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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Under Went TURP And BOO Suggested By Urologist. Having Continuous Pain And Burning Sensation. Treatment?

Respected doctor, I under went TURP and BOO as per the recommendations of urologist at Hyderabad ,as I haveon 2nd July 2012 with a hope to revive my partially contractile bladder (hypotonic) and to reduce my dependency on CISC.(5-6 times) I could presently pee with moderate abdominal pressure and also practicing CISC 3-4 times a day. After surgery i developed continuous pain & burning sensation for 2 months which was relived by amenotrytallin 10mg TID. But 30 minutes after ejaculation i am experiencing severe pain , burning sensation and occational spasms whcih lost for 30-45 minutes even though i use tremadol + parasitamol (50mg+350mg)prophylactically 2hrs before sex. My doctor prescribed pentason polysulfate 100mg BID from past one month along with tryptomer 10mg TID , bethenicol 25mg TID. he asked me to continue them for another 2-3 months . I found no improvement in painful ejaculation during the last month. Is this a chronic prostatitis , is there any cure,as iam really scared of sex, are the doses sufficient and are there any remote chances of my bladder regaining some strength so that i can pee on my own or reduce the dependency on CISC. The surgery partially improved my ability to urinate in the past 4months though with moderate abdominal pressure which always threatens to induce hemorrhoids . with regards Ramakrishna, age 51, Indian , Veterianrian by profession.
Wed, 5 Dec 2012
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Urologist,  's  Response
Hello
Thanks for your query.Feel sorry for your sufferings.You have undergone TURP and BNI for BOO in July 12.But there is no end to your problems that you had before surgery.By the ay were following investigations done before surgery.
1) Urodynamic study to evaluate tone of the bladder muscles.
2) Uroflowmetry to see the average urine flow during micturition.So get these test done now to confirm the diagnosis.
From what you have described it looks that you may have a Neurogenic Bladder rather than Enlarged Prostate.and BOO.
If you hado still to do CSIC 3 to 4 times a day .I would advise you to go for SPC (Supra Pubic Cystostomy) in which a catheter is placed in bladder directly from abdominal wall through a small hole just above the pubic bone so that there is continuous drainage of bladder and you do not have to do CSIC which injures the urethral mucosa and gives burning maturation and pain during ejaculation..You have to be on SPC for 3to 4 months by which time your bladder regains tone and may be able to pass urine Simultaneously you can take Bethanecol and some urinary antiseptics like Nitrofurantoin after consulting your Urologist.Have a Good Luck.and speedy recovery.
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Under Went TURP And BOO Suggested By Urologist. Having Continuous Pain And Burning Sensation. Treatment?

Hello Thanks for your query.Feel sorry for your sufferings.You have undergone TURP and BNI for BOO in July 12.But there is no end to your problems that you had before surgery.By the ay were following investigations done before surgery. 1) Urodynamic study to evaluate tone of the bladder muscles. 2) Uroflowmetry to see the average urine flow during micturition.So get these test done now to confirm the diagnosis. From what you have described it looks that you may have a Neurogenic Bladder rather than Enlarged Prostate.and BOO. If you hado still to do CSIC 3 to 4 times a day .I would advise you to go for SPC (Supra Pubic Cystostomy) in which a catheter is placed in bladder directly from abdominal wall through a small hole just above the pubic bone so that there is continuous drainage of bladder and you do not have to do CSIC which injures the urethral mucosa and gives burning maturation and pain during ejaculation..You have to be on SPC for 3to 4 months by which time your bladder regains tone and may be able to pass urine Simultaneously you can take Bethanecol and some urinary antiseptics like Nitrofurantoin after consulting your Urologist.Have a Good Luck.and speedy recovery.