Q. I would like to get a second opinion for my prostate operation. Please help.

Answered by
Dr. Vivekanandan G
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 01, 2016 and last reviewed on: Sep 07, 2020

Hi doctor,

I am a 74 year old male. 15 days ago, I have had high fever (103 degrees F) with shivering. The actual problem started before 20 days and I was unable to pass urine for three days. I was admitted to hospital due to fever and then discharged after five days of stay. I guess, It was found that I had urine infection and due to enlarged prostate I was unable to pass stool. My discharge report has been attached. I was discharged with Foley catheter. Then, on the follow up visit, they removed the urine bag. But, in the evening, I had abdomen pain. Then, my doctor said that they need to operate, because urine is still not passing normally and it is being collected inside. I am on Foley Catheter again. I would like to get a second opinion. I am also a diabetic patient. Please advise.

#

Hi,

Welcome to icliniq.com.

I have gone through all your reports (attachment removed to protect patient identity).

  • Yes, the prostate gland is enlarged and weighing more than 100 g. You also have other comorbidities like ischemic bowel disease and diabetes.
  • At this juncture, I would suggest you tablet Silodal D 8 mg (Silodosin and Dutasteride) once daily in the morning for a week. Consult your specialist doctor, discuss with him or her and take the medicine with consent.
  • Then, get the catheter removed to see if you are able to pass urine freely. If you can pass urine well, then you need to continue the tablet for at least six months to a year.
  • If you cannot void urine after catheter removal, then you must go for Holmium laser prostatectomy. So, first it is better to try with medications. All the best.

For further information consult a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist

Thank you very much doctor.

#

Hi,

Welcome back to icliniq.com.

If possible, please send your test reports to get more precise management.

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

Hello doctor,

Please find the medication details. Prescription at the time of discharge is as follows: tablet Warf 5 mg at 5 PM, tablet Augpen 625 mg two times a day, capsule Bevon twice a day, tablet Diamicron 60 mg twice a day, tablet Veltam 0.4 mg once at night and syrup Smuth. The same medicines except tablet Augpen were prescribed again for the next 10 days. My present prescription after removal of urine bag is as follows: Tablet Augpen 625 mg twice a day, capsule Bevon twice a day, tablet Diamicron 60 mg twice a day and syrup Smuth.

#

Hi,

Welcome back to icliniq.com.

  • In your last prescription, there is no medicine for prostate. In the earlier prescriptions, the tablet Veltam (Tamsulosin) was given for prostate enlargement.
  • I would suggest you Silodal D 8 mg for one week and get the catheter removed for trial void. If it is successful, please continue the medicine for a year. If it is not successful, then you may have to think about surgery for prostate gland.

For further information consult a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist

Hello doctor,

I am feeling weak. The catheter is not yet removed. I have an appointment with my urologist and once I discuss with him and start Silodal. Please advise how to reduce weakness. Can I have ORS or Electral, because I am a diabetic?

#

Hi,

Welcome back to icliniq.com.

  • So, take plenty of fluids and L-Carnitine tablet for two weeks.

For further doubts consult a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist

Thank you doctor,

If Veltam was a substitute for Silodal-D, then is that the case earlier that they tried to remove catheter with the help of Veltam?

#

Hi,

Welcome back to icliniq.com.

  • The tablet Silodal is a newer and better medicine than Veltam, so the success rates of trial void are much higher.
  • Moreover, since your prostate gland is very large, plain Veltam is not enough. You need to take Dutasteride along.
  • That is why, I insisted on starting tablet Silodal-D, which contains Silodosin and Dutasteride. I would once again request you to take this drug for a week and get the catheter removed.

For further doubts consult a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist

Hello Dr. Vivekanandan,
My doctor prescribed T-Silodal 8mg , urimax 0.4 mg, T. Zifi cv 200mg for 3 days . Also, after that Cystomety test will be carried out. And after that Urine culture is advised. And then catheter will be removed.
# please don't take silodal and urimax together.Stop urimax and then switch over to silodal.

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