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PSA 27/Prostate 60g

Posted 19 Nov 2017 at 21:38
On September 11th I took myself to A&E with urinary retention. I'd had minor symptoms before that (nocturia, hesitancy & leakage after peeing) but the flow had always seemed healthy to me. I was catheterised in A&E,told a district nurse would see me within 48 hours and I'd receive a urology appointment. I didn't see a doctor in A&E and no DRE was performed. I was sent home with sets of urine bags after about 5 minutes instruction from the nurse.

The district nurses & the urology appointment never materialised. After about a week I called the DNs who offered an appointment 14 days away. Feeling abandoned I went to the GP. She prescribed Tamsulosin, organised a quicker visit from the DN and arranged a urology appointment after telling me, "I think you've been forgotten about."

Saw a registrar at the urology appointment who seemed surprised I was catheterised and a little bit put out that he had to organise a TWOC and scan/flow test. I got the distinct impression he wasn't listening to me when he asked me my job and wrote down the wrong profession! Correcting him proved impossible and he just wanted to expedite the meeting. He did a very cursory DRE (less than 10 seconds) estimated my prostate at 40g and recommended I return 6 weeks later but get a PSA done at the GP in the meantime.

I saw a different guy at the second appointment. He did a longer DRE and estimated the prostate at 60g. He was surprised by my PSA of 27 and prescribed ciprofloxacin (4 weeks) in order to rule out infection (my urine was clear on dipping). He took more bloods for a further PSA and liver function tests. We spent a lot of time in conversation and the whole experience was much better than the first. He said they may biopsy once infection is ruled out. I have a further appointment on January.

Everyone seems to have a different experience but things seem to progress at a glacial pace here.Is this usual? What is the significance of the liver function test? What can I expect now and what questions should I be asking? The experience so far has been mixed so I'm trying to do as much 'homework'as possible.
Posted 20 Nov 2017 at 09:37

Sadly, the speed of the NHS is not what it was - but this isn't the place to debate that!  :)

Things seem to be moving much more sensibly now for you, as is often the way once you get properly started.

Antibiotics after TWOC and a while to see if things are working OK is reasonable, and the repeat PSA is sensible.

Not sure why the liver function test, but both Cipro and tamsulosin aren't liver friendly, so if you haven't had a recent LFT (or if you are on other meds concurrently), it's a sensible thing to do.

Remember that PSA is pretty much a blunt instrument, and can be artificially high for many reasons. Your GP should get the results of the repeat test.

Hope that helps a little!

-- Andrew --
"I intend to live forever, or die trying" - Groucho Marx
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