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Incontinence (Urinary) (Expert Forum)
Difficulty urinating (dribble) and ED, but small prostate
Answered by
David A Burks, MD - Interstitial Cystitis, Urology
Henry Ford Health Systems
Detroit - MI
Questions in the Urinary Incontinence forum are answered by Dr. David A. Burks, MD from Henry Ford Health Systems.
Difficulty urinating (dribble) and ED, but small prostate
by DM62, Aug 30, 2009 05:15AM
I am a male with almost exactly the same symtoms as you discussed in 'Treatmnt for Urine Retention', except I am age 47, not 76 ...and feel like my current doctor is too prone to advise a TURP, when I really don't want surgery.
I am told my prostate is not that large, and I have difficulty urinating that seems to be getting worse, as I've just last week increased a dosage of Hytrin from 5mg to 10mg, with only marginal benefit (Hytrin used to work great at only 5mg). I've been originally told that it's likely an inability to relax the bladder sphincter, by one urologist, and told that I may need a TURP by my current urologist, who seems to see the problem differently. On top of that, I think there has been an occasional/periodic slight burn or stinging for several years now (it's so hard to clearly feel what the heck is really going on). I have some ED and I have a general 'dead' feeling down there, but some pointed discomfort around the groin and pubic area sometimes. I also feel uncomfortable like I may have an UTI or something.
I don't want surgery - Im only 47. Confused and worried. ???
I am told my prostate is not that large, and I have difficulty urinating that seems to be getting worse, as I've just last week increased a dosage of Hytrin from 5mg to 10mg, with only marginal benefit (Hytrin used to work great at only 5mg). I've been originally told that it's likely an inability to relax the bladder sphincter, by one urologist, and told that I may need a TURP by my current urologist, who seems to see the problem differently. On top of that, I think there has been an occasional/periodic slight burn or stinging for several years now (it's so hard to clearly feel what the heck is really going on). I have some ED and I have a general 'dead' feeling down there, but some pointed discomfort around the groin and pubic area sometimes. I also feel uncomfortable like I may have an UTI or something.
I don't want surgery - Im only 47. Confused and worried. ???
Doctor's Answer
by David A Burks, MD, Sep 07, 2009 02:34PM
, Sep 07, 2009 02:34PMTo: DM62
HI, The #1 question is--what is the diagnosis? Do you have a UTI, a prostatitis, an enlarged prostate blocking the urethra, or overactive bladder? It is possible for a male with a small prostate to still have bothersome symptoms. It's not so much the size as it is the configuration of the prostate and whether it's causing an obstruction separate from it's size. You need a urodynamic evaluation where pressures are measured in your bladder thru a very small catheter while the bladder is filled with water and during voiding.
If there is no obstruction, an infection in the prostate (prostatitis) could give you these symptoms, and the treatment is a month of antibiotics. If your shhincter doesn't relax, then pelvic floor muscle physical therapy is needed. If your bladder is overactive that can be treated with medications. If there is an obstruction, and your symptoms are bothering you enough, options would include a few deep cuts in your prostate to open it up vrs the standard TURP using cutting or with a laser. The bottom lne is, you need the urodynamic test to sort out for these problems, then consider the appropriate treatment. Good Luck
If there is no obstruction, an infection in the prostate (prostatitis) could give you these symptoms, and the treatment is a month of antibiotics. If your shhincter doesn't relax, then pelvic floor muscle physical therapy is needed. If your bladder is overactive that can be treated with medications. If there is an obstruction, and your symptoms are bothering you enough, options would include a few deep cuts in your prostate to open it up vrs the standard TURP using cutting or with a laser. The bottom lne is, you need the urodynamic test to sort out for these problems, then consider the appropriate treatment. Good Luck
