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Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3563
Experience:  MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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7 mos after radiation for pc. Some urinary dribbling, but not

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7 mos after radiation for pc. Some urinary dribbling, but not severe. I do have to wear adult diapers but that's not much of an inconvenience.Beginning ab 2 weeks ago, have had to get up several times at night to urinate. The first time virtually nothing happens -- no flow but some pressure pain. Occasional rectal discomfort but stools always normal. Subsequent visits to toilet bring some improvement. By morning flow much better and this lasts until bedtime. I realize this is the result of radiation and it is bearable however unpleasant. Will this ease in time or is it a permanent condition now. Is there any medication that would help. I am reluctant to start either Flomax or Rapaflo because of the possible side effects. I am 82 (83 in September) and have lived with pc since 1996. Never had any serious side effects before and generally feel well.
Submitted: 1 year ago.
Category: Urology
Expert:  Dr. Tharun replied 1 year ago.

HI

 

Have you checked your PSA recently?

 

Blood in urine ?

 

Are you taking any hormonal drugs ?

 

Please let me know


Dr.Tharun

Customer: replied 1 year ago.

Thank you for your reply. As to the information you need, here are the answers. My last PSA was 0.3. That was about 3 months ago. I will have another PSA taken before the next visit to the oncologist, in November. I have no blood in the urine, and I am not taking any hormonal drugs at present. Perhaps I should mention that the last round of radiation was the third over the 16 year period that I've had to deal with pc. My symptoms deifnitely do not seem severe. Although I have to relieve myself ab. 3 times a night, the urinary flow definitely increases after the initial effort. Rectal discomfort is minimal. I am just wondering if this condition ever relieves itself over time and what if anything I might do by way of treatment in the interim. Many thanks.

Expert:  Dr. Tharun replied 1 year ago.
HI

There may be some degree of block to the passage to the urine which is causing the initial hesitancy.This can occur due to enlargement of the prostate or regrowth of the tumor.But since your PSA is well under control chances of cancer recurrence are really less.
So there could be either some scarring in the region of prostate or the enlargement of the prostate. Scarring seems more likely given the symptoms.

Ideally a RGU - retrograde Urethrogram or cystoscopy should be done.It will precisely identify the cause of the block. Then accordingly treatment can be given.

It is very contradictory to have both dribbling as well as obstruction.It has to be either one of them in most of the instances.We see leak for some time after which block takes over and dribbling stops.So RGU as well as cystoscopy may be required to confirm the diagnosis.

If it is scarring then the treatment is releasing the scarred part endoscopically. But in your it has to be done carefully as you already have some urine leak. The cut may increase the leak some times.But if the symptoms are manageable then you can opt for no treatment right away.If the symptoms worsen or urine flow becomes poor it can be done.

I hope this answers your question.

Regards

Dr.Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3563
Experience: MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
Dr. Tharun and other Urology Specialists are ready to help you
Customer: replied 1 year ago.

Thank you Dr. Tharun. I appreciate your analysis of the situation. If there is no worsening, I will probably want to lave things as they are. I'm also glad you didn't recommend Flomax or Rapaflo. I know they are widely used but I do not like what I read about their side effects, especially dizziness. Their impact on ejaculation, and etc. mean less to me at my age., But dizziness and some of the other side effects are bothersome. Although the rad. onc. I have seen for the pc since the beginning is highly regarded and very well known, he somehow can't bring himself to acknowledge that the urinary dribbling has been caused by radiation and suggests more practice on my part of Kegel exercises! Easier said than done.

Expert:  Dr. Tharun replied 1 year ago.
HI

If it is enlargement of the prostate gland which is causing the block, you may have to be put on flomax.Dizziness is a side effect which is troublesome if it happens to you.But small number of people have it.
But as I said before there is no hurry to start any treatment right away given the mild symptoms.Elective investigations should come to a diagnosis and then treatment can be planned.

All the best. Keep me updated.

Regards

Dr.Tharun

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