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  • blood in urine, rising PSA, second opinion?

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    Old 02-14-2009, 08:00 PM   #1
    Tung-Sol
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    blood in urine, rising PSA, second opinion?

    Two weeks ago I had bright red bloody urine in evening and dark ice-tea colored urine upon rising. Immediately called uro and went in that day. DRE was normal ... "small, smooth gland." He acknowledged I had a lot of blood in my urine. The bleeding stopped after about 9 days.

    Since I have history of stones, but no pain at the time, he sent me for CT/IVP with and w/o contrast. Results were "normal" although there are stones in my right kidney (been there for years) so he did a cystoscopy about 10 days later. Cysto was normal.

    During this time, before the cysto, I began to have a lot of urgency, like a stone attack might cause, but still no pain otherwise and no moving stone on CT anyway ...

    A few days before my primary care called to tell me my PSA had jumped from 2.3 to 3.4 over four months. We were watching it as it has bounced around from 1.8 to 2.3 then back to 1.7 and back to 2.3 over a year. Now the bounce to 3.4.

    Uro says he thinks the blood came from my prostate. However, he thinks the PSA jump is an error and said to repeat in two months. Although no signs in my urine of infection, he gave me three weeks of levaquin as I have had burning ejaculations, although no more lately than over the last 8 or so years. Four days into levaquin, urgency is still getting worse.

    Sorry, but the story is longer as 8-9 years ago I went through two biopsies due to similar event with a reported nodule, although no bleeding. No PC found. The third biopsy call came six months later so I went to see #2 guy at Johns Hopkins. He said PC does not present like this, he did not feel anything he would biopsy, go home, come back in a year, you have very low chance of PC. The following year he said you do not have PC, your PSA is fine, go back to a different uro.

    I have faith that my uro knows what he is doing. He is highly regarded and about 20 yrs. experience, but the 3.4 and increasing urgency just scares me. I have yet to ask my primary care what he thinks about all this, but will do so this week.

    I am considering taking my films, blood work, cysto results and PSA history to another uro for second opinion. Plus I think two months is a long wait to find out if the jump to 3.4 was just a one-off given I am 54 yrs. old and PC took my Dad at 65.

    Any thoughts on all this most appreciated.

    Thom
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    herniated L4-L5, free frag with footdrop approx. 6-30-03 with a month of lower back pain prior to that
    laminectomy/discectomy 07-14
    I have 5mm herniation of L5-S1 on right side that is asymptomatic, no surgery recommended

     
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    Old 02-15-2009, 11:27 AM   #2
    IADT3since2000
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    Re: blood in urine, rising PSA, second opinion?

    Quote:
    Originally Posted by Tung-Sol View Post
    Two weeks ago I had bright red bloody urine in evening and dark ice-tea colored urine upon rising. ...

    A few days before my primary care called to tell me my PSA had jumped from 2.3 to 3.4 over four months. We were watching it as it has bounced around from 1.8 to 2.3 then back to 1.7 and back to 2.3 over a year. Now the bounce to 3.4.

    Uro says he thinks the blood came from my prostate. However, he thinks the PSA jump is an error and said to repeat in two months. Although no signs in my urine of infection, he gave me three weeks of levaquin as I have had burning ejaculations, although no more lately than over the last 8 or so years. Four days into levaquin, urgency is still getting worse....Thom
    Hello Thom,

    Fortunately you have ready access to the wonderful resources at Johns Hopkins.

    From my savvy layman's perspective, the advice you are getting from your doctors looks right. Infections are often very hard or impossible to pin down, and they typically cause a PSA that will bounce around a bit instead of increasing in that tell-tale pattern that suggests prostate cancer. However, it is wise to remain vigilant.

    I hope you find something that works!

    Jim

     
    Old 02-15-2009, 06:55 PM   #3
    Tung-Sol
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    Re: blood in urine, rising PSA, second opinion?

    Thank you for your reassurance, Jim. Just what I was hoping to hear

    The urgency, and now actual prostate pain has progressed today, getting much worse. If this is prostatitis, the levaquin has not helped at all after five days. Guess I'll be calling my uro tomorrow.

    Thanks again,

    Thom
    __________________
    herniated L4-L5, free frag with footdrop approx. 6-30-03 with a month of lower back pain prior to that
    laminectomy/discectomy 07-14
    I have 5mm herniation of L5-S1 on right side that is asymptomatic, no surgery recommended

     
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