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I Have Been Having Issues With Urgency And Frequency Of

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Posted on Thu, 23 Jun 2022
Question: I have been having issues with urgency and frequency of urination. The symptoms were not serious
but sometimes were a problem specially after a short drive and also varying depending on the food I ate generally related to bloating. (I generally have digestive issues an as a result avoid quite a few foods and also maintain timely eating without eating anything in between)
In September 2021 I visited a Urologist who took a standard Q/A session and gave me tablets “Flatuna” for bloating but there was no improvement. Later I did an Abdominal Ultrasound and CT Scan and the report showed an enlarged Prostate. So the following week I was put on “OMNIC OCAS 0.4mg” which is Tamsulosin HCI to be taken once daily. After two weeks there was no change so I was given “Avodart 0.5mg” which is dutasteride also to be taken one capsule daily.
It has been nearly 4 months on OMNIC with AVODART and there seem to be marginal improvement only.
I would like to stop the medications anytime soon. Please advise if there is any special diet I can maintain to manage the problem as I do not want to take medications for a long period or what is the alternative.
Note: Attached are the CT Scan and Ultrasound reports for your reference
doctor
Answered by Dr. Dr. P. T. Patil (36 hours later)
Brief Answer:
Need few more investigations to be done .

Detailed Answer:
Hello
Thanks for query ,
Based on the facts and reports that you have uploaded you seem to have obstructive and irritative bladder voiding symptoms due to Benign Enlarged Prostate (BEP).

Your Urologist has rightly suggested the treatment which you have been taking since last four months but you are not happy as far as improvement in symptoms is concerned .

As regards the reports of CT scan there are few short falls in reports
1) The dimentions of prostate (size) and weight is not mentioned .
2) The volume of Post Void Urine Residue (PVR) is not mentioned
3) No Uroflowmetry study have been done .
4)Findings of Digital Rectal Examination (DRE) carried out by your Urologist needs to be mentioned .

These are very important as far as treatment modality is concerned .

BEP is a progressive ageing process and diet has no role to play as far treatment ais concerned .

You can add Tab Merabegrone 25 mg twice daily .It will help to ireduce your symptoms of urgency.

Please getfollowing tests done if not done so far and upload the reports
1) Uroflowmetry
2) Blood test for Serum PSA.
3) Ultrasound Scanning of abdomen with specific mention of Post Void Residual Urine (PVR).

If you do not desire to continue taking medications the only other treatment option is to undergo an endoscopic surgery of Trans Urethral Resection Of Prostate (TURP) to remove the enlarged prostate and make urinary passege free from obstruction caused by enlarged prostate .This will improve your symptoms and quality of life .However since you are 52 years old and comparatively in younger age group having a active sexual life you have to be prepared to accept some sexual dysfunctional side effects like retrograde ejaculation ,loss of libido ,painful ejaculation etc caused by these medicines and surgery .

Hope I have answered your query ,please feel free to ask if you have more questions, I shall be happy to help you
Thanks and Regards.
Dr.Patil.



Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. P. T. Patil (40 hours later)
Thank you Doctor for your reply.
Regarding the points you mentioned please note the following:
1)     Urine flow measurement was done and was OK. I do not have quantitive data.
2)     Blood test as prescribed by the Urologist was OK.
3)     Snapshots of Abdominal ultrasound Scan is attached
4)     DRE has not been done.
Also the Urologist here mentioned of a newer procedure called Rezum or Steam Therapy for shrinking the Prostate which will be quick and effective but will require 4 days of tubing for the Urine.
Please let me know more about this procedure and whether it is recommended and which hospital in XXXXXXX (Bangalore) where this can be done.
Thanks and regards,
Merwyn XXXXXXX
doctor
Answered by Dr. Dr. P. T. Patil (7 hours later)
Brief Answer:
Steam Therapy is not widely accepted and results are not longer lasting.

Detailed Answer:
Hello
Thanks for follow up and updating the reports .
The steam Therapy is not univerasally accepted procedure and the results of treatment are not longer lasting .It does cause severe urinary infection after the procedure .

I would suggest you to continue the same treatment else take a decision for surgery to remove the prostate .(TURP)

Thanks and Regards.
Dr Patil.


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. P. T. Patil (2 days later)
Hello Doctor,
One more question Is the medication to be taken permanently or can it be stopped after 6 Months. Also Can the medication be interrupted for say about a week in between.
Thanks and Regards,
Merwyn XXXXXXX
doctor
Answered by Dr. Dr. P. T. Patil (7 hours later)
Brief Answer:
Take medicines for 4 months

Detailed Answer:
Hello
Thanks for follow up .
Take the medicines for four months without interuption .
Thanks and Regards.
Dr Patil.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. LAKSHMI
doctor
Answered by
Dr.
Dr. Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10589 Questions

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I Have Been Having Issues With Urgency And Frequency Of

Brief Answer: Need few more investigations to be done . Detailed Answer: Hello Thanks for query , Based on the facts and reports that you have uploaded you seem to have obstructive and irritative bladder voiding symptoms due to Benign Enlarged Prostate (BEP). Your Urologist has rightly suggested the treatment which you have been taking since last four months but you are not happy as far as improvement in symptoms is concerned . As regards the reports of CT scan there are few short falls in reports 1) The dimentions of prostate (size) and weight is not mentioned . 2) The volume of Post Void Urine Residue (PVR) is not mentioned 3) No Uroflowmetry study have been done . 4)Findings of Digital Rectal Examination (DRE) carried out by your Urologist needs to be mentioned . These are very important as far as treatment modality is concerned . BEP is a progressive ageing process and diet has no role to play as far treatment ais concerned . You can add Tab Merabegrone 25 mg twice daily .It will help to ireduce your symptoms of urgency. Please getfollowing tests done if not done so far and upload the reports 1) Uroflowmetry 2) Blood test for Serum PSA. 3) Ultrasound Scanning of abdomen with specific mention of Post Void Residual Urine (PVR). If you do not desire to continue taking medications the only other treatment option is to undergo an endoscopic surgery of Trans Urethral Resection Of Prostate (TURP) to remove the enlarged prostate and make urinary passege free from obstruction caused by enlarged prostate .This will improve your symptoms and quality of life .However since you are 52 years old and comparatively in younger age group having a active sexual life you have to be prepared to accept some sexual dysfunctional side effects like retrograde ejaculation ,loss of libido ,painful ejaculation etc caused by these medicines and surgery . Hope I have answered your query ,please feel free to ask if you have more questions, I shall be happy to help you Thanks and Regards. Dr.Patil.