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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for urination problems after administration of oral chemotherapy

MY wife had been operated for Rt breast cancer about 3 yrs back. treated with Chemotheraoy & radiation. Got it OK. But since this year a growth near her chest wall between the throat. Traeted with Palliative chemotherapy 3 doses Not much effect. Treated with Local radiation 90% effective started on oral chemotherapy Capecitabine 500mg 3+3 Morning +eveneing for 14 days, A reaction occured getting loose motions, which could not be controlled with Medicines even after 15 days- Weakness occured Soium & Pottasium very low, had to be hospitalised for 7 days with Drip of sodium & Potassium+ other medicines. Problem arose since hospitalisation Normal urine could not be passed. Had to be catheterised. After every week catheter was removed & tried to get normal urine passage but had to be Catheterised. Got a URODYNAMIC Test done: Comments and Findings :- Regional Neurological examination S2 -S4. Sensation are present; Anal tone is Normal; Voluntary contraction of the SPHINCTER is Absent; Bulbocavernosus Reflex is Present; Blader Capacity is Large - 400 ml.; Proprioception is delayed; Compliance is high; Detrusor is Acontracile; SPHINCTER is coordinated relaxing during attempts at voiding volitional activity is absent; Urethral closure mechanism is normal;Recovery in detrusor function is anticipated. Dr. opined that her Bladder wall muscles have become weak, may be due to the Hyponatremia she had undergone and that with time it should get normal. after 15 days again tried it out but urine could not be passed. Gave her Injection Ciflotaxim 1gm. intravenous. Even after 15 minutes Normal urine could not be passed had to be catherised for one month Now Given Pills for Infection Ciplofloxin 500mg for 5 days 2 times a day. Then Ciplofloxin 250 mg. for 25 days 1 a day.Today her testd are Normal Sodium:139’ Pottasium:4.8; Chloride:101; RBC Heamoglobin & WBC are Normal. Urine report states Puss cells : 40-45 hpf Red Cells 10-12hpf all other parameters are normal. WHAT SHOULD BE DONE TO RESTORE NORMAL PASSAGE OF URINE?
Thu, 9 Feb 2017
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Oncologist 's  Response
Hi.
As per the reports the detrusor muscles are acontractlile.As the muscle is not contrracting well your wife can not pass urine on her own.Now things will take time to settle down.antibiotic therapy is given to herbto prevent infection.
My suggestion is don't panic ,muscle will gain its slowly.Consultba physiotherapist for exercises which will increase muscle tone.
keep a eye on her serum electrolyte as rapod fluctuation of electrolyte can cause damage to muscle in her case.
Slowly and slowly things will pick up.
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Suggest treatment for urination problems after administration of oral chemotherapy

Hi. As per the reports the detrusor muscles are acontractlile.As the muscle is not contrracting well your wife can not pass urine on her own.Now things will take time to settle down.antibiotic therapy is given to herbto prevent infection. My suggestion is don t panic ,muscle will gain its slowly.Consultba physiotherapist for exercises which will increase muscle tone. keep a eye on her serum electrolyte as rapod fluctuation of electrolyte can cause damage to muscle in her case. Slowly and slowly things will pick up.