78 Years Old, Urinating Every Two Hours Or Sooner, Starts

Posted on Tue, 12 Mar 2019

Question: 78 years old, urinating every two hours or sooner, starts dribbling at urge, very little pressure. Pass six months unable to obtain erection. Going to urologist every six months but very little results. Had UrOLift fitted 7 months ago but I believe that might me the reason I dribble now? The only heart medication I take is metoprolol succinate 50mg 24 hr tablet. It was for short of breath 5 yrs. ago, no problems now.

Is there anything I can do to improve my present situation?
Thank You, XXXXXXX

Answered by Dr. Bhagyesh V. Patel (1 hour later)

Brief Answer:
nervous system and hormone related factors.please give details.

Detailed Answer:
Hello XXXXXXX
Welcome to Ask A Doctor service.
I have read your query and here is my advise.

* As per my surgical experience, the issue of incontinence with erection disturbances is a
multi factorial problem involving nervous system, hormones and tissue structures.

Kindly provide me further details so that I can answer your query completely.

1. Details of symptoms before the procedure of urolift.
2. What is the level of symptomatic improvement with finasteride and tamsulosin intake
3. Any recent report of ultrasound depicting prostate size if available ?

Awaiting for your response.
Regards.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Bhagyesh V. Patel (27 hours later)

1. Symptoms before urolift were the same as now, except I wasn't dribbling at the urge of urinating.
2. Level of improvement with finasteride and tamsulosin intake I feel very little improvement if any. I have been taking these for several years.
3. No report of ultrasound. Just physical exams stating enlarged prostate. My PSA test was 2.3 about 1 year ago and I was not diabetic.

Answered by Dr. Bhagyesh V. Patel (50 minutes later)

Brief Answer:
Neurology is involved.need uroflowmetry and ultrasound test.

Detailed Answer:
Hi Kanthony
Thanks for the relevant details.

* The current symptoms sound to be more of neurology related more and lesser
contribution of prostate enlargement as there is not much results with prostate
medicines.

* My guidelines for further directions

- Need uroflowmetry and ultrasound examination after prescription from your urologist
to establish the reason of the incontinence.
- Till the time, work up is carried out,
do deep breathing exercises with voluntary spasm of anal sphincter for the maximum
time period and later exhaling the air
which will help most to control the urination and internal sphincter functioning.

- Avoid to get hard stools and constipation with the help of high fiber diet.
- Remain ambulatory and do regular physical exercises of acceptable physical level.
- Avoid stress and anxiety.
- YOGA will also help in some way on long run.

Would like to discuss further as per your need.
Take care.

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Above answer was peer-reviewed by : Dr. Vaishalee Punj