Dr. Vaibhav Vishal
Urology
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Patient's Query
Hi doctor,
My father was operated on for hip replacement surgery a few months back. He is on a Catheter since last month and often passes blood and debris in the discharge bag. He has no control over urine and was initially passing white urine before we put catheter. Blood spots in urine are only after placing the catheter. CT KUB scan impression is ill-defined hyperdensity (CT value=54 HU) in the upper pole calyx of the right kidney, suggestive of a blood clot. Hypodense partially exophytic lesion arising from the lower polar region is likely to represent a cyst. Diffuse urinary bladder wall thickening is suggestive of cystitis. Blood test shows, prostatic specific antigen 2.51, random glucose 123mg/dL, and serum creatine 1.08. Urine test shows pus cells 15-20/hpf.
Kindly advise what step has to be done next.
Hello,
Welcome to icliniq.com.
My advice for you is continue with a catheter till your father is able to walk normally, without any problem. CT scan finding does not require any intervention at present. A cyst can be a normal finding. The best advice regarding cyst can only be given after seeing the CT films. Antibiotics treatment is needed for infection of the bladder. Clots and few debris pieces will be seen in the catheter. That is normal for a person with a bladder infection, and on Ecospirin, unless bleeding from the catheter is very significant, there is no need to worry about it. Regular change of catheter after three to four weeks, can consider using silicon catheter, it has a longer life and fewer chances of urine infection. Get a proper physical examination and prostate examination by a urologist. Once he is able to walk normally, then the catheter will be removed, and trial voiding will be given. If a problem happens with voiding or urine control, then a cystoscopy (endoscopy to see the bladder. and prostate from inside) may be needed.
Patient's Query
Hello doctor,
Thanks doctor. Do we have to do CECT abdomen and pelvis with IVU? He is last prescribed with tablet Adexim 500 mg 1-0-1, tablet Pause 500 mg 1-0-1, Osteofos 70 mg once a week, Alfoo 10 mg 0-0-1, Pramipex ER 0.375 1-0-0, Syndopa Plus 1-1-1, CCM tablet 1-0-0, Cilacar 5 mg 1-0-0 (Now doctor told to stop this), and Ecosprin Gold 10 Forte (Now stopped). For the last two days, we do not see any blood spot in the urine. If we have to do a CT scan, how safe is it for his age?
Thanks in advance for your help.
Hello,
Welcome back to icliniq.com.
CECT (contrast-enhanced computed tomography) with IVU (intravenous urography) can be done at any age. It has no adverse effects related to age. The only thing to check before CT is blood urea and creatine, and diabetes status. If all that is normal, then CECT can be done. A mild risk of allergic reaction to contrast used in CT is present, but that will be taken are by doctors doing CT. Otherwise, CT is safe. For cyst, yes, it is important to get CECT done. This gives a better idea of the nature of the problem.
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Urology
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