Should I Be Concerned About Urethral Dilatation For Discomfort In Urethra And Bladder?

Brief Answer: Try alkalinization of urethra Detailed Answer: Dear Ms. XXXXXXX Hi, Urethral dilatation in women is an extremely simple procedure, and consequently has been overdone by quite a few urologists all over the world as an attempt at reducing non-specific discomfort in urethra and bladder for which there is no apparent reason (Your tingling in bladder will qualify as such), the idea being that at least it will not harm, while it may be beneficial in patients who actually have a mechanical obstruction to the urine passage, which is extremely uncommon among well-educated women, especially in the western hemisphere. You unfortunately seem to have had significant discomfort after the procedure. this could be due to bladder spasms, which is probably why you might be feeling better after use of Vesicare, which is a classical bladder anti-spasmodic. There are other options available. 1) You can try alkalinization of urine by means of oral citrate syrup which could reduce the burning sensation locally. 2) Phenazopyridine is an oral drug which you can try taking for three times a day after meals. This can colour your urine a dark orange, and that is nothing to worry about. Do not use it for more than 2 days. This could be beneficial if you have local pain. 3) Flavoxate is also another oral medication to reduce bladder and urethral discomfort to be taken thrice daily which acts as a mild analgesic and anti-spasmodic with very few side-effects. All the above could be easily obtained on the prescription order of your ob-gyn. In the meantime, you could try taking plenty of oral fluids but avoid taking coffee or alcohol till things get better as they could make matters slightly worse. If you are not feeling well, say, even after a week, then you might get your urine examined and see if there is any infection for which you need to take a suitable antibiotic. Hope I have been of help.

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Brief Answer: Vigorous urethral dilatation can cause incontinenc Detailed Answer: Hi again, I doubt if a guarded urethral dilatation could cause any major trouble but an over-enthusiastic dilatation might damage muscle fibres of the external urethral sphincter which is the control muscle for urination and could result in minor to severe degrees of leakage of urine, especially on coughing or sneezing. I guess any urethral instrumentation could cause some amount of bladder spasms, and will not necessarily result from contact of the bladder wall with the dilators. We see this happening even in minor office procedures like cystoscopy by very experienced urologists and patients do experience varying levels of discomfort for at least a day or two. I have no idea if Cystoprotek will work. I would use any medicine which has been promoted by non-clinicians with minimal expectations and with great caution and only if it is not going to drain my purse.

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Brief Answer: Presence of pus cells needs evaluation Detailed Answer: Hi again, I am sorry you are feeling low and down. I guess it feels worse when you feel the people you think should be taking care of this issue (like the urologists) do not seem to understand what is happening. However, I am certain my empathy alone will not solve your problem :-) If your urine is still showing plenty of pus cells 8 weeks after the office cystoscopy and dilatation, it could mean there is some active inflammation going on. It need not necessarily be a common bacterial infection, though usually that is the cause. You might benefit from use of drugs like Vesicare which you seemed to find useful and it actually does reduce bladder spasms, and alkalinization of urine could also be tried as I mentioned earlier. Doxycycline could be taken to combat some minor unusual infections. I remember a famous Italian Urologist speaking at a conference in 2009 (his name is Dr.Barbagli, and he is one of the foremost experts in management of urethral narrowings in the world today) - His words - 'Urethra does not like metal' - He was trying to dissuade our generation of urologists from metal dilatation of urethra. Unfortunately, you seem to have the kind of urethra which does not like metal.

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