Yet another prostate question

[Nemo2]

the word "postrate"

That's a word?

 

[marko]

That's a word?

No, it isn't. But in almost every verbal discussion I've had on the subject someone says either "prostrate" or "postrate".

Might be a regional thing, not sure.

 

[Nemo2]

No, it isn't. But in almost every verbal discussion I've had on the subject someone says either "prostrate" or "postrate".

Might be a regional thing, not sure.

"Ah Ha", he postulated.

 

[SecondCor521]

That's a word?

I think it's up to fifty-five cents for first class these days.

 

[Nemo2]

I think it's up to fifty-five cents for first class these days.

I haven't mailed a letter for eons.

 

[razztazz]

"Ah Ha", he postulated.

Shouldn't that be "postrulated?"

 

[braumeister]

I would guess that 90% of all the times someone has mentioned it in my hearing, it was pronounced "prostrate" with the extra R.
In the same category as the multitudes who say "nucular" instead of nuclear. Certainly not worth getting excited over, just mildly annoying.

 

[Nemo2]

I would guess that 90% of all the times someone has mentioned it in my hearing, it was pronounced "prostrate" with the extra R.

Maybe they'd just fallen flat on their......?

 

[SteveNU]

Had mine a week ago today......catheter is a (temporary) PITA......but I've had no discomfort and have taken no pills.

So far, so good.

I made it through the night. Not bad, just waking up to take the meds as needed. Took out the catheter this morning and was able to pee a little so hoping it just gets better from here on out.

They gave me some tramadol for the pain but I only took a few and I'm done with them. Another pill for the burning sensation but it is not that bad so I stopped that one also. I do have to take an antibiotic for three days and continue the flomax for a few weeks.

Feeling a bit nauseous this morning but I've been laying in bed for the past 24 hours and just hoping it's due to the anesthesia. Now that the catheter is out I'm up and about feeling a little better.

Drinking a lot of water and waiting for the first big pee!

 

[erkevin]

Here's the extreme that we are all trying to avoid:

https://www.mirror.co.uk/news/world-news/doctor-sucks-800ml-urine-out-20927544

 

[MRG]

Here's the extreme that we are all trying to avoid:

https://www.mirror.co.uk/news/world-news/doctor-sucks-800ml-urine-out-20927544

There's an old joke about that. The punch line is "Doc says your gonna die".

 

[Nemo2]

I made it through the night. Not bad, just waking up to take the meds as needed. Took out the catheter this morning and was able to pee a little so hoping it just gets better from here on out.

They gave me some tramadol for the pain but I only took a few and I'm done with them. Another pill for the burning sensation but it is not that bad so I stopped that one also. I do have to take an antibiotic for three days and continue the flomax for a few weeks.

Feeling a bit nauseous this morning but I've been laying in bed for the past 24 hours and just hoping it's due to the anesthesia. Now that the catheter is out I'm up and about feeling a little better.

Drinking a lot of water and waiting for the first big pee!

Wow...I must have been one of the relatively lucky ones, (I say 'relatively' 'cos if I was really lucky I wouldn't have required the procedure in the first place )..........no pain, took no pills of any kind at any time, no '24 hours in bed', no nausea...just, (as Phil Collins might say) "another day in paradise".

Oh, error in my post #49.....procedure was two weeks ago, not one.....how soon we forget.

 

[skipro33]

I get a DRE every year. Luckily for me, my doctor is a tiny Chinese woman. Very narrow fingers. Whew!

 

[bmcgonig]

Any club that would have me as a member, I don't want anything to do with! (Groucho Marx). Yet, here I am.




+1 I was a normal 1.0 until a UTI 10 years ago. Since then I've been about 10 or 11. Uro and I have agreed that it is a false high. Had a negative biopsy 6 years ago which almost killed me by way of a subsequent sepsis infection; 8 days in the hospital, one month on antibiotics. DW says she will kill me herself if I go for another biopsy, negative or otherwise. Been learning about MRI doing a safer investigation.

I've been doing a lot of research lately as my PSA was elevated. There are a couple of biomarker tests that are very useful in excluding aggressive cancers. One is the 4k test and the other is SelectMDx. They are 95-97% accurate in excluding them. You might still have an indolent cancer but you don't need to worry about them.

The multi parametric MRI can also be very useful in finding or excluding cancers. However it's recommended you go to the most experienced radiographers and radiologists. At best it's 80% accurate I believe. It's more popular in Europe than in USA cos MRI is cheaper in Europe. Also if your MRI is positive it gives the urologist a target for the biopsy. Otherwise they're just throwing darts at your prostate randomly during a biopsy. It's really not very accurate.

The sepsis is almost exclusively the problem in transrectal biopsy. However many urologists now are only doing transperineal biopsies, avoiding the rectal passage entirely therefore practically eliminating infection. They were normally done using general anesthesia, but recently they have come up with a way of doing these under local anaesthesia. Google PrecisionPoint for info. Interesting point is that the percentage of people getting sepsis is actually rising every year from transrectal biopsies because of antibiotic resistance.

I listened to a Peter Attia podcast and he interviewed the urologist that operated on Ben Stiller. His algorithm for troubleshooting high PSA was:

1. 4k test. If negative, go home. (SelectMDX is newer test and might actually be more accurate). If positive then
2. MpMRI. If negative then measure PSA density. That's the prostate volume in cc divided by PSA. If negative and PSA density is less than .15 then go home.
3. If mpMRI positive or PSA density ≥.15 then biopsy.

So if you're being tested and want to avoid biopsy do the 4k or SelectMDx and/or the MRI depending on how thorough you want to be. And definitely find someone that does TP Biopsy if you need one.

One thing I learned is that every urologist is different. Some want to jump to biopsy straight away. Others take a more cautious approach. The problem with testing everyone for PSA was that too many people were going for biopsies and too many people were being treated for minor cancers. I think following the above steps allows you to get the PSA test without too much risk of that. At least that's my approach.

Of course a lot of above might not be covered by insurance. But the 4k and SelectMDx are only about $300 plus a visit to urologist.

 

[braumeister]

1. 4k test. If negative, go home. (SelectMDX is newer test and might actually be more accurate).

I have considered the 4K test, but you have to go to a specialized clinic for it and the closest one to me is over 100 miles away. I haven't worked up the ambition yet.

 

[bmcgonig]

I have considered the 4K test, but you have to go to a specialized clinic for it and the closest one to me is over 100 miles away. I haven't worked up the ambition yet.

My amygdala is probably larger than my prostate so I'll definitely drive the 100 [emoji16]

 

[marko]

I've been doing a lot of research lately as my PSA was elevated. There are a couple of biomarker tests that are very useful in excluding aggressive cancers. One is the 4k test and the other is SelectMDx. They are 95-97% accurate in excluding them. You might still have an indolent cancer but you don't need to worry about them.

The multi parametric MRI can also be very useful in finding or excluding cancers. However it's recommended you go to the most experienced radiographers and radiologists. At best it's 80% accurate I believe. It's more popular in Europe than in USA cos MRI is cheaper in Europe. Also if your MRI is positive it gives the urologist a target for the biopsy. Otherwise they're just throwing darts at your prostate randomly during a biopsy. It's really not very accurate.

The sepsis is almost exclusively the problem in transrectal biopsy. However many urologists now are only doing transperineal biopsies, avoiding the rectal passage entirely therefore practically eliminating infection. They were normally done using general anesthesia, but recently they have come up with a way of doing these under local anaesthesia. Google PrecisionPoint for info. Interesting point is that the percentage of people getting sepsis is actually rising every year from transrectal biopsies because of antibiotic resistance.

I listened to a Peter Attia podcast and he interviewed the urologist that operated on Ben Stiller. His algorithm for troubleshooting high PSA was:

1. 4k test. If negative, go home. (SelectMDX is newer test and might actually be more accurate). If positive then
2. MpMRI. If negative then measure PSA density. That's the prostate volume in cc divided by PSA. If negative and PSA density is less than .15 then go home.
3. If mpMRI positive or PSA density ≥.15 then biopsy.

So if you're being tested and want to avoid biopsy do the 4k or SelectMDx and/or the MRI depending on how thorough you want to be. And definitely find someone that does TP Biopsy if you need one.

One thing I learned is that every urologist is different. Some want to jump to biopsy straight away. Others take a more cautious approach. The problem with testing everyone for PSA was that too many people were going for biopsies and too many people were being treated for minor cancers. I think following the above steps allows you to get the PSA test without too much risk of that. At least that's my approach.

Of course a lot of above might not be covered by insurance. But the 4k and SelectMDx are only about $300 plus a visit to urologist.

Thank you for this and doing the research!! I'm printing it out for reference. My next Uro visit is in two weeks.