Hello Doctor, I Am Really Scared, My Ultrasound Test For

Posted on Thu, 7 Feb 2019

Question: hello doctor, I am really scared, my ultrasound test for abdomen says I have borderline prostatomegaly.. I am seeing the best urologist for the past one year.. apart from anitbiotics o have been on urimax 0.4 for almost more than 5 months and dutasteride 0.5mg plus urimax 0.4 for the past four months .. symptoms have really improved.. when urinating the start is good but towards end after I feel I have done I still get some urine with week force like dribbling . I feel some urine is trapped in urethra and I have to stand for. while to empty it.. now my worry is I may get married this year. will this affect my life . will I be able to have kids ? should I be patient and go back to the urologist ?.. please advice me doctor . I am 30 years old male

Answered by Dr. Bhagyesh V. Patel (21 hours later)

Brief Answer:
associated urethral issue more likely to give such symptoms.

Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read your query and here is my advise.

* The prostate infection does present at the age of 30 years, but typical prostate
enlargement only happens after 45 years of life.

* As per my surgical expertise, your symptoms do suggest associated urethra problem
probably more likely.

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

1. Details of symptoms since beginning and amount of improvement after therapy.
2. Is there associated burning in urination ?
3. Fever if any ?
4. Systemic illness as diabetes or else ?
5. If the reports are available such as ultrasound, cystoscopy or other lab results, kindly
provide as attachment in follow up conversation.

Awaiting for your response.
Regards.

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

Follow up: Dr. Bhagyesh V. Patel (5 hours later)

it all started with a sharp burning sensation that night I could not sleep burning was terrible I could not stand in one place somehow I slept the next day doctor gave me azithral 500 mg this was in December 2017. then the burning kept coming back also itching. some tiny red spots were also seen .. this I changed doctor he said it's nothing to worry ..gave me a cream and some tablet which I don't remember .. and in March 2018 I was urinating frequently I can still see those tiny red dots it becomes worse after masturabation. in March doctor asked me to take ultrasound.. that report I did not attach here. I attached here ultrasound taken in July. so in March the report said mildly enlarged prostate.. I was given some antibiotics. then it was going on I remember I had UTI in between. in the beginning I was given ciprofloxin. urimax 0.2 then I still complained that I could not empty my bladder so he gave urimax 0.4 and in between I also taken norfloxcin. still I complained of not emptying my bladder and burning he asked me to take dutasteride 0.5 mg plus urimax and also alkastan insta poweder for burning... the last time I complained of burning during urinating I took urine culture the report says no growth seen. so far apart from anitbiotics like ciprofloxin and norfloxcin. I have take urimax 0.4 for almost 5 month and then dutasteride 0.5 plus urimax 0.4 for the past six months . Q1. in the beginning urine stream was not continuous I have stand for 10 mins even after 10 mins again I have to rush to toilet... when beginning of treatment also in the day after urinating again in few mins I get the urgency to urinate. but now at present after completing the dosage I can urinate free but in the end when finishing the flow is weak and urine is still there but difficult to get in out I have to strain and sometime the few drops which are difficult to get out burns slightly but still tolerable. I cannot feel that I have completely emptied. urine is like in the tip of the urethra but not coming out.. I felt some pain in urethra some kind poking feeling in urethra before not now. Q2. yes bruning was there in night sometimes it's terrible but goes away after sometime .and doctor gave that alkastan insta poweder burning had controlled till now. but if I stop taking that poweder for some days it will get back. Q3.no doctor no fever I am completely alright I do my work every day . I go to play football every weekend or whenever I get time Q4. no doctor he asked me test for sugar that was also normal . so no diabetes

Answered by Dr. Bhagyesh V. Patel (4 hours later)

Brief Answer:
urethral narrowing ( stricture ) is prime suspicious cause.

Detailed Answer:
Hi
Thanks for the details and reports as attachment.

* The issue sounds more to be urethral narrowing rather than prostate enlargement.

* My guidelines at present for best future outcome

- In absence of infection, there is no role of antibiotics consumption since 5 months persistently, on the reverse, it will develop drug resistance and other problems.
- Seek advise of another urologist and get ascending urethrography, micturating cystourethrogram or diagnostic cystoscopy done for definite diagnosis and further care.
- Till that time, consume plenty of liquids and take care of genital hygiene.

Wish you best health.
Do feel free to ask further doubts.

Take care.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Bhagyesh V. Patel (46 minutes later)

what are the potential risks doctor should I be more worried about future?.. and what could be the cause of this

Answered by Dr. Bhagyesh V. Patel (56 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hi
You should not panic at this stage.

* More important is perfect diagnosis and further management to avoid future complications which can be recurrent infection, thickening of bladder wall or inability to pass urine in some cases.

* I strongly recommend an expert urologist visit other than the current one, for complete thorough diagnosis and precise care.

Whatever the issue is there, once it is diagnosed from root, it will be cured for sure.

Wish you fine recovery.
Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Bhagyesh V. Patel (47 hours later)

hello doctor Thankyou for your advise.. I met the new urologist he saw all my previous reports .. asked some questions he wanted to CT Scan kub with contrast and other couple of tests... I also told him about the tablets I took.. doctor another concern is I never had any erection problems before taking dutasteride for 4 months I have now stopped it it's been like 10 days since I stopped it. but now my sex drive is low. I also mentioned this to the new urologist he gave me mildfil tablet 1 for 10 days.. doctor how long before I get my normal erections? loss of ercetion is because of medications or something else ?

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

Brief Answer:
follow up .

Detailed Answer:
Hi XXXXXXX
Welcome for follow up.

* Dutasteride is meant for inhibition of 5 alpha reductase enzyme, which is responsible for production of DHT ( Dihydro testosterone ) in the body.

* So in absence of DHT, there is obvious lowering of sex drive and erections as part of side effect of the drug ( which should be warned to every patient at the time of prescription by concerned consultant ).

* Now as the drug has been stopped, the reversal will come within certain time frame
(the duration varies from days to weeks ) depending upon the individual response.

* Mildfil tablet is also a drug which will provoke transient sex boost and later on you will feel numb without its use.

* So I recommend just wait and watch policy ( rather than consuming mildfil ) for the erection purpose, rather than again putting yourself in newer problem.

Do remain in regular follow up and progress of the condition with newer urologist.
Regards.

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Above answer was peer-reviewed by : Dr. Prasad