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Prostate Cancer (Expert Forum)
Prostrate nodule
Answered by
Ash Tewari, MD, M.Ch. - Prostate Cancer, Robotic Prostatectomy, Urology, Oncology, Surgery
Weill Medical College of Cornell University
New York - NY
This forum is for questions about: Advanced or Metastatic Prostate Cancer, Biopsy, Bone Scan, Blood in Urine or Semen, Benign Prostatic Hyperplasia (BPH), CT Scan, Cystoscopy, Erectile Dysfunction, Hormone Therapy, Incontinence, Pain (abdomen, low back or hip), PSA Test, Prostatitis, Radiation Therapy, Rectal Exam, Recurrent Cancer, Risk Factors, Screening, Staging (Tumor size; Metastasis), Surgery, Transrectal Ultrasound, Urinary Difficulty or Burning, Urinary Urgency (Leaking), Watchful Waiting.
Prostrate nodule
by Karen621, Jul 21, 2008 07:48PM
My husband (55) has an enlarged prostrate with a nodule that develped last year. His primary doctor did the PSA and ordered an ultrasound. Both came back negative. Since then, he has become ill three time with what feels like a urinary tract infection--fever and frequent painful urination. He is allergic to the cillins and has trouble with all antibiotics so he has not gone to the doctor with the infections except for the current one. When his fever peaked at 102 the 3rd day in, he agreed to go to an urgent care center. They told him there was no sign of infection in his urine, though there was some blood. They gave him an antibiotic and something to relieve the pain of urination.
His primary doc told him he might be more susceptible to urinary tract infections and there's not much to do about it.
I'm concerned that my husband has these recurrent problems and that they did not find infection in his urine. His primary doctor does not seem to feel that he should see a urologist.
What should we be doing?
His primary doc told him he might be more susceptible to urinary tract infections and there's not much to do about it.
I'm concerned that my husband has these recurrent problems and that they did not find infection in his urine. His primary doctor does not seem to feel that he should see a urologist.
What should we be doing?
Doctor's Answer
by Ash Tewari, MD, M.Ch., Aug 13, 2008 06:01PM
, Aug 13, 2008 06:01PM
It is possible that your husband has a urinary tract infection. Some men with enlarged prostates can develop recurrent bladder infections. Symptoms of an enlarged prostate (called BPH) are urinary frequency, urgency, weak stream, frequent nighttime urination and possible urinary retention. There are medications he can take that can reduce the size of his prostate if it is part of his condition.
Another consideration is prostatitis. Prostatitis is the most common urologic diagnosis in men younger than 50 years and the third most common urologic diagnosis in men older than 50 years (after benign prostatic hyperplasia [BPH] and prostate cancer),
Prostatitis can range in its severity and level of bother to a patient. Although prostatitis may have more than one etiology, it is often considered bacterial until proven otherwise. There are three major categories of Prostatitis, but it is easier to think of them as two; acute and chronic.
Acute Bacterial Prostatitis
Acute Prostatitis is characterized by an acute onset of pain combined with frequent urination as well as difficulty in initiation of urination in a patient with fever/ chills and/ or achy joints. Patients typically complain of urinary frequency, urgency, and pain with urinating. Patients often also complain of pain in the groin, buttocks lower abdomen may have associated pain the genitalia.
Chronic Bacterial Prostatitis
The most important distinction between acute and chronic prostatitis is a history of documented recurrent urinary tract infections. 25% to 43% of patients diagnosed with definitive chronic bacterial Prostatitis had a history of recurrent UTIs
Chronic bacterial prostatitis is characterized by repeated episodes similar to acute prostatitis that come and go. Patients may be relatively asymptomatic between acute episodes pain, which was most commonly felt in the scrotum, buttocks and lower abdomen. Pain can also be felt in penis, groin or low back. Pain during or after ejaculation is one of the most prominent, important, and bothersome features.
Treatment for prostatitis involves antibiotic use, frequently for many weeks. It can also be very difficult to treat and some men require multiple treatments.
Although I cannot definitely diagnose your husband based on the information you relayed, these are some issues that can be considered which may explain your husband’s condition.
I think visiting a urologist would be prudent to adequately evaluate out his condition and if he has a similar episode as before, a visit to the ER is warranted.
Best.
Ash
Another consideration is prostatitis. Prostatitis is the most common urologic diagnosis in men younger than 50 years and the third most common urologic diagnosis in men older than 50 years (after benign prostatic hyperplasia [BPH] and prostate cancer),
Prostatitis can range in its severity and level of bother to a patient. Although prostatitis may have more than one etiology, it is often considered bacterial until proven otherwise. There are three major categories of Prostatitis, but it is easier to think of them as two; acute and chronic.
Acute Bacterial Prostatitis
Acute Prostatitis is characterized by an acute onset of pain combined with frequent urination as well as difficulty in initiation of urination in a patient with fever/ chills and/ or achy joints. Patients typically complain of urinary frequency, urgency, and pain with urinating. Patients often also complain of pain in the groin, buttocks lower abdomen may have associated pain the genitalia.
Chronic Bacterial Prostatitis
The most important distinction between acute and chronic prostatitis is a history of documented recurrent urinary tract infections. 25% to 43% of patients diagnosed with definitive chronic bacterial Prostatitis had a history of recurrent UTIs
Chronic bacterial prostatitis is characterized by repeated episodes similar to acute prostatitis that come and go. Patients may be relatively asymptomatic between acute episodes pain, which was most commonly felt in the scrotum, buttocks and lower abdomen. Pain can also be felt in penis, groin or low back. Pain during or after ejaculation is one of the most prominent, important, and bothersome features.
Treatment for prostatitis involves antibiotic use, frequently for many weeks. It can also be very difficult to treat and some men require multiple treatments.
Although I cannot definitely diagnose your husband based on the information you relayed, these are some issues that can be considered which may explain your husband’s condition.
I think visiting a urologist would be prudent to adequately evaluate out his condition and if he has a similar episode as before, a visit to the ER is warranted.
Best.
Ash
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