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Bit of a long story

User
Posted 16 Mar 2020 at 10:15

Hello all,

Sorry this may be long but I am keen to know if I am 'unique' with the symptoms I am having nearly a year post Radical Prostatectomy.

What led me to the Urologist in the first place was discomfort after peeing, not real pain, more a sense that I hadn't finished. Far worse after a bowel movement and I was wondering if 'something was irritating something else'! GP prescribed antibiotics to no avail. Saw urologist and he felt the prostate was firm on one side and after an mpMRI of pelvis and CT scan of abdomen I received a non-diagnosis of PI-RADS 3 and a scan suggestive of possible prostatitis. We agreed to wait 3 months and during this time I suffered these same effects. Perineal 'stinging' and general discomfort in that area with the odd feeling of not having finished. I also had a disrupted flow. Despite a follow-up mpMRI showing PI-RADS 2 we go for a template biopsy and out of the 40 cores taken cancer was discovered in 1mm of one of the cores. Diagnosed T1C Gleason 6 In February 2019. I decided to have the op (Anxiety too high for AS).

March 2019 operation went well although I did then have some complications (possibly as a result of daily clexane injections which do not seem to be routine in other countries) which started with cellulitis near one of the wounds (despite daily showers) and a 'large collection' in my pelvis. Another CT scan showed this to be about the size of a large apple which explained some of the discomfort. I also had a very bad reaction to antibiotics (at one point they had me on 4 types) which continues to this day (teeth pain, tendon issues). Anyway, by December 19 I was actually feeling better in that area and put most of it behind me. Whilst being investigated for the antibiotic issues I had an MRI of my spine as well as abdomen and pelvis (again). Those were done in November of last year and the abdomen/pelvis was clear outside the 'collection' which is now a 3cm 'ball' still resolving. Spine showed some degeneration at L5/SI but not 'serious' although I do suffer from back pain down there (pretty common I think!).

So, roll on to February 2020, and I have the same symptoms as when I first had this problem!! Stinging sensation in perineum after peeing and much worse after bowel movement with a dull ache that remains quite a long time and even extends into the shaft of my penis. I have noticed my tailbone and 'sit' bones are a bit painful due to my job which is annoyingly sedentary and I can sit for many hours which is something I need to sort out as it is causing me serious back pain! Anyway, my questions are:

1) Anyone else had this kind of discomfort 'come and go' even after having the prostate removed?

2) Could this mean some kind of spread? Last MRI in November was clear so I am certainly hoping not!

3) Could my original symptoms have been more orthopaedic/muscular/nerve generated rather than from the prostate, and the prostate just upped the irritation level, almost by accident?

My Urologist is high up the list of famous ones, but seems more interested in ensuring his handiwork is not the cause, so cannot really advise on my questions (which seems odd to me) and my GP just chucks co-codamol at me (not great) and isn't sure either. I have heard of pudundal nerves and Piriformis syndrome in the last few weeks and both of those could be candidates but I never receive a definitive answer and the people I talk to seem to bat my theories away (fair enough, I am not a doctor)!

As for spread. My final diagnosis is Gleason 6, T2A with negative margins (in-situ pathology) and it totalled 1% of my prostate volume - so not very big by any measure! I am hoping this will not be a cause for concern. 3 PSA tests were 0.006, 0.006 and 0.016 so far.

Anyway - sorry for babbling on. If this resonates with any of you please let me know as I thought a year after the op, with no prostate, I would not be suffering what feels a bit like prostatitis still!

 

Cheers all for your help and for reading this!

Mark

User
Posted 16 Mar 2020 at 11:06
With only 1% of your prostate found to be affected, it is highly unlikely that any of those symptoms were related to the cancer in your prostate - it seems you have another condition and the cancer was found accidentally during the process. Problems with the spine can affect the nerve messages to your brain so irritation in one area can present as referred pain elsewhere. If your work involves sitting for long periods and you are employed, your employer has a duty (under HSE regulations) to do an ergonomic desk assessment / display screen assessment to ensure you are in the correct position, at the right height and with the correct chair, etc. I would also be asking the GP to send a blood and urine sample to the hospital lab to check for urinary tract or other infection (some determined UTIs are notorious for not showing up on a basic dip test) and, if that comes back clear, for a referral to a urologist (perhaps one that doesn't specialise in cancer?) to check for bladder stones.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 16 Mar 2020 at 11:24

Thanks Lyn - I do agree with what you are saying! I had the dip test (all fine) and the MRI's are all good but it must be said the spinal one has a lot more information in it! Whereas the pelvis and abdomen is clear everywhere (outside the haematoma) the spinal one talks about 'modest degeneration', 'posterior disc protrusion' and 'pars defect L5-SI'. Interestingly though, despite all that, there is great reluctance to do anything as it usually means an operation and specialists seem to have that as last resort (I guess paralysis is a real threat) - in fact the conclusion indicates that the issues 'shouldn't' be pressing on nerves and not much else.

It does seem odd that the symptoms are the same but nothing of obvious nature is found, after all I have had 2 CT scans and about 4 MRI's in 16 months and not one has really pinpointed an area of interest outside of that spinal info. Maybe a physio is a decent next step too?

Thanks for reading and for the answer though...food for thought!

Mark

User
Posted 16 Mar 2020 at 12:52
Poor Mark,

You do seem to have been very unlucky, as with your symptoms - G6 T1C initially, I would have been on active surveillance for as long as I could have got away with it.

The word โ€œcancerโ€ sometimes encourages understandable panic in some people, yet they are not all the same. If I had been diagnosed with lung cancer two years ago, I would be in a box by now.

Keep babbling on, and I hope your issues are resolved soon.

Best of luck.

Cheers, John.

User
Posted 16 Mar 2020 at 13:04

Thanks John - to be honest, without these annoying symptoms I could easily try to forget all about it! The actual result of the operation seems good and I was continent pretty much straight away etc. Maybe I need a job with more activity and standing up! I do think sitting a lot (including around 40 long haul flights per year for 5 years has caused other things that just add up to more anxiety and irritation! If someone could just tell me what is going on then that would help, but there is a lot of naval-gazing and almost as much sucking of teeth as a mechanic or builder gets through in a week!

Mark

User
Posted 16 Mar 2020 at 13:14

Lie back and think of the Gold Card, priority boarding, the lounge access, the upgrades to First Class flat beds and the free flights - surely a price worth paying for a little discomfort now?๐Ÿ˜‰

Cheers, John

Edited by member 16 Mar 2020 at 13:33  | Reason: Not specified

User
Posted 16 Mar 2020 at 15:25

Well, luckily (or unluckily depending on POV) the last 12 months have been weekly to Paris. So lounge access is great, early boarding - check, but not much else to recommend airports, other people (all other people) and Paris outside food etc ;-)

User
Posted 16 Mar 2020 at 15:52
My son has been to Paris twice in the last few years for uni sport competitions and he basically describes it as Birmingham with Baguettes :)
User
Posted 16 Mar 2020 at 17:17

Yes - pretty accurate description! 

User
Posted 16 Mar 2020 at 21:02
I love Paris but John doesn't enjoy being there at all. I need a man to go with, preferably with a prostate ๐Ÿ˜‚
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Mar 2020 at 15:04

Why do you need a prostate for Paris?!? ;-)

User
Posted 17 Mar 2020 at 16:39

Do you need diagrams and animations with sound effects? :) :) :)

User
Posted 17 Mar 2020 at 16:43
Sound effects are against the forum rules
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Mar 2020 at 20:28

It might add interest as we are all having to become antisocial!

 
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