinced that it's 100% my bladder. I have noticed that after 6 hours sleep I will produce around 550 mls of urine. I'll go back to bed for an hour and when I get up I'll pee another 2-300 mls, now that doesn't seem right to me, it seems somewhat excessive a mere hour later. Apparently we produce a certain hormone that stops you going as much at night so could I be low on that> ? The urologist seems to think that's a difficult procedure to look at that possibility?! I also am surprised that they haven't as yet looked into whether my kidneys are working properly or once again if this really is a prostate issue which my previous GP whom has now emigrated thought it was.

So has anyone gone down the road of asking to see a different urologist for another opinion and it that a good idea as I don't want to disagree with this current guy but something just doesn't give me much confidence in him?

User

Posted 21 Apr 2018 at 10:35

I think you need to have the cystoscopy and then go from there. Not much point seeing a specialist and then preferring to believe Dr Google.

I understand that the botox injections are often very successful. If the cystoscopy is clear you could also ask for a referral for bladder retraining?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 21 Apr 2018 at 17:59

Max

Because I have a suprapubic catheter and bag I am aware of how much urine I produce. Over night I get between 300 and 1000 ml depending on intake. In the the morning I rise, empty the bag, drink about 250 ml and return to bed until the household had cleared the bathroom and gone, in that time, about an hour, I produce between 300 and 600 ml. When I was working and before RARP,I would void on getting up, get ready go out and drive for as much as five hours without the need to urinate. So I think going back to bed is the issue.

I have CK3 and it seems to have little effect on my urine output, it was only picked up by blood tests.

As suggested get your cystoscopy and take it from there.

Thanks Chris

User

Posted 11 May 2018 at 20:22

Hi Guys,

Well I had the cystoscopy and the results which I post below.

All ok'ish which is good obviously but I am still a tad concerned about this "pigmented prostate". I sort of remember during the procedure my prostate flashed up on screen (which surprised me as I was pretty sure they can't see the prostate on a cystoscopy?!) and it was covered in what I can only describe as purple pimples, and I sort of remember the consultant saying some of the pain could be caused by crystals that I pass (bladder, prostate stones?) but I wasn't quite "with it" so it didn't all go in.

The description of this pigmentation is not particularly detailed with the comment "might indicate prostatitis" and I am reluctant to consult Dr Google!! Obviously you have to trust your consultant but just wish they had been a tad more clear on what this mottled pigmentation actually is.

"Further to ******* underwent a flexible cystoscopy due to symptoms of bladder over activity and slight dysuria/penile pain.
The urethra was normal, the prostate was pigmented all over which might indicate prostatitis, but I am delighted to report there was no bladder pathology and both ureteric orifices looked normal.

I fully explained the findings to ***** and there is no doubt he does not need Finasteride because his prostate is not really enlarged (normal size) and if he does experience dysuria or penile pain, which can be an ongoing problem, he just needs to use some Ibuprofen.

His nocturia is variable from zero to twice (between 12 midnight and 6 am), passing a fair amount of urine between 300 and 400 mls each void.

I strongly advised him to stop drinking three hours before bedtime to avoid getting up at night. However, if he gets up two to three times every night despite this, he may benefit from a small dose of Desmopressin Acetate before going to bed.
At this stage he does not need any further investigation or treatment. Therefore I have reassured him and discharged him back to your care."

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