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Had laser ablation. Severe pain and bleeding later, burning with urination. Can the urine be draining? How to reduce pain?

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Practicing since : 1995
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Had laser ablation for BPH 1/10/2012. Bled a more than would be considered normal post surgery for the next week. Had severe pain, returned to urologist six weeks later and scope showed that I was healing abnormally slow. Have infection, was on doxycycline, changed to CIPRO two days ago. The burning with urination that due to infection has already decreased by 90%. The problem that I have had all along, which the urologist can't figure out is as follows: when I'm laying down (sleeping) or reclined in a chair I have minimal problems. If I wake at night to urinate - not too much pain. HOWEVER...if I am awake/STANDING, I feel a little 'movement' that seems like it is either in my prostate or just distal from it - then a severe pain that makes it feel like I better get to the bathroom NOW. Oddly, the less urine there is to pass the more it hurts. If I pass just a few CC's the pain is incredible. If normal urine volume minimal pain. It seems to be a positional thing - like urine is draining into something and irritating....? At any rate the pain is so severe that I have been having difficulty functioning. Never had this before getting the laser treatment to the prostate.
Posted Tue, 22 May 2012 in Men's Health
Answered by Dr. V. Sasanka 3 hours later
Your condition is not unusual in that Laser prostate ablation does produce severe irritating symptoms in a significant number of patients, as there is a raw area which takes time to heal, and as you have realized yourself, some patients heal slower than others.
Urinary alkalinizers to reduce the acidity of urine might be of symptomatic benefit. Ciprofloxacin or Doxycycline do help in that they help prevent rather than actual treament of any infection.
Some times patients may benefit from a class of drugs known as anti-cholinergics which reduce the bladder spasms and the urge to void urine immediately.
You could also try to learn to intermittently squeeze your sphincter as if you are preventing urine from coming out. You could squeeze for 5 secs, and let go for 10 secs, and squeeze again. Such cycles need not last for more than 5 minutes at a time, and you could repeat it hourly through the day. There is no guarantee that this will benefit, but it might help in avoiding urine coming in contact with a raw area which probably is the cause of distress.You could do this through the day even when you are idle and watching the television.
Please do let me know how you are progressing.
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