Enlarged Prostate Gland

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exiledred
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Joined: Wed Oct 01, 2014 2:09 pm
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by exiledred on Thu Nov 05, 2020 4:08 pm

Enlarged Prostate Gland

Hi
Back in 2018 while an inpatient at Chesterfield Royal Hospital with an unrelated problem I found out I had an enlarged prostate. Not unusual as I am now 79 years old.

Subsequent examinations proved it to be benign until March this year when an examination revealed a nodule.

My Consultant told me that the only way to establish if it was cancerous was to have a biopsy. She then listed the problems that this could cause. She told me I could contract sepsis. As I have had this twice I declined a biopsy.

Then 2 weeks later lockdown.

I have had 2 telephone reviews in June and September. My PSA reading in September was 14.

Covid permitting I will see my Consultant next March for a further examination a PSA blood test. Maybe an MRI.


Do the risks of a biopsy outweigh the possibility of me having prostate cancer?


Thank you.

Norman Martin

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Mr Benjamin Challacombe
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Joined: Mon Nov 12, 2012 2:41 pm
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by Mr Benjamin Challacombe on Sun Nov 08, 2020 10:28 pm

Re: Enlarged Prostate Gland

Norman
If you have had 2 biopsies previously then i wouldn't have another at this stage.
An MRI would be a very sensible thing to do if they can manage it.
Prostates above 100cc often will result in a high PSA due to the benign growth and the urinary symptoms. This can be up to around a level of 20-30.
The biopsy can cause bleeding and infection and yes rarely sepsis.
In your situation it would only be indicated if a large abnormality was found on an MRI.
and the biopsy in that case should be via a trans-Perineal rather than the old fashioned trans Rectal route.

Ben
Mr Benjamin J Challacombe
Consultant Urological Surgeon and Honorary Senior Lecturer

http://www.talkhealthpartnership.com/on ... acombe.php

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Dr Prasanna Sooriakumaran
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Joined: Tue Oct 30, 2018 12:30 pm
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by Dr Prasanna Sooriakumaran on Tue Nov 10, 2020 2:40 pm

Re: Enlarged Prostate Gland

Dear Norman

I'd recommend an MRI first. And then a trans-perineal prostate biopsy ONLY if the MRI is abnormal.

Cheers

PS
scastle@santishealth.org
Dr Prasanna Sooriakumaran
Consultant Urological Surgeon

http://www.talkhealthpartnership.com/on ... umaran.php

exiledred
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Joined: Wed Oct 01, 2014 2:09 pm
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by exiledred on Thu Nov 12, 2020 3:42 pm

Re: Enlarged Prostate Gland

Thank you for your reply.

Is the biopsy you mention done under a general or local?

Regards

Norman Martin

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Mr Benjamin Challacombe
Posts: 120
Joined: Mon Nov 12, 2012 2:41 pm
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by Mr Benjamin Challacombe on Sun Nov 15, 2020 11:58 pm

Re: Enlarged Prostate Gland

Almost always best to do a trans perineal biopsy
this can now be done under local anaesthetic in many centres

https://pubmed.ncbi.nlm.nih.gov/30431694/
https://doi.org/10.1111/bju.14620
Hopefully these links from our unit will work and explain it more

Ben
Mr Benjamin J Challacombe
Consultant Urological Surgeon and Honorary Senior Lecturer

http://www.talkhealthpartnership.com/on ... acombe.php

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