Fight Prostate Cancer
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Bladder problems - a warning?

Hi, I am a newbie on this board. I'm 68 and have been on PSA watch for about 4 years with 6 monthly blood PSA tests. My PSA levels tend to bounce around at bit with highest about 12 and lowest 6. My consultant urologist has told me I have an enlarged prostate (golf ball size vs walnut size) but the biopsy was clear. That was 3 years ago and my GP has been asked to refer me back if PSA >8.

I also have a rare blood cancer (essential thrombocythemia) and on a recent blood test for that it showed PSA of 8.2 - so probably borderline. I need to drink 2-3 litres of water a day for the ET, but I find I am always needing to pee - probably 12-15 times per day and increasing. My bladder area also feels quite tender.

I am generally in good health, but getting a bit concerned about the bladder problem. I would appreciate any advice or your experiences if you have been there too.

Thanks

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Hi there. It appears that since your prostate is enlarged but biopsy negative that you have Benign Prostatic Hyperplasia, BPH. Because of it's size your prostate is causing an obstruction, like a dam, at your bladder neck. This may cause a larger amount of urine to stay in your bladder even after taking a pee. This means that when the pressure in your bladder goes higher, you'll want to pee, but it's like water over a dam. This will happen frequently as the pressure in your bladder will not drop to nothing.

Taking into account that acid urine is staying around in your bladder which might cause some inflammation, along with the pressure. This could explain the tenderness.

Additionally some urine may be pushed out of your bladder because of the pressure. This may be pushed through the bladder neck (upper) sphincter but not your lower (prostatic) sphincter, I.e. it's going into your prostate and may be causing prostatitis, inflammation of the bladder and could be causing your raised PSA.

I'm not a doctor, but what I describe is quite common. If it not already happened ask your doctor or preferably a urologist to test you for LUTS (Lower Urinary Tract Symptoms) or Prostatis.

Such symptoms could be treated with alpha blockers or if very severe a Trans Urethral Resection of your prostate which would reduce the size of your prostate without the consequences of a radical prostatectomy, (complete removal of the whole gland).

Like I say I' not a doctor but have experience of this phenomenal

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Thanks that's really helpful. I will raise the question with my GP once the flu season is over

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Hi, I agree with what Timz has said but would like to add that there is another procedure other than TURP called Urolift which, as it sounds, is a procedure to move the prostate out of the way without the need to resect it. You might have to hunt around for a urologist who does this and check with them your eligibility. Maybe worth checking this out. There are videos on YouTube about this procedure (and TURP).

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Thanks for the additional information. At the moment the need to pee frequently is a nuisance rather than a problem, so provided there are no medical issues I will stick to the 'watch and wait' approach. It's still good to be informed though - forewarned is forearmed s they say.

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You Indicated " My consultant urologist has told me I have an enlarged prostate (golf ball size vs walnut size) but the biopsy was clear." Did you have a biopsy of the prostate performed? My urologists kept telling me I didn't have PCa , only an enlarged prostate. I wanted to know for sure if I had PCa so, I had a biopsy performed and , YES I had prostate cancer, with a Gleason score of 4+3 =7.

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Yes the biopsy was on the prostate itself and the consultant assured me that all samples (8 I think) were clear and do was the ultrasound scan.

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The "urologist" sounds great! But if you don't want any surgery you might want to try the alpha blocker. I had chronic prostatitis for 7 years and took one tablet a day and Saw Palmetto a herbal remedy. That kept the inflammation under control.

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Excellent responses.

Part of you issue is simply the amount of water you need to drink. A 200ml batch of urine is,a reasonable amount when awake. That means 10 urinations a day for the extra water.

Half a teaspoon of bicarbonate of soda in a glass of water would make your urine more alkaline which might irritate things a bit less.

Urolift is a good suggestion. There are also laser versions of TURP ("Green light laser" is one) which cause much less bleeding.

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