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Urology (Expert Forum)
urinal leakage
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
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.
urinal leakage
by a. d, Aug 16, 2003 12:00AM
Hello I'm a 27 y.o male whose medical condition started when I was at the age of 19 after a series of emotional traumas including an institutionalization in a mental hospital by my mother following
an attempt to commite suicide by her from which she survived only barely .Howver
through all this period till now I've never been given any psychiatric pills .Those events occured at the age of 18.5 and in my mind serve as a prelude to my disease which started to envelop afterwards .I know that my history as a mental patient make me a better candidate to complain about diseases that dont exist however my expectation from this correspondence is to be able to receive some suggestions based on your area of expertise on how to solve the problem and not a psychiatric evaluation .let me cut right to the description of symptoms which bother me basically what it's is uncontrolled urination one or two drops at a time there is no physical pain involved
and sometimes it's even hard to detectwhen it actually occures (have to look) the symptoms occure less in the morning or after sleep and more at the periods after urinationsthrough out the day
My initial response to the symptoms was
an effort to try and curb them by increasing up the holding back but as i soon after realized this was only serving to increase the pressure there are some noticeable changes inmy urination characterastics , thats when I go to the bathroom, among them the last phase of urination where there should be strong, short and abrupt streams turns upside down in my case i.e my last phase of urination is weak and the pumped like abrupt streams feels more like a leakage .This is the place to mention that among some medical examinations that I went through there was one that checked my stream strength which turned up to be fine another medical procedure that i went through and concerned examination of the prostate gland was as I was told by the urologist back then 2 phases examination the immidiate phase turned up to be fine and in concern to the sec phase whichinvolved waiting for lab results I dont know how it turned up to be because i did't follow through on the results.These half results attributed somewhat to a feeling of mine that medicine has nothing to offer in acquiring a physical reasoning of my condition ,nor it can help me to find a cure at one point i was given a pill which had no positive impact on my condition (unfortunatelly I cant recall its name).nevertheless right now ive new determination to take another shot of trying to solve the problem Im willing to go at any length in order of doing so and this is where your advice is required. I live in Thailand but if lets say youll tell me that there is a certain place which is more capable than anywhere else im treating my condition
then ill be willing to flythe distance have u ever heard about a case similiar to mine and if so can u give me any leads towards what it might be and what should I do about it
an attempt to commite suicide by her from which she survived only barely .Howver
through all this period till now I've never been given any psychiatric pills .Those events occured at the age of 18.5 and in my mind serve as a prelude to my disease which started to envelop afterwards .I know that my history as a mental patient make me a better candidate to complain about diseases that dont exist however my expectation from this correspondence is to be able to receive some suggestions based on your area of expertise on how to solve the problem and not a psychiatric evaluation .let me cut right to the description of symptoms which bother me basically what it's is uncontrolled urination one or two drops at a time there is no physical pain involved
and sometimes it's even hard to detectwhen it actually occures (have to look) the symptoms occure less in the morning or after sleep and more at the periods after urinationsthrough out the day
My initial response to the symptoms was
an effort to try and curb them by increasing up the holding back but as i soon after realized this was only serving to increase the pressure there are some noticeable changes inmy urination characterastics , thats when I go to the bathroom, among them the last phase of urination where there should be strong, short and abrupt streams turns upside down in my case i.e my last phase of urination is weak and the pumped like abrupt streams feels more like a leakage .This is the place to mention that among some medical examinations that I went through there was one that checked my stream strength which turned up to be fine another medical procedure that i went through and concerned examination of the prostate gland was as I was told by the urologist back then 2 phases examination the immidiate phase turned up to be fine and in concern to the sec phase whichinvolved waiting for lab results I dont know how it turned up to be because i did't follow through on the results.These half results attributed somewhat to a feeling of mine that medicine has nothing to offer in acquiring a physical reasoning of my condition ,nor it can help me to find a cure at one point i was given a pill which had no positive impact on my condition (unfortunatelly I cant recall its name).nevertheless right now ive new determination to take another shot of trying to solve the problem Im willing to go at any length in order of doing so and this is where your advice is required. I live in Thailand but if lets say youll tell me that there is a certain place which is more capable than anywhere else im treating my condition
then ill be willing to flythe distance have u ever heard about a case similiar to mine and if so can u give me any leads towards what it might be and what should I do about it
Doctor's Answer
by Kevin Pho, MD, Aug 16, 2003 12:00AM
, Aug 16, 2003 12:00AM
You have obviously been examined by a urological specialist - it would be difficult to say what is going on.
Here are some tests to consider if haven't already done. This would include renal function tests, glucose, calcium, and a vitamin B12 level. It goes without saying that a urinalysis should also be done.
Urodynnamic testing should also be considered. You may have had some of them before. Here are others you may want to discuss with your urologist:
- Fluid cystometry demonstrates bladder proprioception, capacity, detrusor stability, contractility, and voiding efficacy.
- Carbon dioxide cystometry may be unreliable because the gas is compressible and can irritate the bladder.
- Simultaneous measurement of abdominal pressure is necessary to exclude the effects of abdominal straining and detect DHIC.
- Fluoroscopy, abdominal leak-point pressure, or profilometry is required to detect and quantify stress urinary incontinence.
- Pressure-flow studies are required to evaluate outlet obstruction.
Here is the website from the American Urological Association. You can find another urologist for a second opinion:
http://www.urologyhealth.org/find_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.
Thanks,
Kevin, M.D.
DuBeau. Clinical presentation and diagnosis of urinary incontinence. UptoDate, 2003.
Here are some tests to consider if haven't already done. This would include renal function tests, glucose, calcium, and a vitamin B12 level. It goes without saying that a urinalysis should also be done.
Urodynnamic testing should also be considered. You may have had some of them before. Here are others you may want to discuss with your urologist:
- Fluid cystometry demonstrates bladder proprioception, capacity, detrusor stability, contractility, and voiding efficacy.
- Carbon dioxide cystometry may be unreliable because the gas is compressible and can irritate the bladder.
- Simultaneous measurement of abdominal pressure is necessary to exclude the effects of abdominal straining and detect DHIC.
- Fluoroscopy, abdominal leak-point pressure, or profilometry is required to detect and quantify stress urinary incontinence.
- Pressure-flow studies are required to evaluate outlet obstruction.
Here is the website from the American Urological Association. You can find another urologist for a second opinion:
http://www.urologyhealth.org/find_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.
Thanks,
Kevin, M.D.
DuBeau. Clinical presentation and diagnosis of urinary incontinence. UptoDate, 2003.
Member Comments
by LPB9999, Nov 13, 2003 12:00AM
To: Urology - General
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