I am a little concerned about my brother's diagnosis and treatment. I have an opinion but I would like a second opinion so to speak.
He is aged 69. Two months ago he was admitted to A&E due to urinary retention for presumably an enlarged prostate. His GFR was 10. He was told he needed a TURP and discharged 2 days later with a catheter.
The only investigation he had whilst in the hospital was a DRE, blood test, and abdominal ultrasound.
Other than repeat kidney function tests, urinalysis, and a psa via a nurse at his surgery, he has had no face-to-face consultation since. The GP over the phone flatly refused to disclose his psa result saying it was too early. My brother assumed that was because of his serious urinary obstruction. He has since found via the nurse who took further bloods his psa was 8. That was 6 weeks after his hospital discharge.
Throughout the past 2 months, he awakens 4 times every night with pain indicating a full bladder. Once he stands up and tenses his abdominal muscles the largely empty night bag fills up. It flows in the daytime provided he does not lie down. Most times there are microclots in the bag. He had to phone 111 and go to a medical hub to get a catheter flush which did not work, so the catheter was changed. The above problems have persisted since then.
He is not one to make a fuss and just accepts the situation, despite my encouragement to pester the GP.
I am concerned on two fronts. Was the above hospital diagnosis adequate? Should he have received an MRI and subsequent biopsy? Could the medics be basing a diagnosis of bph on just prostate density and the abdominal ultrasound, and is this adequate? Is the urination difficulty and microclots a concern that should be investigated? He did mention this to the GP over the phone, but no concern was expressed.
I am worried that he may have prostate cancer, and that he has not been investigated fully. I am also worried that his catheter is not being managed properly.
The above is just a brief outline. I have not gone into all the details of how I feel he is not being properly treated. Should I be concerned?
D
Good Morning Dedalus
Your brother's issues are almost identical to mine, a visit to A & E - Low eGFR (Mine was 8) - the fitting of a catheter and the listing for a TURP. The only difference was my PSA was 182 and not 8. You can read the full 22 month story by clicking on the icon of the beach. My personal views - not medical views are:
* They are concentrating on returning his Kidney function to normal. Mine was only 58 out of 60, 12 months on.
* The blood in the urine is normal at first but should have cleared within 10 days. There should be no issue at night the night bag should fill up during the night provided it is at a lower level than the penis (common mistake!). Some further investigation is needed into the blood and the urgency to urinate at night.
* Catheter care is very important - he needs to roll back his foreskin (if he has one) every day and wash the area where the catheter enters the penis with cooled boiled water and remove any debris (there will be some!).
* His PSA is higher than normal for his age so it needs a proper investigation. They won't undertake a TURP without investigation so this needs to be sorted. You need to contact his GP or Urology department (Oh - the waiting list for a TURP in my locality was 2 years - mine was bumped up the list as I needed Radiotherapy and couldn't have this with a catheter).
* If your brother is resident in England I would urge him to download the NHS App and request FULL access to his medical records - you can then access all his results and diagnosis as the happen. You can find out was has gone on in the past too!.
* Yes - he need to get things sorted!
I hope this helps - If I can do anything else to help you please don't hesitate to contact me.
Best wishes - Brian.
Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm
Strength, Courage, Faith, Hope, Defiance, VICTORY.
I am a Macmillan volunteer.
Hello Dedalus
It's no problem, I hope you can get him sorted.
* Most G P surgeries will have a form of consent you can ask your brother to sign and you should be able to deal with his issues once this is in place.
* The G P Surgery will have a "Practice Manager". Ask for a meeting with them to air your anxieties. ( I had an issue with my G P - no patients with Prostate Cancer on HT and Type 2 Diabetic on the books - I was the first and they were clueless - Practice manager to the rescue - everything sorted now!!).
* If he's under a hospital they will have a PALS office. (Patient Advice and Liaison Service) use these to express your concern that he's not getting the treatment he needs and tell them it's causing stress and anxiety..
I hope the above helps.
Best wishes - Brian.
Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm
Strength, Courage, Faith, Hope, Defiance, VICTORY.
I am a Macmillan volunteer.
