User talk:Satyendra Nath Malik

POT-PROSTATE SURGICAL PROBLEM

I am 69 yrs. old male residing at New Delhi. For the last 7 - 8 years I am having POST PROSTRATE urinary problem as under:

Problem: Delay in passing urine (5 – 15mts), incomplete evacuation and frequency( 15 – 20times). Delay is, in starting, intermittent stop – pass – start and at the end. At times there is sensation to pass but there is no excretion in spite waiting and effort. For passing urine probably I have to use abdominal pressure. After passing urine I have the urge to drink water. Immediately after taking water I feel the urge to pass again and most of the times I pass some qty. I have to get up 2 – 3 or more times in the night to void and many a times my sleep gets disturbed and I am not able to sleep after that. In such an event I have to use toilet almost every half an hour. I have to go for urination up to 15 – 20 or more in 24 hours. It takes me upto 10 – 15 minutes to void.. My water intake is above two liters exclusive of other fluids. Number of medicines have been tried by various urologists but they have not worked instead have caused problems At present I am not taking any medicine. I feel no extreme urge and have never felt a state of leaking. On the contrary withholding creates more difficulty in voiding than otherwise. After second surgery I developed retrograde ejaculation problem.

History: In the year 2000 I had prostrate removed through TUEVP method along with surgery for Hernia (RIH). Before surgery my prostrate was of 50 gms and I had no specific problem except frequency of urination. The enlarged prostrate was a chance discovery during the course of abdomen MRI in the year 1998 which I was advised to undergo for weight loss. Since I subsequently developed Hernia in the year 2000 I was informed that it is on account of enlarged prostrate and I must go for its removal. My problems after surgery continued and on consultation Urologist advised me after tests to undergo cystoscopy. Holmium Laser surgery was performed in the yr. 2002. In spite this I had some or the other problem. I had to go again for cystoscopy in the yr. 2005 when they found strictures, which were removed, and I was advised to undertake self-dilation once a week using no 16-rubber dilator. Initially I had been dilating once a week but gradually I reduced to once in three months. I had no problem in self dilatation except slight resistance near the bladder neck, in pushing the dilator up to the bladder till urine starts flowing. Uroflometery study conducted on 13.03.02 prior to Laser surgery had indicated normal pressure bladder with evidence of detrussor sphincter dyssenergia. For the last one year I have stopped self dilation under advise of a urologist. All other clinical parameters like BP, sugar etc.are normal. 30 years back I was diagnosed ISB (Irritable Bowl Syndrome). I have appetite but no hunger, disturbed sleep, irregular motions.

Though urologists consulted so far differ in their views on my problem and would like me to go for cystoscopic examination, which I do not see will serve the purpose. CAN SOMEONE ADVISE ME ON THE SOULUTION TO THE PROBLEM? S. N. M.