Posted 7/3/2020 10:38 AM (GMT -6)
hope all is well with evryone
Well biopsy results in-dissapointing but still good
first little history
Due to slightly high PSA(4.3, no prev screening) referreed to Uro. found nodule and recomended biopsy(1/12 g65%).Switched Uro to Penn Med in Phila did MRI,CAT,chest Xray and bone scan all good. recomend AS. After 2nd biopsy(neg) switched to another Uro in Penn(dont 1rst fully on board with AS). Saw an an RN under another Uro(Dr Wein). Little conerned at first but very thorough and answered questions well(qucikly got to the meat of my concerns) so continueing to see. At third biopsy PSA uptick(round 3.2 to 4.2) biopsy results 1/12, G6<5%, several show chroni and accute inflamation inflamation, need to get urodynamic then appt with Dr wein afterwards, Have regular 3mo appt with RN
Currently AS-PSA and appt evry 3Mo, MRI and biopsy annual
Am experiencing urinary symptoms
DRE-2/18-nodule,6/18 and 1/20 slight induration
PSA-init 4.3 down to 3.0 to 3.5 for 1.5yr uptick to 4.2 on 6/20
MRI 6/18 and 1/20- same pirad2 no focal lesion BPH indicated
BX-4/18 1/12 G6(5%) right apex,6/19 12core neg,610 1/12 G6(<5%) left apex, several cores show acute and chronic inflamation
urinary flow issue uroflometry 2 to 3 ml/min avg based on 2 test, PVR 63 and 2ml-empty bladder sufficiently
So the biopsy was a dissapointment was hoping for neg but thee good thing nothing new was found and was similar to original biopsy.. same thing found but in a different but adjacent location also reported as <1mm(5%) which I interpret as its ther but cannot measure tha amound very well cause it is so small.. Also cause it is in an adjacent location from first could be part of what was originally found. The other interesting difference is the original Uro found a nodule but those at penn are finding a slight induration??. No other test indicat the presence of a nodule or focal lesion. The other good news(kind of) is the presence of inflamation(explain PSA uptick).
They want a urodynaic-no specific reason given just want more info on urinary issue. prescribed flowmax started in june.
Will have appt with Dr Wein to discuss plan further. Would like to be able to spread biospy out further if safe to do so. Been told that if biopsy continue to show low risk protocol allows for doing biopsy every other year but have not been told specific criteria other than want to see at least 3 biopsy
So any comment on biopsy issue, any questions or comment I should be makeing on this issue in my upcoming appointment. Also what can I expect on dealing with the inflamation issue(typical treatment and success).
Finally on the urinary issue this is something I have had more or less most of my adult life. have always been one to have to get up a couple tiem a night. during the day not much of a problem typically do not have sudden and strong urges(except when drinking beer or too much coffee). Will typically go 2 to 4 hr before I really have to go although due to coffe may be erratic and more often in morn. now will get up 3 or 4 nights to go. its not urgency but the sensation I have to go keeps me up. Also If I eat certain foods at night(ice cream) can be more of a problem.
If I drink beer any time during the day I will have this feeling that night which will keep me up.
So not sure what I can expect on urinary issue. maybe bladder is overactive or sensitive. So any insight and question to ask doc at appt
Right now need to set appt for urodynamic and once done will do appt with Dr Wein.
As always thanks much for anyinsight-always get good feedback here
Hope all is well with everyone