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Catheter query after biopsy

User
Posted 17 Jul 2019 at 12:34

Hi everyone. My dad had a prostate biopsy around 3 weeks ago as some blood tests for various things came back with a high PSA level of 11. A DRE examination suggested a slighty enlarged prostate but the doctor said it felt smooth and overall benign but they wanted to be sure everything was ok so booked a biopsy.

The biopsy went well and dad seemed fine peeing for a while until a week after when he really had problems peeing and was in agony. The dr sent him to a&e where they put in a catheter which of course helped and told him he will have to keep it in until he sees the urologist in a few weeks. No antiobiotics were given which i found odd but just over a week later we had to rush him to hospital again due to him being very confused and having hot/cold sweats and overall just very unsteady on his feet (and losing interest in wine which was the most worrying!).. this time they said it was a UTI but all samples from a catheter apparently test positive for UTIs so they gave him strong anti biotics to be on the safe side which seemed to have helped greatly.  It was a really scary time as 14 years ago he had a major stroke so we thought we were heading down that route again.  It has really knocked the energy out of him combined with 3 weeks of hell waiting for the results which I know you have all been through yourselves. 

Anyway, As the results were taking so long we almost resigned ourselves to the fact he did have PC and its something we were ready to deal with until we got another fright from a unexpected letter from the colorectal department saying they will be in touch soon for an appointment - it seemed every casual and non urgent but googling this just really sent out minds into overdrive.  My dad decided on Monday to call urology again and chase his results & query the new letter from the colorectal.  The lady he spoke to said she had his results and no cancer was found in the samples taken in the biopsy and the other letter was just a referral for a polyp they found while doing it.  I understand all polyps have to be removed/investigated but i wonder has this ever happend to anyone else here? 

 

Today my father rang up again to query when he can have the catheter removed as now hes had it in just over two weeks.  The urology department said he will have to keep it in for maybe 3 more weeks to give his prostate the best chance to heal and i assume the swelling to go down... I have heard that in some cases the biopsy aggravates the prostate causing it to swell and put pressure on the bladder causing difficulty (which is what we suspected the first time) but is a total of 5 weeks catherterized normal? 

 

I'm just a bit confused . We still haven't had any letters from urology with the actual biopsy results (i hope to god that woman was correct in saying no cancer was detected!!) 

 

Any advice or help would really be appreciated! My poor dad just wants to pee normally now! 

 

Emma xx

 

User
Posted 17 Jul 2019 at 15:49

Hi Emma,  Nowadays people usually have an MRI before the biopsy.  That the biopsy didn't find anything doesn't make it certain as it might have missed.   I'd expect an MRI and monitoring of psa level.   PSA trends can be significant but on its own psa doesn't give a diagnosis.  You need all 3 psa, MRI and biopsy.

I wouldn't expect a letter with the results they usually ring you up or call you in.  I never received any letters except for appointments and after post op consultations.

It's unusual to get such a reaction although I'm sure it does happen.   

I'd be more interested in getting an appointment with a Urologist to tell you what they think and propose.   If they give you another psa test and it's going down then they might wait for another psa test but if it stays up an MRI might be expected.

Hopefully some other opinion will come on here as I'm just a patient.  

All the best.

User
Posted 17 Jul 2019 at 15:57

Thank you for the response.  I forgot to mention he did have an mri before the biopsy! The mri showed a few areas they wanted to investigate that they said took him out the low risk category (also taking into consideration the psa level) but nothing sinister was seen on the MRI.  I assume the areas they wanted to investigate further are the areas they took the biopsies from...

 

So i guess now he will have to wait for his urology appointment and hopefully the catheter will be out soon. 

 

Thank you for responding 

User
Posted 17 Jul 2019 at 18:35

hi Emma

Poor dad.  I was given ciprofloxacin ie antibiotics before the biospy.

You should get full metrics 're. size of prostate from MRI.  He was probably unlucky. 

ie infected prostate, procedure is quite basic. Maybe already enlarged prostate.  had dad had a slower flow for some time ?

Catheter that long duration not ideal as you say. Hopefully you can find out exactly what has happened and another PSA in a few months will give good base line for future  tests.  Hopefully no more biopsies.

Those symptoms are signs of sepsis not just UTI.  Hopefully he's recovering and feeling a lot better.

 

regards Gordon 

 

User
Posted 17 Jul 2019 at 23:02

Hi Gordon,

 

thanks for your reply,  yes I think my dad was very unlucky in his experience.  His prostrate was enlarged already and the urologist said he doesn’t empty his bladder properly so all this combined with the biopsy most certainly caused all the complications resulting in the catheter.  I did suspect sepsis but they gave him IV anti biotics when they brought him in on Thursday evening while monitoring him and sent him home with a 7 day course of very strong anti biotics. It seems to be doing the trick so fingers crossed he keeps getting better but I am keeping a close eye on him. Before they discharged him they said if they found anything sinister in the blood work they would call straight away to change the medication.

In regards to the MRI and Biopsy results - we haven’t received any paperwork yet which is quite frustrating. Numerous calls to urology seem to get us no where.  It is just a waiting game but I suspect they will monitor his PSA regularly

 

Thanks again for your response

 

Emma x

 

User
Posted 17 Jul 2019 at 23:50

hi Emma 

Reading this again. you said about other tests ?

Please don't assume the health system is autonomous in sharing data.

ie your dad has dealt with GP, A&E   and Urology. 

do see https://www.nice.org.uk/guidance/ng131

The GP should have recd copy correspondence  after this time period. Again depends how you  / he engage with your surgery.

Has he got other appointments with either GP or Urology booked ?

Everything should be explained and options etc.

I know MRI values as PIRADS

however I hadn't heard of Likert..

so I've learnt something tonight..

seems same thing. 

text from that doc..

PI-RADS (Prostate Imaging – Reporting and Data System) score or your Likert score. It tells your doctor how likely it is that you have cancer inside your prostate.

PI-RADS and Likert scores have the same values, and your score will be between 1 and 5.

 

regards

Gordon

 

 

Edited by member 17 Jul 2019 at 23:56  | Reason: Not specified

User
Posted 18 Jul 2019 at 08:08

Hi Gordon

The previous tests that picked up the PSA level were to do with his kidneys. He has Chronic Kidney Disease which needs to be monitored closely. My parents moved to this area not long ago so have been referred by their new doctor to different specialists to monitor my dads different health conditions (he also has a heart condition). 

I don't know if the GP has the results now but when my dad called he said he hadn't recieved them and actually chased up urology to see what was happening

 

I have heard of the PIRADS score but again nothing was on any letters we recieved but i assume because they decided to do the biopsy anyway it must have been a grade 2 or 3 .... all i know is when my mum questioned the surgeon doing the biopsy he said it was simply because there were a few areas they wanted to double check but nothing untoward was seen on the mri...my dad has a pace maker so im not sure if this determined the type of MRI he could have...

 

I feel like I'm doubting everything that has been said now because the communication between the hospital and us has been so bad. The overall result according to the lady at the urology department was no cancer was found... 

Am i right in thinking if the results are positive for cancer they call you in and tell you in person or on the phone? Do they actually write that in a letter?

I hope those with cancer are treated more respectfully and sensitively 

Emma x

 

Edited by member 18 Jul 2019 at 08:11  | Reason: Not specified

User
Posted 18 Jul 2019 at 22:54

hi Emma 

Each hospital has it's own procedures, which one is your dad's.  others may then post specifically. 

I had a post biospy, face to face, meeting after receiving a std letter for appointment.  They tend to keep that short .  ie 15 mins  on basis if you are told you have cancer, you don't digest much.  I had zero contact with GP.

I understand reading some posts on here results are given over phone.. ummm.  Not ideal in my opinion. (unless you have agreed how you would like to be informed )

I can't fault NHS Royal Devon Exeter. Very professional.  My surgeon even phoned my wife up before I had come around from Da Vinci RP, we were not expecting that.

regards Gordon 

 

 

 
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