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Suggest treatment for urine blockage and upper thigh pain when suffering from enlarged prostate?

DOCTOR OF THE MONTH - Jul 2016
Jul 2016
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Practicing since : 1971
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Suffering from urine blockage and pain in the upper thigh, IBS with constipation dominant. Taking clonazepam o.25 mg BD, Mirtazapine 7.5 mg OD and Rabeprazole sodium 10 mg, Isbagol husk 10 gm two times in a day for the last 4-5 years. For urine blockage took prufloxin 700 mg for a month and alpha blockers ( Alfoo and urimax) for a month. UB Normally distended, Prostate 24 CC, enlarged, PVRU 62 CC, urine examination normal, peak flowrate 10 ml/s, time to peak flow 6 s, voided volume 504 ml, flow time 85 s, voiding time 85 s and average flowrate 6 ml/s Imp. Prostatomegaly grade -I No relief so far. Your opinion please. What treatment you will advise and the approximate charges involved for the treatment
Posted Tue, 28 Jan 2014 in Urinary and Bladder Problems
 
 
Answered by Dr. P. T. Patil 1 hour later
Brief Answer: Bladder Outelet Obstruction due to Fibros Prostate Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have difficulty in passing urine with poor flow as revealed on Uroflowmetry study. Though your ultrasound scanning is reported to have grade 1 enlarged prostate you have symptoms like poor flow of urine (only 6ml per second) ,difficulty in passing urine,significant post void urine residue(62 cc ) ,prolonged voiding time etc.All these symptoms are suggestive of Bladder Outflow Obstruction due to fibrous prostate. Please consult qualified urologist for clinical assessment who may carry out endoscopic examination of bladder (Cystoscopy) to confirm the diagnosis. I think you need endoscopic incision of bladder neck (BNI) to remove the obstruction to improve your urine flow. Discuss with your Psychiatrist about the side effects of the drugs that you are taking for anxiety and depressive disorder.These drugs are known to have side effects like difficulty in passing urine etc. Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you Thanks and Regards. Dr.Patil.
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for urine blockage and upper thigh pain when suffering from enlarged prostate? 28 minutes later
What will be approximate charges of Cystoscopy and BNI. As I am taking low dose of anti anxiety and antidepressant medicines, Can these medicines affect my problem to such an extent.
 
 
Answered by Dr. P. T. Patil 1 hour later
Brief Answer: It is not entirely dueto these drugs. Detailed Answer: Hello Thanks for follow up. The charges depend upon the city and hospital where you want to get these procedures done,But Cystoscopy will cost you roughly 6-7 thousand Indian Rs and BNI will cost you Rs 25000 to 30000 . Thanks and Regards. Dr.Patil.
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for urine blockage and upper thigh pain when suffering from enlarged prostate? 4 hours later
Sir, what can be the complications if problem remained untreated and within how many days I have to get my problem treated since I have to arrange for the charges. If treated, then what the side effects can be. If I go for Cystoscopy or BNI, is there chances of getting infection in the urinary tract etc. Is there any other medicine which can be tried/effective. For the treatment , for how many days I have to remain in the hospital.
 
 
Answered by Dr. P. T. Patil 17 minutes later
Brief Answer: It is not urgent. Detailed Answer: Hello Thanks for follow up. You can get operated as per your convenience within 2-3 months. After BNI you will face problem of retrograde ejaculation which is a known complication of this surgery. The chances of getting urinary infection after the surgery are minimal. You will be hospitalised for 2-3 days. You have been already taking alpha blockers for months with no satisfactory results .Hence better to get operated to improve quality of life. Thanks and Regards. Dr.Patil.
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Follow-up: Suggest treatment for urine blockage and upper thigh pain when suffering from enlarged prostate? 44 minutes later
Thank you so much Is retrograde ejaculation problem occurs in all cases
 
 
Answered by Dr. P. T. Patil 6 hours later
Brief Answer: Yes It occurs almost in all the cases. Detailed Answer: Hello Since in surgery of Bladder Neck Incision bladder neck is incised widely retrograde ejaculation occurs in almost all the patients. Thanks and Regards. Dr.Patil.
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