Queried Prostrate Problems

[Truss]

Hi, My 82 year old father, who is cathiterised, called out his Dr three weeks ago and after examination was told he had constipation. The following morning his testicles were greatly enlarged, I phoned the surgery who recommended an admission to A&E which went ahead. The A&E doctor prescribed trimethoprim for two weeks with an ultrasound scan follow up. The Dr at A&E asked if he had had a prostrate check, to which my father replied yes (not sure about this because he was a bit toxic at the time so I dont believe this check was recent). The dr then said he would not do another one but was 99% sure his current problem was prostrate related. The scan went ahead and the doctor who scanned said the report would go back to his GP but there was no problems. What I need to know is did the ultrasound check the prostrat - they only scanned his testicles, I was in the room but remain unclear as to why the prostrate has not been checked. Should I follow this up? or will the scan have checked his prostrate?

[Philippa Aslet]

Prostate problems in men of your fathers age are common but not necessarily anything sinister or anything to worry about. Men can need a urinary catheter for a number of reasons. There is a risk of developing infections when you have a long term urinary catheter.
An ultrasound of the testicles would not include the prostate. You would not routinely ultrasound the prostate in the scenario you describe.
Once any infection is treated with the antibiotics your fathers symptoms should settle. If you remain concerned then a visit to your GP may help resolve any other worries.

[Dr Jon Rees]

Hi

I would agree with Philippa - men with catheters are prone to infection and this can spread from the bladder to the testicles causing quite dramatic swelling and discomfort. Provided all is settled with the antibiotic he was given, nothing more has really changed from before this episode. I would hope his prostate was adequately checked when he had his catheter inserted...

[Mr Christopher Eden]

Your father had a urinary infection as a result of his catheter, which is not uncommon. The infection back-tracked along the sperm carrying tube (vas deferens) into the testicles, causing swelling and pain. The role of the ultrasound was to exclude malignancy (cancer) in the testes. The prostatic enlargement is really a separate issue and can either be treated with a keyhole operation (TURP) if your father is fit enough or by long-term catheterisation if he is not. He needs to drink more to reduce the risk of future infections. Antibiotics will take care of his testicular infection.