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Treatment for enlarged prostate

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Practicing since : 1995
Answered : 518 Questions
I have an enlarged prostate. Sometimes I would like to do activities that keep me away from a restroom too long. I wanted to try one of those hydro.. personal catheters to see if I could drain all urine before the activity and not need restroom until much later. I tried inserting one this evening and didn't get to relieve any urine . It hurt about 6" in so I withdrew it and bright red blood started coming out. I pinched off the flow for awhile and it stopped. The next time I urinated, about an hour later, a clot came out, it burned and I had to do the pinch process all over again. What do I do now, anything? Or will it heal on its own eventually?
Posted Fri, 14 Mar 2014 in Men's Health
Answered by Dr. V. Sasanka 37 minutes later
Brief Answer: You can try medicine for benefit Detailed Answer: Hi, You have not mentioned how big your prostate is or what your symptoms are, but I can assure you that there are quite a few medicines to reduce the size of prostate (e.g. Dutasteride) and drugs to help you evacuate urine better (e.g. tamsulosin, available as Flomax and several other brands). I also feel that you should get a urologist's opinion and get a digital rectal examination along with a blood test for Prostate Specific Antigen (PSA) done to ensure you do not have malignancy of prostate. They also might ask you to get an ultrasound of your prostate and a uroflowmetry done to assess the kind of problem you have. All the symptoms that are exhibited by people with enlarged prostate are also seen in patients with stricture of urethra. This is a mechanical narrowing of the lumen of urine passage and will prevent passage of catheter as could have been the case with you. This might need an endoscopic procedure as there are no medicines for stricture of urethra. Anyway, self drainage by catheter does not look like much of a solution right now, and I suggest that if you really need to do, it you ensure that you perform it under good urologist's guidance (after he has excluded or treated a stricture of urethra) till you learn the technique. What you have experienced is a classical injury of urethral mucosal lining. Hopefully it will heal without residual sequelae, though development of a stricture of urethra is a significant possibility. Hope I have been able to help you.
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Follow-up: Treatment for enlarged prostate 12 minutes later
Thank you. You've been very helpful. Prostate not too enlarged. Only get up once a night. PSA is <2. Will have stricture possibility checked out. Thanks again.
Answered by Dr. V. Sasanka 2 hours later
Brief Answer: Welcome Detailed Answer: Hi again, You are welcome. Glad to have been of help. One suggestion though - If you are reasonably comfortable right now and there is no urethral bleed, do not get any tests done for stricture straight away. The reason - you have most likely a classical false passage due to urethral self-instrumentation. Quite often, this heals by itself, but your Urologist might want to see a special radiograph called Retrograde Urethrogram to assess the kind of injury that has been sustained. In the presence of active bleeding in urethra, there could be significant intravasation of contrast XXXXXXX into local pelvic veins and the whole thing could be a mess. So wait till things are relatively normal. I will be quite happy to advise you if you have any further queries in this matter.
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