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Question: My father aged 65 needs immediate treatment to correct urinary stricture. What would be the correct procedure to address his stricture at this stage. He is diabetic but doesn't have BP or heart problem now. Attached few of his latest report for reference
Brief History:
My father had fever for one neight 8-9-2016 after reaching XXXXXXX on 7-9-2016. Docter advised Ertepenum (Invanz 1gm in 100 ml NS) after looking at his culture report done on 26-8-16
Recently (25-8-16 till 4-9-16) my father admitted in a govt medical college to treat feaver (102F, ) due to UTI. During his presence in hospital he was given Netromax 300, meropenum, ducas-T, veloz D. During this period his diabetes was also very high (250-450) and higher dose of insulin was suggested to bring down this level. He was discharged from hospital with following. He was also advised to report to OPD again after one week:
- Feropenum 200 twice daily
- Niftas 100 once daily
- Veloz D one cap daily for 15 days
- Ducas T two tab once daily for 1 month
- Voxate one tab twice daily for 5 days
- Bevon one tab daily for one month
Brief History:
My father had fever for one neight 8-9-2016 after reaching XXXXXXX on 7-9-2016. Docter advised Ertepenum (Invanz 1gm in 100 ml NS) after looking at his culture report done on 26-8-16
Recently (25-8-16 till 4-9-16) my father admitted in a govt medical college to treat feaver (102F, ) due to UTI. During his presence in hospital he was given Netromax 300, meropenum, ducas-T, veloz D. During this period his diabetes was also very high (250-450) and higher dose of insulin was suggested to bring down this level. He was discharged from hospital with following. He was also advised to report to OPD again after one week:
- Feropenum 200 twice daily
- Niftas 100 once daily
- Veloz D one cap daily for 15 days
- Ducas T two tab once daily for 1 month
- Voxate one tab twice daily for 5 days
- Bevon one tab daily for one month
Brief Answer:
Some details needed for further advice.
Detailed Answer:
Hello Gopalkrishnan and welcome to HCM.
As an Urologist,i can understand your concern.
Your attachments show a urethral stricture very clearly.
Also,an enlarged prostate with significant residual urine,for which,he's on treatment.
He's a diabetic,which's not under control,according to your query.
You'll need to answer certain questions,to be able to get an expert opinion.
1. How did he get a urethral stricture ?
2. Has his diabetes and fever come under control.?
3. Send the latest reports of his urine and blood tests,done so far.
Once your reply is received,an expert opinion can be given.
Wish you well.
Dr.Matthew J. Mangat.
Some details needed for further advice.
Detailed Answer:
Hello Gopalkrishnan and welcome to HCM.
As an Urologist,i can understand your concern.
Your attachments show a urethral stricture very clearly.
Also,an enlarged prostate with significant residual urine,for which,he's on treatment.
He's a diabetic,which's not under control,according to your query.
You'll need to answer certain questions,to be able to get an expert opinion.
1. How did he get a urethral stricture ?
2. Has his diabetes and fever come under control.?
3. Send the latest reports of his urine and blood tests,done so far.
Once your reply is received,an expert opinion can be given.
Wish you well.
Dr.Matthew J. Mangat.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanking you for your response.
To answer your three questions above
1. How did he get a urethral stricture ?
Ans: Not known. But he had undergone a endoscopic surgery around 18 years back but after 2 years of surgery again his flow reduced. He was having this poor flow since last 14 years aprrox
2. Has his diabetes and fever come under control.?
Ans: His diabetes has come down to control he is now on insulin only and taking lupisulin r (40IU) : 12, 10, 10 during breakfast, lunch and dinner respectively. He is taking insulin glargine 16 units at 11pm in night. He is having diabetes now at 110 (avg -approx) before food and 160 - 180 after food. Fever has also not there any more.
3. Send the latest reports of his urine and blood tests,done so far.
Ans: I have attached two files in my last post with his latest reports. Additionally attaching uroflowmetry report for your analysis.
Please let me know if you're looking for any specific report and I'll upload that. I can go for fresh lab test if it is required.
To answer your three questions above
1. How did he get a urethral stricture ?
Ans: Not known. But he had undergone a endoscopic surgery around 18 years back but after 2 years of surgery again his flow reduced. He was having this poor flow since last 14 years aprrox
2. Has his diabetes and fever come under control.?
Ans: His diabetes has come down to control he is now on insulin only and taking lupisulin r (40IU) : 12, 10, 10 during breakfast, lunch and dinner respectively. He is taking insulin glargine 16 units at 11pm in night. He is having diabetes now at 110 (avg -approx) before food and 160 - 180 after food. Fever has also not there any more.
3. Send the latest reports of his urine and blood tests,done so far.
Ans: I have attached two files in my last post with his latest reports. Additionally attaching uroflowmetry report for your analysis.
Please let me know if you're looking for any specific report and I'll upload that. I can go for fresh lab test if it is required.
Brief Answer:
He'll definitely need a surgery to correct his urethral stricture.
Detailed Answer:
Hi XXXXXXX
Now i'll answer the first question,as to how he got the stricture.
After his previous endoscopic surgery,there must've been some urethral injury.
That's the cause for his stricture,which gradually became more severe.
He'll definitely need a surgery to correct the stricture.
Actually, he should've undergone this surgery,many years back.
Before that,he'll need to get a medical fitness for the surgery under anesthesia.
If you've any doubts,feel free to send your queries.
Wishing him well.
Dr.Matthew J. Mangat.
He'll definitely need a surgery to correct his urethral stricture.
Detailed Answer:
Hi XXXXXXX
Now i'll answer the first question,as to how he got the stricture.
After his previous endoscopic surgery,there must've been some urethral injury.
That's the cause for his stricture,which gradually became more severe.
He'll definitely need a surgery to correct the stricture.
Actually, he should've undergone this surgery,many years back.
Before that,he'll need to get a medical fitness for the surgery under anesthesia.
If you've any doubts,feel free to send your queries.
Wishing him well.
Dr.Matthew J. Mangat.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
There are numerous types of procedures available to treat urinary strictures. Which one would be the best suitable for us looking at my father's age?
We've consulted one urologist available near to my place and he is now suggesting buccal mucosa urethroplasty. I'm little scared about this procedure for my father. Is this something which is really necessary for his condition or have any other option?
Thanking you again for your kind response.
We've consulted one urologist available near to my place and he is now suggesting buccal mucosa urethroplasty. I'm little scared about this procedure for my father. Is this something which is really necessary for his condition or have any other option?
Thanking you again for your kind response.
Brief Answer:
Your father isn't an old man.Surgery is safe for him.
Detailed Answer:
Hi XXXXXXX
At the outset,let me assure you, that your father is not an old man.
His diabetes,if well controlled,doesn't pose any major risk.
The type of surgery will depend on the intra-operative findings of the stricture.
The X-ray shows a short stricture,which could be re-constructed in an easy way.
It's called an excision of the stricture,with a straight forward re-alignment suturing.
You should go to an Urologist,experienced in re-constructive surgery.
It's a simple surgery,with good results.
You're welcome to clear any other doubts,you may have.
Dr.Matthew J. Mangat.
Your father isn't an old man.Surgery is safe for him.
Detailed Answer:
Hi XXXXXXX
At the outset,let me assure you, that your father is not an old man.
His diabetes,if well controlled,doesn't pose any major risk.
The type of surgery will depend on the intra-operative findings of the stricture.
The X-ray shows a short stricture,which could be re-constructed in an easy way.
It's called an excision of the stricture,with a straight forward re-alignment suturing.
You should go to an Urologist,experienced in re-constructive surgery.
It's a simple surgery,with good results.
You're welcome to clear any other doubts,you may have.
Dr.Matthew J. Mangat.
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. Nagamani Ng
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