Chronic right hydrocoele with resolving left orchitis/Prostatomegaly
He is feeling relieved with medicines and his scrotal swelling has reduced to almost 80% now, but still 20% exist Meanhile, his CBC is wnl, Urine R,M is normal Urine CS - Awaited S. PSA is 8.5 (Reference range is <4) Kindly guide further in treatment for this patient?
Epididymoorchitis usually require long term antibiotic therapy Continue antibiotic for 2 - 3 weeks There is likely to be accompanying prostatitis, therefore PSA is raised Please do per rectal examination to feel the prostate, nodularity, hardness and tenderness If per rectal examination do not suggest hard and nodular prostate, then he can be managed conservatively and PSA test repeated after 1 - 2 months
It is obvious Dr.Ajitji to have elevated PSA. One herbal medicine i remember of my experience.. FORTAGE + BANGSHIL..( Alarsin). This medicines my Late father and Principal, BHU has suggested me to practice some 50 years back..I prescribed in hundreds of pts and find 95 % results without Alpha blocker.
Pt is 64 yrs of age Having BPH and raised PSA Chr orchitis with hydrocele resolving as per history In my opinion no hydrocele can resolve completely rather recurrence are there In this age rather trying conservative i will suggest for surgical intervention TURP Consistent bph is cause for infection and a future malignancy as PSA indicates
It will take time for COMpLITE recovery Ruleout mycobacterium tuberculosis inf Cont orapenum 7day Wieght urine cul sens
NEED'S.. HEMOGRAM.. URINE ROUTINE AND..C &S EXAMINATION.. CTCE STUDY ABDOMEN.. HPE..STUDY..
When the prostatic volume is high, a higher PSA value is accepted/acceptable. Clearly the orchitis was secondary to retrograde infection and also UTI. So it is advisable to wait for 3 weeks and repeat the PSA total and free.If the psa is still high, a u/s guided multicore prostate biopsy is advised. Further treatment for prostate will be decided by the HPE report.
Usg abdomen Previod urine Post void Wt of prostate 25 gm normal Color Doppler sos biopsy HP
P S A is more we can go for prostatectomy for HPE if Malignancy then Chemotherapy + Radiotherapy
Rx Galo ghan tab 1bd Bangshil tab 2bd Fortage tab 2bd Kanchnar guggul 2bd SH tab 1bd for 4 to 6 weeks
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Case continued, check attached case below So this is a case of Hydrocoele, when I did transillumination test, it came out to be positive Urine R,M and CBC is WNL He compalints of mild pain while urinating, and admits left scrotum decrease in size and increase to the size as shown, not more than shown size Right testicular pain is resolved now I have ruled out testicular torsion, epididymitis, varicocoele. So give me your opinion regarding managing this case of hydrocoele? Do we need a conservative one or a surgical approach for this? Also tell me about scrotal support, which would be best?
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