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Suggest Treatment For Urinary Retention
Question: Hello doctor. I have had urinary voiding problems for the last 8 months. The urologist found scar tissue, but removing it did not fix the problem. Little comes out. Last checkup I felt the urge, but was unable to give a sample. The nurse told me my bladder was not retaining. Yet, my urologist keeps pushing self-cating for the rest of my life. I also have a pulsating feeling around my sphincter and mild throb in my testicles. For the last couple of days I feel (once a day for about 20mins) a pulse in my shaft. When this all started, my feces and urine smelled. No tempature or fevers.
The smell lasted for several weeks an went away. I also often lose the urge to urninate once i stand. However, I do have strings of good days when everything is fine. It usually haves for a few days every 3 weeks or so.
Best voiding times are form 7am to 5pm. After that i have light streams.
The smell lasted for several weeks an went away. I also often lose the urge to urninate once i stand. However, I do have strings of good days when everything is fine. It usually haves for a few days every 3 weeks or so.
Best voiding times are form 7am to 5pm. After that i have light streams.
Brief Answer:
You have Urethral Stricture Disease with UTI.
Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have long standing Urethral Stricture Disease and endoscopic surgery of Optical Internal Urethrotomy has been done by your Urologist which has failed to give longer lasting results .
I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Have you done radiological test of Retrograde Cysto Urothrogram and Micturating Cysto Urothrogram to find out
a) Site of Stricture
b)Length of the stricture
c)Any back pressure changes in bladder , ureter or kidneys
2) Did stricture developed due to
a) Trauma (Injury) in perineal region
b) Due to infection
3) Have you done Urodynaemic studies of Bladder with uroflometry.
The urethral stricture disease is very complex disease and needs proper evaluation and precise diagnosis as regards site ,extent and denseness of scar tissue in order to decide treatment modality to get permanent and satisfactory results .
I would suggest you to consult experienced qualified Urologist and get above mentioned investigation to arrive at Precise Diagnosis.
Based on your symptoms I Think you will need to undergo Open surgery of Urothroplasty the nature of surgery will depend upon the radiological findings of tests of RGU and MCU.
Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil
You have Urethral Stricture Disease with UTI.
Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have long standing Urethral Stricture Disease and endoscopic surgery of Optical Internal Urethrotomy has been done by your Urologist which has failed to give longer lasting results .
I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Have you done radiological test of Retrograde Cysto Urothrogram and Micturating Cysto Urothrogram to find out
a) Site of Stricture
b)Length of the stricture
c)Any back pressure changes in bladder , ureter or kidneys
2) Did stricture developed due to
a) Trauma (Injury) in perineal region
b) Due to infection
3) Have you done Urodynaemic studies of Bladder with uroflometry.
The urethral stricture disease is very complex disease and needs proper evaluation and precise diagnosis as regards site ,extent and denseness of scar tissue in order to decide treatment modality to get permanent and satisfactory results .
I would suggest you to consult experienced qualified Urologist and get above mentioned investigation to arrive at Precise Diagnosis.
Based on your symptoms I Think you will need to undergo Open surgery of Urothroplasty the nature of surgery will depend upon the radiological findings of tests of RGU and MCU.
Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Most of these symptoms started before the striture was removed. I was given antibiotics after it was removed so I would not get a UTI, and the removal didn't help with getting the "urge" to go. I usually knew when because i felt some sensation on the side of my penis.
Again, no other signs of a UTI. No fevers, etc. Urine is not cloudy, but was - and it doesnt explain the mild throbbing in testicals and sphincter.
It was half a centimeter of scar tissue.
I will not under go urodynamics due to the amount of discomfort and pain. I had it when I was younger and the doctors tried to force the tube inside my bladder. I believe this is what caused the scar tissue.
He had a nurse try it again but faced the same problem of not being able to get it inside of me. This is why I do not want to self-cat and none of the drugs like rapid flo and flo XXXXXXX help me. Infact, it just makes me void more frequently with a constant scensation to urinate (even if i dont need to)
I have xrays of my pelvis and testicles if you need them to determine the condition.
What is a RGU and MCU? No culture was taken when he removed the striture.
I have also been seeing an experience urologist in the area for the last 8 months. He said i might have a low bladder wall/ceiling(?). But after my last visit, the nurse said I was not retaining when I felt the urge. I have no idea if im holding, when i do urinate (usually after 5pm) little comes out.
How long before scar tissue reforms and do you want to see the MRI/xrays taken?
Again, no other signs of a UTI. No fevers, etc. Urine is not cloudy, but was - and it doesnt explain the mild throbbing in testicals and sphincter.
It was half a centimeter of scar tissue.
I will not under go urodynamics due to the amount of discomfort and pain. I had it when I was younger and the doctors tried to force the tube inside my bladder. I believe this is what caused the scar tissue.
He had a nurse try it again but faced the same problem of not being able to get it inside of me. This is why I do not want to self-cat and none of the drugs like rapid flo and flo XXXXXXX help me. Infact, it just makes me void more frequently with a constant scensation to urinate (even if i dont need to)
I have xrays of my pelvis and testicles if you need them to determine the condition.
What is a RGU and MCU? No culture was taken when he removed the striture.
I have also been seeing an experience urologist in the area for the last 8 months. He said i might have a low bladder wall/ceiling(?). But after my last visit, the nurse said I was not retaining when I felt the urge. I have no idea if im holding, when i do urinate (usually after 5pm) little comes out.
How long before scar tissue reforms and do you want to see the MRI/xrays taken?
Brief Answer:
Urethral Stricture has tendancy to recur again .
Detailed Answer:
Hello
Thanks for follow up
Urethral disease is a notorious disease that has tenedency to recur .
many a time excision of scar tissue does not help at it recurs again .
In such a situation the only option is to excise the entire affected (Diseased ) urethra and either do end to end Anastomosis or replace it with a graaft of mucus membrane form oral cavity(Buccal Mucosa Graft) This helps to restore the continuity of urethra and resolves the issue for life long .
The RGU and MCU are the studies where a Radio opaque dye(Urograffin) is pushed through penis(Urethra) and x rays are taken while the XXXXXXX is being pushed in .This helps to visualize entire urethra and reveal distal end , site of the stricture ,denseness of stricture and length of the stricture .
MCU is a study where X ray is taken while patient is passing urine (Micturating) after the bladder is filled with radio opaque XXXXXXX (Urograffin) This helps to reveal proximal extent of stricture and back pressure changes in bladder and proximal urinary system .
These two tests are very important tools to establish and to decide modality of treatment in Urethra Stricture Disease .No urologist can plan management of stricture Urethra without doing these test.
Thanks and Regards.
Dr.Patil.
Urethral Stricture has tendancy to recur again .
Detailed Answer:
Hello
Thanks for follow up
Urethral disease is a notorious disease that has tenedency to recur .
many a time excision of scar tissue does not help at it recurs again .
In such a situation the only option is to excise the entire affected (Diseased ) urethra and either do end to end Anastomosis or replace it with a graaft of mucus membrane form oral cavity(Buccal Mucosa Graft) This helps to restore the continuity of urethra and resolves the issue for life long .
The RGU and MCU are the studies where a Radio opaque dye(Urograffin) is pushed through penis(Urethra) and x rays are taken while the XXXXXXX is being pushed in .This helps to visualize entire urethra and reveal distal end , site of the stricture ,denseness of stricture and length of the stricture .
MCU is a study where X ray is taken while patient is passing urine (Micturating) after the bladder is filled with radio opaque XXXXXXX (Urograffin) This helps to reveal proximal extent of stricture and back pressure changes in bladder and proximal urinary system .
These two tests are very important tools to establish and to decide modality of treatment in Urethra Stricture Disease .No urologist can plan management of stricture Urethra without doing these test.
Thanks and Regards.
Dr.Patil.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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