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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Frequent Painful Urination, Previous Prostate Operation

I am 88 years old and am facing urinary problem. I urinate seven to eight time a day and about a dozen time at night. Urination is not only frequent but a little painful also. I go to pass urine and come back and feel that I have to urinate again. My daily passing of urine is about 1 to 1.1/2 litres. I had been operated for prostrate two years ago. What should I do now.
Thu, 10 May 2012
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General & Family Physician 's  Response
HI,

Welcome to Health care Magic.

Based on the symptoms you have mentioned following are the possible causes

1. Urethritis- This often presents as frequent and painful micturition.

2. Prosatic hyperplasia- Commonest cause among men above 70 years.

3. Cystitis- Presents as Strangury, incomplete and frequent voiding which is painful. Sometimes some blood may be present in urine. Taking antibiotics will treat this condition

4. Diabetes mellitus- Frequent urination is commonly seen in diabetics but pain suggests urinary tract infection.
5. Defective spinchter mechanism.


As you have already been operated for prostrate the possibility of Prostatitis can be ruled out.

Among other possibilities cystitis ( inflammation of Urinary bladder) is the most probable diagnosis in your case.

But Diabetes with UTI has also to be ruled out. You have not mentioned whether you have diabetes or not.


Anyways get a complete urine analysis and Urine for culture and sensitivity done.
An ultrasound abdomen is to be done to rule out cystitis.

Based on the reports please see an Urologist or a physician and discuss about the treatment options.

Wish you a speedy recovery.

Take care

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Gastroenterologist, Surgical Dr. Ketan Vagholkar's  Response
The symptoms you have described are typical of prostatism. There is a high likelihood of a recurrent enlargement of the residual gland. I would suggest you to get the following investigations done and consult your urologist thereafter.
1. Trans rectal ultrasound (TRUS)
2 Trans abdominal USG for residual urine and status of the bladder.
3.Urine examination for organisms and malignant cells
4. CBC for infection .
5. PSA -prostate specific antigen levels in blood.
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Frequent Painful Urination, Previous Prostate Operation

HI, Welcome to Health care Magic. Based on the symptoms you have mentioned following are the possible causes 1. Urethritis- This often presents as frequent and painful micturition. 2. Prosatic hyperplasia- Commonest cause among men above 70 years. 3. Cystitis- Presents as Strangury, incomplete and frequent voiding which is painful. Sometimes some blood may be present in urine. Taking antibiotics will treat this condition 4. Diabetes mellitus- Frequent urination is commonly seen in diabetics but pain suggests urinary tract infection. 5. Defective spinchter mechanism. As you have already been operated for prostrate the possibility of Prostatitis can be ruled out. Among other possibilities cystitis ( inflammation of Urinary bladder) is the most probable diagnosis in your case. But Diabetes with UTI has also to be ruled out. You have not mentioned whether you have diabetes or not. Anyways get a complete urine analysis and Urine for culture and sensitivity done. An ultrasound abdomen is to be done to rule out cystitis. Based on the reports please see an Urologist or a physician and discuss about the treatment options. Wish you a speedy recovery. Take care