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Urology (Expert Forum)
Chronic Urinary tract problems
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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Chronic Urinary tract problems
by puckinthehead, Jan 13, 2006 12:00AM
I will first give you the details. 36, five foot nine, 200 lbs.
History: two cycstoscopy surgeries within the past two years by another Doctor who has since retired..
Both were "successful" the second resulting in a catheterization.
Present: Four months ago had problems with burning and Itching sensations during urination. Also had minor-pus like discharge and sought advice my famliy physician. (a fantastic doctor... I owe him my life... Literally!). Tests for stds/chlamydia taken and proved negative. I was referred to another Eurologist. I must admit I was NOT pleased with the treatment. He did NO further urine testing and did a prostate palpation but did not swab for discharge. He booked me for another cystoscopy and was quickly dismissed. After my previous surgeries I had concerns and questions about having a 'third' cystoscopy. I tried to book an appointment before the surgery but no time was available before the scheduled date.
He instead returned my call (which I think is fair and commendable), however he was quite impatient, and made little attempt to answer my questions. (which is why I am here). I asked him why a third surgery, and when I asked him if there was a risk of creating more scar tissue (resulting in more strictures), why would we do it and I quesitoned if there were alternatives to rushing into the O-R?s He was short, and impatient and was quite rude. Instead of addressing my concerns,
he said he was going to cancel my surgery and told me to go back to my family doctor and hung up. Perhaps this was a blessing in disguise as I am pretty I don't need this guy as my doctor.
I have since re booked with my family physician for possibly more tests and a referral to another Eurologist. That being said...
Here are my concerns.
Presently, I have been noticing a foaming in my urine when it hits the toilet water. I feel a dull ache in my prostate, no more itching but recently I have been up all hours of the night going to urinate, however my bladder doesn't feel full. It seems to me more like I feel pain and swelling somewhere between prostate area and the Urethra. (I know it's diffuclt to determine where this kind of pain can be located but I have had all kinds of urinary tract problems since I was a child, been poked, tested, sampled and scoped so much that I am feeling kinda frustrated about it. Been put on Cipro a few times in my twenties and early thirties). I find that after ejaculation I am sore internally, and I feel like I have to urinate for hours afterwards. Again I think it has to do with some kind of inflammation somewhere.
I am frustrated... I desperately DO NOT want another Surgery, and I honestly think that not enough thought, effort or investigation is being made into the etiology of my problem. Can you make any suggestions?
Thanks ever so much
History: two cycstoscopy surgeries within the past two years by another Doctor who has since retired..
Both were "successful" the second resulting in a catheterization.
Present: Four months ago had problems with burning and Itching sensations during urination. Also had minor-pus like discharge and sought advice my famliy physician. (a fantastic doctor... I owe him my life... Literally!). Tests for stds/chlamydia taken and proved negative. I was referred to another Eurologist. I must admit I was NOT pleased with the treatment. He did NO further urine testing and did a prostate palpation but did not swab for discharge. He booked me for another cystoscopy and was quickly dismissed. After my previous surgeries I had concerns and questions about having a 'third' cystoscopy. I tried to book an appointment before the surgery but no time was available before the scheduled date.
He instead returned my call (which I think is fair and commendable), however he was quite impatient, and made little attempt to answer my questions. (which is why I am here). I asked him why a third surgery, and when I asked him if there was a risk of creating more scar tissue (resulting in more strictures), why would we do it and I quesitoned if there were alternatives to rushing into the O-R?s He was short, and impatient and was quite rude. Instead of addressing my concerns,
he said he was going to cancel my surgery and told me to go back to my family doctor and hung up. Perhaps this was a blessing in disguise as I am pretty I don't need this guy as my doctor.
I have since re booked with my family physician for possibly more tests and a referral to another Eurologist. That being said...
Here are my concerns.
Presently, I have been noticing a foaming in my urine when it hits the toilet water. I feel a dull ache in my prostate, no more itching but recently I have been up all hours of the night going to urinate, however my bladder doesn't feel full. It seems to me more like I feel pain and swelling somewhere between prostate area and the Urethra. (I know it's diffuclt to determine where this kind of pain can be located but I have had all kinds of urinary tract problems since I was a child, been poked, tested, sampled and scoped so much that I am feeling kinda frustrated about it. Been put on Cipro a few times in my twenties and early thirties). I find that after ejaculation I am sore internally, and I feel like I have to urinate for hours afterwards. Again I think it has to do with some kind of inflammation somewhere.
I am frustrated... I desperately DO NOT want another Surgery, and I honestly think that not enough thought, effort or investigation is being made into the etiology of my problem. Can you make any suggestions?
Thanks ever so much
Doctor's Answer
by Kevin Pho, MD, Jan 14, 2006 12:00AM
, Jan 14, 2006 12:00AM
Difficult to say without examination.
Foaming in the urine may be indicative of protein in the urine. A urinalysis should be done to evaluate this. Blood tests to evaluate kidney function, as well as an ultrasound of the kidneys should be considered.
A non-revealing cystoscopy would be anatomical abnormalities of the lower GU tract less likely (i.e. strictures or polpyps). I would further evaluate the prostate. Any type of lingering infection or abscess can lead to some of your symptoms.
Workup of the prostate can include prostatic massage, looking for any bacteria that may not have been appropriately treated, or a transrectal ultrasound to image the prostate.
These options can be discussed with your urologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
Foaming in the urine may be indicative of protein in the urine. A urinalysis should be done to evaluate this. Blood tests to evaluate kidney function, as well as an ultrasound of the kidneys should be considered.
A non-revealing cystoscopy would be anatomical abnormalities of the lower GU tract less likely (i.e. strictures or polpyps). I would further evaluate the prostate. Any type of lingering infection or abscess can lead to some of your symptoms.
Workup of the prostate can include prostatic massage, looking for any bacteria that may not have been appropriately treated, or a transrectal ultrasound to image the prostate.
These options can be discussed with your urologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
Member Comments
by maryfran, Apr 08, 2006 12:00AM
To: Urinary Tract Infections
0
