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Hello all. Concerned, and after some advice

User
Posted 12 Mar 2024 at 08:05

Hello all. I’ve just turned 46. Eight years ago I was diagnosed with Prostatitis, though no DRE or PSA test was done. I was prescribed two weeks of antibiotics and the symptoms - primarily frequent need to urinate and feeling as though bladder had not completely emptied - cleared up.

I would say that I have always urinated slightly more than average, but not significantly so. In the intervening period I’ve had no other issues or obvious symptoms.

Fast forward to just before Christmas and I noticed that I started to wake up once in the night needing to pee. Not every night, but probably two or three times per week. I thought nothing more of this other than it being part of the aging process.

Then, about three weeks ago, I very suddenly experienced the development of a range of symptoms, particularly:

- Frequent need to urinate, particularly during the day. Feeling as though I needed to pee again almost as soon as I had finished.

- Slight increase in night time urination, waking up once or twice at night, every night.

- occasional burning sensation in urethra after urination.

- Uncomfortable feeling in perineum. Not really a pain, but almost like a pinching sensation. 


All of these came on very suddenly. I.e., 4 weeks ago none of them were there but then, in a matter of days, all were present.

I visited the GP who said that he thought it was likely a UTI or recurrence of Prostatitis. He prescribed two weeks of antibiotics and took a urine culture sample which came back as negative.

I completed the course of antibiotics yesterday. There has been some improvement - or at least there was until yesterday.

Whilst there was still a sense of needing to urinate even when I didn’t really want to go, I was able to comfortably ‘hold’ this for three to four hours. When I do go, the stream is not particularly hesitant in starting and does not have a noticeably decreased flow (when I haven’t been for a while). There was though still a bit of post completion dribble. I kept a log of when I went to the toilet and over the last few days was going around 7 or 8 times during the day, which felt about normal for me. On three of the last seven nights I woke up to pee once, the other nights not at all.

I took all of this as  sign that things were on the mend.

Then, yesterday, things were back with vengeance. Near constant feeling of needing to pee. Going lots. Because going frequently not much there, and so poor flow. Discomfort in right groin. 

Because the UTI test was negative, and the antibiotics haven’t worked, I am concerned that maybe there is something more serious going on and I know that PCa rarely presents with symptoms unless relatively well advanced which is worrying me sick. But then, would the symptoms come on so acutely so suddenly?

I’m very worried in could be prostate cancer and, if it is, the fact that there are symptoms might suggest it is already well developed. That scares me.

I’m really unsure what to do, and would appreciate any words of wisdom you good folks may have. Should I now insist on a PSA test, or given I ‘may’ have had in infection which I understand could raise PSA levels would the value of this be negated at this time?

one final bit of info, my dad has very recently been diagnosed with PCa, aged 65. I know this increases my risk profile, and so I will need to start with regular PSA Tests. I guess the question is, should I do this now?

Thank you. 

Edited by member 12 Mar 2024 at 08:37  | Reason: Typos

User
Posted 12 Mar 2024 at 16:03
A PSA test is sensible and provides a baseline for future monitoring. However, you need to leave a decent gap after the infection has been cleared - no point having a PSA test at this moment as the infection / inflammation will produce a higher than normal result.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 12 Mar 2024 at 08:05

Hello all. I’ve just turned 46. Eight years ago I was diagnosed with Prostatitis, though no DRE or PSA test was done. I was prescribed two weeks of antibiotics and the symptoms - primarily frequent need to urinate and feeling as though bladder had not completely emptied - cleared up.

I would say that I have always urinated slightly more than average, but not significantly so. In the intervening period I’ve had no other issues or obvious symptoms.

Fast forward to just before Christmas and I noticed that I started to wake up once in the night needing to pee. Not every night, but probably two or three times per week. I thought nothing more of this other than it being part of the aging process.

Then, about three weeks ago, I very suddenly experienced the development of a range of symptoms, particularly:

- Frequent need to urinate, particularly during the day. Feeling as though I needed to pee again almost as soon as I had finished.

- Slight increase in night time urination, waking up once or twice at night, every night.

- occasional burning sensation in urethra after urination.

- Uncomfortable feeling in perineum. Not really a pain, but almost like a pinching sensation. 


All of these came on very suddenly. I.e., 4 weeks ago none of them were there but then, in a matter of days, all were present.

I visited the GP who said that he thought it was likely a UTI or recurrence of Prostatitis. He prescribed two weeks of antibiotics and took a urine culture sample which came back as negative.

I completed the course of antibiotics yesterday. There has been some improvement - or at least there was until yesterday.

Whilst there was still a sense of needing to urinate even when I didn’t really want to go, I was able to comfortably ‘hold’ this for three to four hours. When I do go, the stream is not particularly hesitant in starting and does not have a noticeably decreased flow (when I haven’t been for a while). There was though still a bit of post completion dribble. I kept a log of when I went to the toilet and over the last few days was going around 7 or 8 times during the day, which felt about normal for me. On three of the last seven nights I woke up to pee once, the other nights not at all.

I took all of this as  sign that things were on the mend.

Then, yesterday, things were back with vengeance. Near constant feeling of needing to pee. Going lots. Because going frequently not much there, and so poor flow. Discomfort in right groin. 

Because the UTI test was negative, and the antibiotics haven’t worked, I am concerned that maybe there is something more serious going on and I know that PCa rarely presents with symptoms unless relatively well advanced which is worrying me sick. But then, would the symptoms come on so acutely so suddenly?

I’m very worried in could be prostate cancer and, if it is, the fact that there are symptoms might suggest it is already well developed. That scares me.

I’m really unsure what to do, and would appreciate any words of wisdom you good folks may have. Should I now insist on a PSA test, or given I ‘may’ have had in infection which I understand could raise PSA levels would the value of this be negated at this time?

one final bit of info, my dad has very recently been diagnosed with PCa, aged 65. I know this increases my risk profile, and so I will need to start with regular PSA Tests. I guess the question is, should I do this now?

Thank you. 

Edited by member 12 Mar 2024 at 08:37  | Reason: Typos

User
Posted 12 Mar 2024 at 08:41

Insist on PSA test! At the minimum this gives you a baseline marker. Two years ago I had similar symptoms, also having had Prostatitis years ago and some UTI’s often only found when urine was cultured. Dip stick did not show anything. My PSA was stable for years until I hit that wacky what is happening. The past two years my PSA started jumping up and down and although my urologist was not to worried, finally agreed to a MpMRI. Showed what was read as scarring from likely past prostatitis, however PSA continued like a yo yo, and he ordered a ExoDx urine test which showed I likely had a higher advanced Gleason score. By now 18 months had passed and decided to do a second MpMri, so it could be compared with the past one. It showed a .9X.5x.9 lesion. That led to a fusion MRI ultrasound biopsy which the lesion came back benign, however 5 of the other 12 cores had two 3+3, two 3+4, and one 4+4. Led to PSMA PET, however showing very mild SUV uptake with prostate. Awaiting Decipher genomic testing on the biopsy. Definitely get the PSA. Depending on result if low monitor annually, it not and if it’s really high then your Doctor obviously will be more concerned and if it just seems somewhat up to you, but the Doctor is not worried try to get him to agree to another PSA in three to six months if your symptoms continue. You know your body, be your advocate

User
Posted 12 Mar 2024 at 09:07

I would say GET a PSA test. If it is PCa then the sooner you know about it, the more options of treatment will be available to you. During COVID I should have gone to my GP, but you know….. When I did go post COVID my choices were restricted.

It will also give you piece of mind and I agree you should probably get checked regularly, I will be making sure my son does when he reaches an age.

Derek

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User
Posted 12 Mar 2024 at 08:41

Insist on PSA test! At the minimum this gives you a baseline marker. Two years ago I had similar symptoms, also having had Prostatitis years ago and some UTI’s often only found when urine was cultured. Dip stick did not show anything. My PSA was stable for years until I hit that wacky what is happening. The past two years my PSA started jumping up and down and although my urologist was not to worried, finally agreed to a MpMRI. Showed what was read as scarring from likely past prostatitis, however PSA continued like a yo yo, and he ordered a ExoDx urine test which showed I likely had a higher advanced Gleason score. By now 18 months had passed and decided to do a second MpMri, so it could be compared with the past one. It showed a .9X.5x.9 lesion. That led to a fusion MRI ultrasound biopsy which the lesion came back benign, however 5 of the other 12 cores had two 3+3, two 3+4, and one 4+4. Led to PSMA PET, however showing very mild SUV uptake with prostate. Awaiting Decipher genomic testing on the biopsy. Definitely get the PSA. Depending on result if low monitor annually, it not and if it’s really high then your Doctor obviously will be more concerned and if it just seems somewhat up to you, but the Doctor is not worried try to get him to agree to another PSA in three to six months if your symptoms continue. You know your body, be your advocate

User
Posted 12 Mar 2024 at 09:07

I would say GET a PSA test. If it is PCa then the sooner you know about it, the more options of treatment will be available to you. During COVID I should have gone to my GP, but you know….. When I did go post COVID my choices were restricted.

It will also give you piece of mind and I agree you should probably get checked regularly, I will be making sure my son does when he reaches an age.

Derek

User
Posted 12 Mar 2024 at 16:03
A PSA test is sensible and provides a baseline for future monitoring. However, you need to leave a decent gap after the infection has been cleared - no point having a PSA test at this moment as the infection / inflammation will produce a higher than normal result.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 12 Mar 2024 at 17:06

Good point

 
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