Suggest Treatment For Urinary Incontinence

25th February, 2010 Dear Doctor, Greetings. Please find hereunder my problems, in brief : Case History : Urological problems since 1996 (above 13 years). Patient : Anwar A. Khan, Sex : Male Age : 56 years A. Present Problems : 1. Frequent urine discharging, urine colour yellowish, a little burning in releasing urine, obstruction in releasing of urine, cant keep urine pressure (need to go to the toilet immediately to release urine), itching on the back and little pain on both thighs (muscles). 2. An Ultrasound of KUB, Prostate & PVR recently done reveals that both the kidneys are normal, urinary bladder is regular in outline, wall thickness is normal, no intravesical lesion is seen. Prostate is enlarged in size (44X46X16mm). Volume is about 49cc. PVR is almost nil. 3. Recently done Uro-Uroflowmetry + other tests show as follows : A. i) Max flow rate : 12.2ml/s ii) Voided volume : 352ml iii) Residual urine : Nil iv) Flow time : 76s v) Ave. flow rate : 4.6ml/s vi) Voiding time : 86s vii) Time to max flow : 4s B. S.Cr. : 1.24MG C. PSA : 2.7NG/ML D. Urofow Q max : 9.7ML/SEC 4. Diabetic patient for about 2 years which is under control. 5. Bronchial asthma patient since childhood which is also under control. B. Past History : 1) April/May, 1996 : Suddenly I was suffering from burning and obstruction in releasing urine. I was then 42 years old. Optical urethrotomy was done on 31.05.1996 on a wrong diagnosis considering stricture urethra. Thereafter, I did not feel comfort. Rather, so many problems, such as, burning of urine, frequent discharge of urine, continuous pinching inside the whole abdomen, obstruction in releasing of urine with incomplete voiding, sometimes 40-60CC urine remained inside after discharging, severe thigh (muscles) & back pain, little pain on the whole of lower abdomen including bladder neck problem developed with me. Since then, I have been suffering urological problems. 2) June, 2001 : Lithotripsy was successfully was done to disintegrate a stone of 7mm in my left ureter in CMC Hospital, Vellore, India. Please advise me your valuable suggestions ( whether operation is necessary or medicinal treatment is okay) in this regard for which I shall remain ever grateful to you. I shall provide you with further information about my problems, if needed. Please also let me know about price, procedures, experience of doctors and duration of stay in the hospital. With regards. Anwar A. Khan 25/1, Green Road (2nd Floor) Dhaka-1205, Bangladesh E-mail : YYYY@YYYY