Q. I have urination problem with less urine output and leakage. Please help.

Answered by
Dr. Ankush Jairath
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 16, 2020

Hello doctor,

Patient is a 50-year-old female. She had a history of early menopause (periods stopped after 35 yrs). Her gall bladder removed last year and she has hypothyroidism and taking Thyronorm .25 mg for the past three years.

Her present complaint is problem in urination, urine flow is low and she has to go to the toilet several times for urination but the urine is very scanty even after applying force. Sometimes there is urine leakage. She was prescribed Urimax 0.2. But she discarded its use as it induced constipation, flatus, and obesity. Sometimes there is a pain in the pelvic region, joint pain, and easily fatigued.

#

Hello,

Welcome to icliniq.com.

Do you have leakage when you feel to urinate? Do you have urine leakage when you cough or sneeze? When you hold urine at that time did you feel burning or pain? For what maximum time you are able to hold urine? Any history of diabetes or hypertension or any medications?


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Thank you doctor,

Yes, I feel leakage and my innerwear gets wet. I do not feel any burning or pain in urine. My urine culture test remains always negative. I cannot hold urine for a long time. I have to urinate every two hours on average. My sleep is disturbed because of it.

But when I go to urinate, I feel the urge but no pressure. The flow of urine is weak. I can hold the urine but generally, I void it whenever I feel even a little urge.

I am not diabetic. I do not have any blood pressure. I am suffering from hypothyroidism and take tablet Thyronorm 0.2 daily in empty stomach for the last three years. I am attaching the prescription for your perusal.

#

Hello,

Welcome back to icliniq.com.

I have seen the prescription. (attachment removed to protect patient identity).

Can you upload an ultrasound abdomen with PVRU (post-void residual urine) report? Have you undergone any surgical procedures like dilatation /OIU until now?

There are three things which can be overactive bladder, neurogenic bladder, and urethral stenosis.

For first, I can prescribe you medication. For the last, surgical procedure like dialatation/OIU is needed. For second nothing much can be done (continuous intermittent catheterization to empty the bladder fully).

But before prescribing any drug I need to see an ultrasound abdomen with PVRU report.


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Thank you doctor,

USG report is attached. My gallblader was removed last year by laproscopy. No other surgery is done.

#

Hello,

Welcome back to icliniq.com.

I am keeping a possibility of overactive bladder as probable diagnosis. I will recommend you to start tablet Roliten (Tolterodine tartrate) 4 mg once a day for two weeks. We will get back after after two weeks again to see how much better you feel.

It has a side effect of mouth dryness. It is very important you should not have constipation so start some laxative like syrup Cremalax at bed time (dose can be modified according to your need).


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