Dr. Khant Shahil Ramesh Bhai
Urology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have been taking Furosemide (Lasix) for swollen legs prescribed by PCP 20 milligrams daily as needed since last year. This was during a followup following a hospitalization for swollen legs due to feet infection. The hospital doctor said that the swelling would go down in time, but was not so. I saw the PCP. The medication has only helped a little. There was some improvement, but legs and feet are still swollen. A week ago, I started having problems that when I urinate and go to wipe, I cannot get dry. I have to keep on wiping going through 12 rolls of tissue and still am not dry. It stops on its own after I put depends on an hour or more later. It looks like urine on the tissue. So, I am assuming it is urine. I do not know what else it could be. It is taking me an hour or longer to wipe.
The PCP took a urine sample to test for UTI. He does not know what the problem is. He has not come across this problem ever before. He does not think the Lasix is causing this. I stopped the Lasix five days ago before seeing the PCP. But, the problem has continued. This is very distressing and interferes with getting my daily activities done. I was diagnosed with overactive bladder by a urologist four years ago. Due to a problem with colonic inertia, the doctor would only prescribe one medication Myrbetriq which did not work and the doctor had me stop it because it only raised my blood pressure. The medication was stopped four years ago. Please tell me what you think is causing the urination problem described above.
Hello,
Welcome to icliniq.com.
Relax and do not worry. I do not think the problem is due to Furosemide. You may be suffering from severe form of stress urinary incontinence which is very common at this age. The cause and severity of stress incontinence are to be found out. I suggest you see a urologist as you require a physical examination and also a vaginal examination to rule out any prolapse. You require the below tests: Ultrasound abdomen and pelvis with pre and postvoid residual urine, and urodynamic study. So, get yourself evaluated properly by a urologist.
I hope this helps. Thank you.
Patient's Query
Thank you doctor,
I have heard of stress incontinence that typically happens when a person sneezes, coughs, laughs, lifts heavy things, etc. My understanding is that this is usually a rather small amount of urine leakage that stops quickly. I see many small pads in the store for this. My leakage does not occur at those times. It occurs only when I urinate and go to wipe. It takes 12 rolls of tissue and at least two hours for the urine to stop leaking. It stops two hours or more after I give up and put a depends on.
Please respond: since it only occurs when I urinate and wipe, can you narrow down what the problem is? What is causing the problem? What is the "stress" since it only happens when I urinate and gently wipe? The time it takes to deal with this every time I urinate (reminder I have an overactive bladder) makes it extremely difficult to accomplish my necessary daily activities and worry about accidents. Looking forward to your response.
Hello,
Welcome back to icliniq.com.
It looked to me like stress incontinence. A severe form of stress incontinence also manifests this way. Although it is not classical. I do not think it is an overactive bladder. Overactive bladder does not manifest this way. Another possibility I am thinking of is any fistula communicating with the bladder. A bladder fistula is also one of the possibilities. If there is any fistula which is communicating with the bladder, then it will lead to continuous leak of urine as in your case. You need to get examined by a urologist so that he can diagnose if any fistula or any other abnormalities are present. He might suggest you CT (computed tomography) urography to diagnose fistula.
I hope this helps.
Thank you.
Patient's Query
Thank you doctor,
What is a fistula? What part of the body are you referring to, a fistula in the anal area or elsewhere?
Hello,
Welcome back to icliniq.com.
I am talking about fistula which may be connecting from urinary bladder or urethra to vagina. This may cause a continuous leak of urine as in your case.
Thank you.
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Urology
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