Suggest Treatment For Enlarged Prostate

Posted on Mon, 3 Aug 2015

Question: For more than a week i have had great difficulty controlling urination-tested for infections but came up negative. Urinating every 15 minutes. Takes time, is painful and can be very painful after urinating, for as long as two or three minutes. Am on amoxycillin for past five days but absolutely no change, in fact it may be worse

I have an enlarged prostate and have taken medication for that for 7 years-the pain I am inquiring about is in the penis. ONe other factor==I had a penile implant 9 months ago

Answered by Dr. Dr. P. T. Patil (3 hours later)

Brief Answer:
Needs evaluation.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have penile implant since nine months and have been taking medications for enlarged prostate since last 7 years and now have pain in penis and frequency for urination,

Pain in penis associated is mostly due to Infection secondary to obstructive urinary flow due to enlarged prostate and inflamed urethra due to implant.
.
I shall be happy if you can post me few more details to help me in making comments on your problem.
1)Have you done ultrasound Scanning of abdomen to know the present size of your prostate and post void residual urine ?
2) Have you done urine culture to trace out organisms causing infection

Please consult qualified Urologist for clinical and digital rectal examination and get following basic
tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Serum PSA.
4) Ultrasound Scanning of penis

In the mean while take broad spectrum antibiotics like Cefixime along with urinary antiseptic like Nitrofurantoin twice daily and urine alkaliser thrice daily.Later on switch on to appropriate antibiotics as per culture report.

Continue taking Tomsulosin once daily and pain killers like Diclofenac twice daily.

Get the prescription of medicines from your family Physician.

Ensure to drink more water.To keep your urine dilute This will help to control dysuria.

Further treatment will depend upon result of these tests and final diagnosis.

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. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (8 hours later)

I ws prescribed Bactrium by my doctor and have been taking it for the past five days-will that be as good as cefixime. I have not been given nitrofurantoi. I have not had my penis scanned

ONe final thought--should I have the penile implant removed-in other words, is this more likely to recur if I keep it in then if it is removed

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
You need to take appropriate antibiotic as per culture report.

Detailed Answer:
Hello
Thanks for follow up.

Your urinary symptoms are primarily due to infection that is secondary to Enlarged Prostate hence you need to get Ultrasound Scanning of the abdomen done to assess the size of the prostate and post void residual urine .

As regards pain in penis it is unlikely to be due to implant as it has been put 9 months back .However the scanning of penis will help to take decision regarding removal of implant if deemed necessary and proved to be inflammation due to implant itself..

Take the medications suggested earlier.and get the investigations done .

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar