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Guidance on cystoscopy - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Urinary and Bladder Problems
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3388 Questions
User :   I have undergone a TAH on may 15th at XXX hospital at Bangalore where they have removed my uterus as I was suffering from uterine fibroid. my left ovary was removed in 2000 wen I underwent cysectomy. now I m going thru loss of bladder control. I also have completed IVP just yesterday. and today dr said I need cystogram. please let me know is it really necessary. why did this start after the surgery.
Doctor :   HI
Doctor :   let me read your query
User :   Hi Doc, is there anyway that I can avoid this problem by taking medicine
User :   wat am I supposed to do
Doctor :   Sometimes post surgery
Doctor :   if there is any neurological damage during surgery,
Doctor :   there may be resultant bladder issues
User :   so
User :   what do u think might have happened
Doctor :   Have you have Urine outflow studies done (UROFLOW analysis)
User :   no
User :   they did IVP yesterday
Doctor :   THIS is a simple test, where in you urinate in a instrument which checksthe rate of urine flow.
User :   ok
Doctor :   Also due you have incontinence problems when you cough, laugh, or when in stress ?
Doctor :   was the IVP normal ?
User :   no not stress incontinence
User :   the ivp result shows impressionL probable retrocaval ureter.
User :   Pre and postmicturition cystogram are also within normal limits
Doctor :   so do you mean your doctor is advising cystoscopy
User :   yes
Doctor :   since cystogram is already been done
User :   earlier it was not done
User :   he suggests it now as a next step to ivp
Doctor :   have you tried any medications for now?
User :   he says it is not stress incontinence he says bladder is near the vagina so surgery can be recommended
Doctor :   I AM not suggesting that you have stress incontinence
User :   no he did not give me any med. he says cystoscopy is necessary and then he will see if med is reqd or surgery.
Doctor :   I feel you might be having neurological damage resulting due to TAH. whcihc can can cause incontinence (either overflow)
User :   so what do u suggest now that I should do
Doctor :   sometimes, cystoscopy is done to rule out any, damage to the inner syphincter
Doctor :   of the bladder
Doctor :   Please tell me the currrent symptoms now -
Doctor :   Do you wet your inner clothes, ?
User :   the problem is every 20 or 30 mins I m passing urine
User :   yes it dribbles even after I pass urine and wet my panty
Doctor :   Do you have discomfort, when in public, due to this ?
Doctor :   are you able to hold urine for a longer time ?
User :   discomfort in the sense I m not going out due to this prob
User :   no
User :   i cannot hold
Doctor :   How often do you wake at night to urinate?
User :   I have to pass urine wen it comes
User :   i actually sleep quite less at nite these days being afraid that I will bed wet
User :   I sleep may be 3 or 4 hrs not at a stretch
Doctor :   According to me you have overflow incontinence, also a small bladder , So i will advise you to go ahead with the procedure.
User :   r there no med to cure this.
Doctor :   It will help you to see the interior of the bladder , and rule out other conditions
Doctor :   BUT TO GIVE MEDS, you need to know the exact condition
User :   I m separated and staying with my parents, problem is I quit my job and we do not have so much money to spend. he said it would cost around 12000 for a day
Doctor :   as treatment differs for different conditions
Doctor :   i understand,
Doctor :   Do you have any other qury.
Doctor :   thanks for consulting me here
Doctor :   bye for now
User :   hello dr.
User :   r u there
Doctor :   yes i am here
User :   so u suggest that I should go for cystoscopy
Doctor :   can you mail me all your reports to
User :   sure I can, do u want me to scan the reports and send.
Doctor :   I will review them, and then give you the detailed info on this matter
Doctor :   Yes please send the scanned images to this email
User :   but how will u revert back to me.
User :   on my email id or over ph
Doctor :   We have your email ID
User :   oh ok I will do that
Doctor :   and your phone no, and I will try to guide you correctly .
User :   is it possible to get your name and also I want to ask could it be possible infection
User :   or any kinda damage during surgery
Doctor :   A infection is suspected if you have fever, buringin micturition , pain in lower belly, etc.
User :   yes i do have pain in the lower abdo
User :   did have burning sensation 2wice
Doctor :   Is the pain reduced when you urinate ?
User :   but the consulting dr said I cannot say anything now
User :   no I did use a lil hot water which reduces the pain
Doctor :   ok
User :   wat could it be
User :   ecoli
Doctor :   Please mail me the reports
Doctor :   yes E coli is the main infection caused post surgery
Doctor :   but these cause UTI , but these are not associated with incontinence issues
Doctor :   Your problem could be due to neurological damage
User :   wat do u mean by neurological damage
Doctor :   Once i get your reports , i will review them and get back to you.
Doctor :   the nerves controlling the bladder, are near to the uterus,
Doctor :   SO during TAH, there are probability that these nerves get damaged
Doctor :   and result in incontinence
User :   but the uterus was removed
Doctor :   For all reasons, You can be given a trial of certain medicines, which can reduce your symptoms
Doctor :   cystoscopy is not a curative treatment in this case
Doctor :   But to decide which medicine to give, a complete history and examination is needed
Doctor :   The injury happened when the uterus was being removed, resulting in your current problem
Doctor :   Please mail me the reports and i will give you my opiNION on cystoscopy, on your email ID.
User :   so wat could be done now wat sort of remedy u suggest or do u know any urologist here at XXX where I can go
Doctor :   Are you following me ?
User :   yes
User :   do u know any dr. here
Doctor :   ok,
Doctor :   there are many urologists available on the homepage of our website
Doctor :   and there is a advanced list in there
Doctor :   you can choose any of them
Doctor :   But i will guide you accordingly
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