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frequent urination NSAIDs

follow-up to my original question.  I should have noted that I was prescribed Cipro (500 mg per day; 7 days for possible UTI.  I didn't have one.  I did have a significant reaction after several cups of coffee while on Cipro (could caffeine have damaged receptors in bladder?  I have been checked for blockage (stones).  I have had an MRI on upper spine and a brain scan.

On the first few nights, something was definately irritating the lower bladder and urethra all the way to the head of the penis, if I recall correctly.  I remember getting up possibly 10x in the first 1 1/2 hours after going to bed due to an urge though there was minimal volume.  Got up probably 15 to 20x the first few nights.

I had injured my lower back and was under some stress about the slow recovery (concerned about full recovery in general).  I don't recall being particularly stressed that night, but it had been 7 weeks since the injury (diagnosed as discogenic micro-tears causing muscle strain).  I did not take pain relievers (during this period until 9/24 (again dose of Ibuprefen then was far less than what I took on the day in which I had frequent urination that evening.

I have been on flo-max for over six weeks (still have problem).  Also have been prescribed clonazepam if cause is stress related.  I'm certainly under stress now with this problem.

If stress related, how should this be treated?  Give me some success stories if possible.

I am seriously considering bladder neck surgery (already diagnosed as cause of difficulty in emptying bladder, weak flow, etc. one year ago).  Could bladder neck, bladder etc. have tighted up considerably due to stress?  Could a tight bladder neck cause urge even when bladder was not full?

When tested recently I (I came to urolgist with full bladder.  I emptied 375 ml to the best of my ability.  Catherization indicated there was about 200 ml still in by bladder.

Any other advice on addressing my particular case (circumstances, fact scenario, etc.) of frequent urination would be greaty appreciated.

Thanks
1 Responses
233190 tn?1278553401
MEDICAL PROFESSIONAL
I would make sure that an infection is not a possibility - this can be easily done with a urinalysis and tests for STDs such as gonorrhea or chlamydia.  

The next consideration would be tests to evaluate prostate size.  You note that you have been on Flomax - which helps shrink the prostate.  If the prostate continues to be big despite medication, then surgical options may be discussed.

If the symptoms are stress related, then modalities such as antidepressants and counselling may be helpful in treating the stress, thus helping the symptoms.  I would make sure that medical diseases are ruled out before attributing the symptoms to stress.  

If there is concern about the bladder neck, there are a series of tests that can be considered to evaluate this.  This would include cystometry (or cystometrogram) to evaluate bladder function by measuring pressure and volume of fluid in the bladder during filling, storage, and voiding; uroflowmetry measures the rate of urine flow, and urethral pressure profile tests.  They can all 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.

Thanks,
Kevin, M.D.
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