Urology Expert Forum
Voiding Pain
About This Forum:

Questions in the Urology forum are answered by medical professionals at Healthcare Magic. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Avatar universal
Voiding Pain
Without going into too much detail, I had a TURP done about 18 months to remove some infected tissue. It left with three new problems:

a. UI: This was fixed with botox injections. Also have some SI, but it's minor enough to live with, at least right now.

b. If I empty completely I get a spasm-like pain that is all of 9-10 on a 10 pt. scale. Fortunately it is short-lived (15 seconds to a minute) and I can control it by not emptying. I don't know exactly where this pain is, but I know it's somewhere in my bladder or prostate. I feel it more in my lower belly than in my perineum.

c. Too explicit to talk about here, but it's also a pain issue.

My original urologist tried me on just about all OAB medications: Detrol, Ditropan, Enablex, etc. My current urologist had me try Flomax, even though I don't have a flow problem. As I said, the Botox fixed my UI, but has done nothing for this pain. (It was injected only into the front wall of my bladder.)

I have developed a theory, but I'm having trouble getting her (my urologist) to really listen. As part of the TURP, I know at least some of my bladder neck was removed. I'm wondering if, when I empty, my bladder neck gets the signal to close, but some afferent nerve endings were removed and are not present to tell my micuration center that it has closed, so my bladder neck continues to squeeze, causing the painful spasms. (I'm wondering if this is also causing problem "3.") Is this even possible? Anyone have ideas for places I could look to gather info for her?
Discussion is closed
Cancel
2 Answers
Page 1 of 1
233190 tn?1278553401
I am not a urologist, so my insight into this question is limited.

The medications you have tried are a standard approach to conservative therapy.  

Although possible, I am not aware that the scenario you described being a common complication of the TURP.  

You can consider a cystoscopy to further evaluate the lower GU tract.  Imaging with a transrectal ultrasound can determine whether there is a residual abscess.  

I would also send the urine off for analysis and culture.

Obtaining another opinion, preferably at a major academic medical center, can be considered if the symptoms continue.

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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com
Discussion is closed
Cancel
Avatar universal
Sorry, not much help for my $16.00...
Believe me, I have had all of that done, several times.

I just want to know if my theory, from the standpoint of the physiology of voiding, is even possible.
Discussion is closed
Cancel
A
A
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
233488 tn?1310696703
Blank
Marathon Running Done Over Many Yea...
05/15 by John C Hagan III, MD, FACS, FAAOBlank
233488 tn?1310696703
Blank
New Article on Multifocal IOL vs &q...
05/15 by John C Hagan III, MD, FACS, FAAOBlank
748543 tn?1463449675
Blank
TMJ/TMJ The Connection Between Teet...
01/15 by Hamidreza Nassery , DMD, FICOI, FAGD, FICCMOBlank