Dr. Karthik Rajan
Urology
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Patient's Query
Hello doctor,
After I got delayed urinating and had mild pain in the lower back, I got many discussions with many doctors, and the last doctor did a CT scan and urethra X-ray. He did a cystoscopy on me, but during the urethral X-ray, I got so much pain (before that, he gave me local anaesthesia), and he also tried it twice. I masturbate, and my sexual activity frequency is two to three times daily. I also have a bad lifestyle (eating junk food, do not have any sports activities, and staying up late). However, I do not have STD, and I still get erections and ejaculate normally without any pain. I have a delayed and slow stream when urinating (more than 30 seconds), but I do not feel any pain or burning sensation when peeing. I also have sore pain in the lower back, a feeling of fullness in my lower tummy, constipation (but I still can defecate), dripping before stopping urinating and a split of the stream when urinating (when very slow stream).
My test result are; PSA Test: 0.7, full urinary check two times: All good, no bacteria, no blood, USG: All good, urine flowmetry: Obstruction Outlet Bladder, CT scan abdomen: All good, and rectal examination: Feel a bit of pain and feel something coming out. I have been taking Flomax capsules for almost 17 days, but there has been no significant improvement. Please help.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
Your urine flow shows some amount of obstruction. The urethrogram done has suggested obstruction in the prostatic urethra. However, a cystoscopy must confirm this to evaluate the entire urethra and bladder. First, I would suggest you undergo the procedure under anaesthesia as it would be painless, and secondly, if any blockage is noted, it can also be treated. If the cystoscopy turns out to be normal, then the bladder function has to be checked by doing a urodynamic study. I would also suggest you take some medication to treat your constipation, as treating constipation can sometimes make the urinary symptoms better.
Hope this helps.
Thank you and take care.
Patient's Query
Hello doctor,
Thank you for your reply.
When the uroflowmetry test was taken, I had not slept for three days or eaten anything (just water, juice, and soup) for two days. Will that have any effect on my uroflowmetry test? And when the urethrogram was done, I got very scared. Would that have affected my result too?
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
Diet does not affect the uroflowmetry test, but anxiety does. So again, during urethrogram, if you get scared and do not relax, the results can be a bit off, but usually, the radiologist will interpret that correctly. Since they have specifically mentioned there is a stricture, it is best to do a cystoscopy, and since you have anxiety, it would be best done under short anesthesia.
Hope this helps.
Thank you and take care.
Patient's Query
Hello doctor,
Thank you for your reply.
If I do get the prostatic stricture, is there any other solution to be done besides dilation? Perhaps urethroplasty? If I do nothing about it except take the antibiotics and the tablet Harnal, will it affect anything, or can it worsen?
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
Since the prostatic urethra was not visualized, it is impossible to predict the most effective treatment. Strictures in the prostatic urethra are uncommon, usually seen only in those who have had previous surgery. That is why a cystoscopy is necessary to confirm. But generally, urethroplasty is not done for prostatic urethral stricture. If there is a stricture and you do not treat it, then there will be gradual damage to the urinary bladder over time. So it is not advisable to leave a stricture untreated.
Hope this helps.
Thank you and take care.
Patient's Query
Hello doctor,
Thank you for your reply.
Can TURP help cure the stricture? If you think that is uncommon can you please give me any possibility about my condition?
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
At 24, it is impossible to develop prostatic enlargement, so TURP (transurethral resection of the prostate) will not help you. So your problem is related to some blockage in the urethra which now needs cystoscopy to rule out with certainty. If that comes as normal, the contractile pressure within the bladder will be checked to see if the bladder function is normal. This is called a urodynamic study. Once we get a picture of where the problem is, then we can suggest what treatment can be given. Right now, it is too early to talk about treatment options.
Hope this helps.
Thank you and take care.
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