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172023 tn?1334672284

Prostate enlargement in 30 year old male

I have a
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242579 tn?1252111171
MEDICAL PROFESSIONAL
A TUIP is an incision of the prostate usually done when there is an elevated bladder neck which is causing obstruction to the flow of urine. This is done if on cystoscopy the bladder neck appears to be elevated but the lobes of the prostate are not enlarged.

If however the bladder neck appears normal and the patient still has obstructive symptoms it would also be advisable to perform urodynamic studies prior to surgery especially since
your husband had 500cc retained in the bladder after voiding 300cc.

A urodynamic study is more elaborate than a simple uroflometry and evaluates the bladder which may also be responsible for  poor urine flow.

This answer is not intended and does not substitute for medical advice- the information is for patient education only.





Helpful - 0
93532 tn?1349370450
Well, after the appt we are almost left with more questions than answer. My poor husband had to undergo a scope of his urethra as the doc was trying to rule out strictures due to past catheterizations (during his WPW ablation surgeries) and found nothing. He stated his prostate was unremarkable, which seems odd that only a week before a doctor who performs routine prostate exams found it to be grossly enlarged, especially for someone of my husband's age. Could the medication have caused the decrease in size? Doesn't seem appropriate to me, but i am not well versed on urology ; )

Anyway, the doc suggested increasing the meds from 2mg a day to 4 mg a day, giving it a week, if no change in urinary issues, increase to 6mg a day, and if after a week there is still no change considering surgery. His plan is to perform a TUIP. Now my husband had a vasectomy in Dec of 2006, so the damage to fertility is not an issue. And the prospect of not having to take meds for the next 50 years is appealing to my husband. He is actually somewhat excited about the idea of the retrograde ejaculation (men!).

I guess I just feel like something is being missed? It seems odd that we went from prostate to bladder neck? His flow test was horrible and he was left after voiding 300 cc's to still having 500cc's retained. Would it be reasonable to ask for a second opinion? Or is this a common occurence?

Thank you again for your input. I am so happy MedHelp was able to attract a specialist in this particular field and the timing could not be better.
Helpful - 0
242579 tn?1252111171
MEDICAL PROFESSIONAL
Yes, you are welcome to post here with the results.
Helpful - 0
93532 tn?1349370450
Thank you for you advice. Peek was posting this for me as I had my hands full with the kids.

He does have an appt with a urologist tomorrow morning. Our GP was quite astonished to find his prostate so enlarged (his words compared my husband's to that of an 80 year old). He has had no s/s of an infection, bladder or otherwise and the symptoms have been persisting for over a year.  I was hoping it would be something minor, but given the family hx, I was starting to worry about something more serious. It seemed so rare for someone of his age to experience these issues.

I had found in the course of my researching that PSA's weren't terribly accurate for men his age? Is that true? I am not quite sure what to doctor has planned for tomorrow, but my husband has asked that I go along in case he forgets to ask something or garbles the information. He has a slight reputation for doing that, sometimes i feel like I have 4 boys ; )

Would be okay to post here tomorrow after the appt to run things past you?
Helpful - 0
242579 tn?1252111171
MEDICAL PROFESSIONAL

Both prostate cancer and benign prostatic hyperplasia are relatively uncommon in this age group.

Small prostate cancers are present in 29% of men between ages of 30-40. Serum prostate-specific antigen (PSA) and Transrectal ultrasound (TRUS)-guided core needle biopsies are used to diagnose prostate cancer. Family history is a risk factor for the development of prostate cancer and the presence of one ,two or three affected family member increases the risk to first degree relatives by 2-5- and 11-fold respectively.


Bladder stones, and urinary tract infections, prostatitis and urethral strictures( narrowing of the urethral passage) or a neurogenic bladder are some of the other conditions which can cause the symptoms you describe.

This patient would benefit from a Digital Rectal Examination by a trained urologist, a uroflowmetry, possibly a cystoscopy and an abdominal ultrasound. Other investigations such as a PSA, or a urethrogram ( an X-Ray  study which shows the anatomy of the urethra) or a trans-rectal ultrasound can be then done at the discretion of the treating urologist.

This answer is not intended and does not substitute for medical advice- the information is for patient education only.

Follow-up with a urologist is essential.
Helpful - 0
93532 tn?1349370450
Thanks peek for copying this for me!! Hopefully I can get some ideas on what this could be or what could be causing this problem.

Helpful - 0

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