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Vasectomy
I had a vasectomy about 3 months ago with no initial problems.
However when I last had intercourse with my wife (today) I noticed quite a large amount of a browny in appearance substance (blood I assumed) in my semen.
Obviously a little concerned as this has never happened before.
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I have just been diagnosed with prostate cancer
I had a TURP for bladder obstruction five weeks ago. I had had symptoms for three years. The doctors thought I might have to self catherterise after the operation because my bladder muscle had been so stretched. But I have managed to almost empty my bladder so that worry is over.
This week I went for a scan to check I was still emptying my bladder. The nurse told me that my notes said I had cancer. This was the first I'd heard of it and I was very surprised that I had not been told in the five weeks since my operation. The nurse said is was "low risk". Yesterday I phoned my consultant's secretary she was shocked at how I was told and got a nurse specialist to phone me back. He insisted there was nothing unusual in the way I have been told.
He told me that I have Gleason score 3+4 but my PSA is <10.
I have an appointment next Tuesday where I hope to discuss what should be done about it.
In the mean time my wife and I are very anxious. Please could you let me know what kind of treatment I should have - (I want this cured) and also whether it was right not to tell me for 5 weeks.
Thank you.
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The effect of returning testosterone levels on PSA levels.
In late Feb ’09 I had a supra pubic prostatectomy to reduce the size of a very large prostate (>100 cucm). Also, during the 6 months prior to this, two PSA tests showed a rise from typically 7.8 to 13. A Gleeson 2+3 tumour of < 1cucm was found in the removed tissue. However PSA tests on 5 May 09 and 3 Jun 09 gave levels of 1.02 to 1.2 respectively. As a result the urologist (in Greece) put me on injected leuprolide (Elityran) 3.75mg monthly and bicalutamide 50mg once daily. The treatment was continued in spite of a negative CT scan result later in June. After 3 months my PSA went to 0.024 and to virtually zero 3 months after that and he said I should stay on this treatment ‘for life’. I returned to UK permanently in Jan ’10 (just after the last injection) and the private UK urologist suggested coming off the medication and having a MRI scan and 4 point biopsy via the bladder. Thus I was on the treatment from early Jun 09 till Jan ‘10 (injections) and pills till late Feb.
The scan and biopsies were negative. My next PSA in July was 0.5. My sexual function has been returning and is back to normal or thereabouts. The 3 monthly PSA tests which will follow with the next one on Oct 12th could in my view be influenced by returning testosterone. The new reduced prostate size means that the new base PSA level can now only be established if and when repeated test levels stabilise. I consider that without knowledge of testosterone level movements, any continuing PSA increases could suggest either a remnant of cancer or still increasing testosterone levels, or both. I suggested to the NHS urologist that testosterone tests should start along with the PSA test in Oct., but he said this wouldn’t be part of any normal procedure. With the double tests, if the Oct. and Jan ‘11 results show an increase, but the testosterone was by this time stable, then the first indication of a problem would be in place at that time, ie, Jan. In this way, if the PSA figures continue to increase then action presumably would get started earlier in 2011 than would be the case with PSA tests only.
Do you agree with this theory and if so how should I go about getting a test and are there inappropriate test types, eg, for body builders?
I wrote to you in early July about a progressively reducing urine flow after a bladder neck incision and Dr. Shergill said he was interested to know the outcome. The flow stabilised 9 weeks after the op. at well under 4ml/sec. The urologists expected that the cut tissue would become less swollen and the flow would gradually increase. It is now typically 4.5ml/sec (4 ½ months after op.) and probably still rising. I did not get an infection resulting from the low flow having followed the advice you gave.
Also, on 6th Oct I received an email requesting feedback on your service, and can say I am very satisfied.
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discomfort in the prostate area ( between the scrotum and rectum
Last year I starting have some discomfort in the prostate area ( between the scrotum and rectum ). It was becoming uncomfortable to sit. It wasn't painful, just uncomfortable. It went away but has now returned,I have had it for the last 6 weeks. I have been to my local doctor who sent me for a PSA blood test but did not exam me. The PSA result was good.
I still have this discomfort that some times is like burning, that also radiates into the top of my legs .As quick as it comes it then goes.
I Do not have to go to the toilet in the night and do not have burning sensation, my urine flo is good.
It is worse when I sit down.
After a night sleep it goes but builds up in the day
I take Ibuprofen to get through the day
I am a 50 year old male,I do not smoke or drink alcohol
Can you advise
thanks
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