Q. What is the cause for frequent urination issue?

Answered by
Dr. Raguram Ganesamoni
and medically reviewed by iCliniq medical review team.

Hello doctor,Three years back, I had frequent urination problem. I underwent several tests, scans, TRUS and also underwent cystoscopy twice. They found classification in prostate and termed it as prostatitis. I had consulted close to 5 doctors and some of them said it is not prostatitis. So, still I am not sure what condition do I suffer from. But, my symptoms remain the same. I urinate even when my bladder is not full. After urination, there is irritation, itching, burning sensation as well as slight dribbling. During urination, I do not feel any burning. But, it is a weak stream after bowel movement and the irritation in the penile area is high. 6 months back, when I did a urine culture, it showed infection. But, doctors discarded it and linked it to prostatitis. I hope, I can find a proper diagnosis and treatment and also get rid off these symptoms, that I am suffering with since 2 years. Thank you.

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Dr. Raguram Ganesamoni

MBBS., MS., MRCS (GLASG)., MCH (URO)., FELLOW IN ENDOUROLOGY
Andrology Urology

Hello,

Welcome to icliniq.com.

I am sorry to know about your persistent problem.

  • Prostatic calcification is a common finding and more frequently seen in elderly. It is associated with chronic prostatitis in which infection leads to calcification. However, it is not diagnostic of chronic prostatitis.
  • Chronic prostatitis is a part of chronic pelvic pain syndrome (CPPS). It is a group of diseases and your problem fits into one of them. Unfortunately, there is no straight forward and simple solution for this problem.
  • Unlike a stone disease or an enlarged prostate, where the urologist can give immediate relief with medications or surgery, your problem is more complex and needs regular treatment and follow up.
  • This condition does not cause any permanent damage or problem. Most patients require months of regular treatment and some may need longer.

There is no point in changing the urologists. I would suggest you to read and understand about prostatitis. I would suggest the following treatment plan:

  1. Get a recent urine microscopy and urine c/s (culture and sensitivity) and get your prostate palpated (examined) by a urologist to rule out pain on touching (which signifies acute infection).
  2. Start with a course of antibiotics for 6 weeks. If culture is sterile, start with Levofloxacin.
  3. Add alpha-blockers (like Silodosin), which will relax your prostate and improve the urine stream.
  4. Have bladder relaxants like Tolterodine, which will reduce frequent urination.
  5. Take drugs like Amitriptyline which reduces burning sensation by calming down nerves from prostate.
  6. Alkalize the urine by taking Potassium citrate syrup.
  7. Finally add drugs like Pentosan polysulfate that is known to work in many patients.
  • You need to take these drugs for at least 2 to 3 months and adjust the dosage according to your symptoms.

Meanwhile, do not worry about your problems and keep your focus on your work and family life. I suggest you to visit an endourologist and discuss about these drugs. Wish you a speedy recovery.

Revert back after the investigations to a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist

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