Brief Answer:
You need to get a USG-KUBP done

Detailed Answer:
Thanks for asking on HealthcareMagic.
I have gone through the details but I would request you to upload the urine report using the facility on the upper right of this page. If the urine is haxy, it could be due to excess albumin (protein) in urine which could indicate a renal pathology, which in turn could be related to the high blood pressure. The problem is unlikely to be related to anxiety but anxiety definitely has a significant role to play in increasing the blood pressure.
I would suggest you to get a ultrasound of KUBP (kidney, ureters, bladder, prostate) done as increase in the size of prostate could cause urinary problems like hesitancy.
You have not done the right thing by discontinuing anti-depressants on your own. I would recommend a follow up with your psychiatrist.
Hope that helps.
Regards
Dr. Kunal Saha

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Brief Answer:
I would appreciate if you could upload the USG report

Detailed Answer:
Thanks for writing back.

I have gone through the attachment.
* Frankly speaking, the report does not seem quite trustworthy. Probably you should repeat it from somewhere more reliable. In that case, I would also recommend urine culture along with routine microscopy.
* Even though you mention the USG report to be normal, I would still appreciate if you could upload the report.
* Furthermore, I would like to ask what exactly you mean by 'inconsistency'. I assume that you mean hesitancy. Clarification sought.
* I would suggest you to get a routine blood count done and to share the report.

The description till now has not been adequate to make a diagnosis. As mentioned already, I feel that prostatic enlargement could be the cause of hesitancy. Another possibility is urinary tract infection which should be apparent if the blood test results indicate that way.

Regards

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Brief Answer:
I have already indicated the possibilities.Hard to confirm which one exactl

Detailed Answer:
Thanks for asking back again. Good to hear that the urine test is from a reliable source. I have seen the attached images but could you upload the report rather than the plates. Not all the information can be made out from the plates. I need the size and description of the prostate in particular.

The high BP is due to age related degenerative changes of the blood vessels. It includes the effect of deposition of lipids in the lumen of blood vessels, thus narrowing them and increasing the pressure of blood as it flows through those vessels.

My suspicion about the reduced urine flow is enlarged prostate as already mentioned. Hard to comment without the exact specifications of the USG. The hazyness of urine could be due to excess albumin (protein) in urine which could indicate a renal pathology, which in turn could be related to the high blood pressure. All these require clinical correlation and I find it very hard to comment further without being able to directly evaluate you.

Regards

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Brief Answer:
The attached plates are all showing the right and left kidneys

Detailed Answer:
Thanks again for writing back. I had lost my internet connectivity and could not answer earlier. Let me deeply apologize for that.

I do not see the report attached. I see multiple plates (4 images), each constituting of the right and left kidney. Moreover, other than the size, the report contains details like post void residual urine. These things cannot be made out from a plates, at least not by a person who is not a radiologist. So I request for your cooperation once again.

Regards
Dr. Kunal Saha

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Brief Answer:
Urinary tract infection needs to be ruled out

Detailed Answer:
Thanks for uploading the image this time.

Urinary hesitancy can be caused by:
Drugs (some cold remedies, some nasal decongestants, tricyclic antidepressants, and anticholinergic drugs used for incontinence)
Enlarged prostate (benign prostatic hyperplasia)
Inflammation or infection of the prostate gland (prostatitis)
Nervous system disorders
Recent surgery (postoperative retention)
Scar tissue (stricture)
Shy or bashful bladder syndrome (being unable to urinate when another person is in the room)
Urinary tract infection

The prostate size in the ultrasonogram seems fine and so that is unlikely to be the cause. I was not quite satisfied with the urine report and you did not want to repeat it from elsewhere. So, I find it hard to rule out urinary tract infection as a possible cause and hence I would request you to talk to your treating physician. Post operative factors are probably not relevant in your case. Nervous system causes need to be evaluated by your doctor.

Regards

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Brief Answer:
Anxiolytics should give you relief.

Detailed Answer:
Thanks again.

Lower urinary tract symptoms (LUTS) is not a disease in itself. It is just a group of symptoms. If your doctors thinks it to be due to stress, he can ask you to take anxiolytics like alprazolam. But these are prescription medicines and we cannot prescribe medicines through this platform. In such a case, you need to request your doctor to write it down for you.

If your doctor thinks it to be due to side effects of certain medications, you have to talk to the concerned doctor about modification of the doses or the medicines.

Hope that helps.

Regards
Dr. Kunal Saha

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