Hi everybody.
I was wondering if anyone have had urethral stricture causing there prostatitis. I was at local uro last week, and he suggested to do a cystocope investigation on me. He did not find my prostate very abnormal and it did not hurt either when he examined me. I told him that I was in a bike accident 1 year ago, and he told me that I might have a stricture in my urethra causing my frequency and my prostatitis.
Can this be benneficial to do for me? I was never cystoscoped earlier?
Is there any risks??
This communication provides general information, and is not a substitute for face-to-face medical care. A doctor-patient relationship should not be assumed by the reader.
Jordan Dimitrakov, M.D., Ph.D.
I was just asking if urethral stricture could be a cause of prostatitis, which I know I suffer from. I am suffering from Impotence from my prostatitis YES I HAVE ALREADY MENTIONED IT. But I was asking if stricture could be the cause!
Wally wrote:I was just asking if urethral stricture could be a cause of prostatitis, which I know I suffer from.
Yes, strictures can cause prostatitis in theory. In practice, a study from the University of Washington in Seattle actually found them to be quite RARE as a cause of prostatitis in young men. I don't think you have a stricture, anyway, but that's a wild guess. ANd why cystoscope, anyway? The rule for stricture diagnosis is uroflow followed by retrograde urethrogram and not cystoscopy!
I am suffering from Impotence from my prostatitis YES I HAVE ALREADY MENTIONED IT. But I was asking if stricture could be the cause!
No need to be upset about it. You are asking for an opinion and you are getting one...for free. What's the problem?
This communication provides general information, and is not a substitute for face-to-face medical care. A doctor-patient relationship should not be assumed by the reader.
Jordan Dimitrakov, M.D., Ph.D.
I was wondering if anyone have had urethral stricture causing there prostatitis. I was at local uro last week, and he suggested to do a cystocope investigation on me.
Strictures are one of the anatomical circumstances that are hypothesized to be a possible cause of chronic prostatitis. Thats what I actually read in Nickel's Prostatitis Manual.
(Noboby really knows if thats the cause in your case, neither the cause of your impotence!?)
Why are you always trying to be antagonistic? Do you have a degree in medicine or medical background?
This communication provides general information, and is not a substitute for face-to-face medical care. A doctor-patient relationship should not be assumed by the reader.
Jordan Dimitrakov, M.D., Ph.D.
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Postby webslave »
I tend to agree with Dr Dimitrakov in this case. Strictures are a rare cause of CPPS. However, if you had a biking accident it's possible you injured your urethra, so a cystoscopy may be a good idea.
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Since this is a scientific board, here's the study I was referring to:
Urology 1998 Sep;52(3):417-21
Few patients with "chronic prostatitis" have significant bladder outlet obstruction.
Mayo ME, Ross SO, Krieger JN.
Department of Urology, University of Washington, School of Medicine, Seattle, USA.
OBJECTIVES: A high prevalence of significant bladder outlet obstruction has been reported among men diagnosed as having "chronic prostatitis." To evaluate the possibility that case selection may determine this high prevalence, we compared findings in patients referred directly to our Urodynamic Unit with that of patients evaluated in our Prostatitis Clinic.
METHODS: The videourodynamics records of 201 men aged 18 to 50 years who presented to the Urodynamic Unit with any lower tract symptoms (irritative and/or obstructive with or without pain) were compared with the findings in 123 Prostatitis Clinic patients. The latter were evaluated for obstruction with flow rates and, if abnormal, by retrograde urethrograms and videourodynamics. RESULTS: Only 37 (18%) of 201 patients referred to the Urodynamic Unit had pain as a significant symptom and might have been diagnosed as having chronic prostatitis. Of these 37 patients, 4 (11%) had definite obstruction, 6 (16%) were equivocal, 6 (16%) were hypocontractile, 1 (3%) had pseudodyssynergia, and 7 (19%) had normal findings. The remainder had abnormalities of bladder filling (hypersensitivity in 11 [30%] and detrusor instability in 2 [5%]). Fewer of the 123 patients with prostatitis had obstruction (definite in 2 [1.6%] and equivocal in 1 [0.8%]) (P = 0.03), 2 (1.6%) had hypocontractile detrusors, and 2 had urethral strictures. CONCLUSIONS: Patients referred to the Urodynamic Unit with lower urinary tract symptoms and pain rarely have bladder outlet obstruction. However, they are significantly more likely to have bladder outlet obstruction than patients referred to the Prostatitis Clinic who can be screened for obstruction by history, flow rate, postvoid residual, and retrograde urethrogram.
This communication provides general information, and is not a substitute for face-to-face medical care. A doctor-patient relationship should not be assumed by the reader.
Jordan Dimitrakov, M.D., Ph.D.
Location: Please give your location so we can help better
Postby webslave »
With this patient's history of a bike accident, it would be interesting to know the details of the accident. Wally, was there any trauma to your pelvic area?
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EVen if he has had a bike injury, his suspected voiding dysfunction would rather be classified as "neurogenic" and not as "structural"(=stricture), I would say. Of course, this is of paramount importance since stricture = urethrotomy (operation) and neurogenic voiding dysfucntion = medical treatment.
This communication provides general information, and is not a substitute for face-to-face medical care. A doctor-patient relationship should not be assumed by the reader.
Jordan Dimitrakov, M.D., Ph.D.
Location: Please give your location so we can help better
Postby webslave »
I understand your point. I was wondering if a severe enough trauma could cause a stricture or other physical abnormality, like scar tissue. Of course an accident is just as likely to damage nerves, and that can't be treated surgically I would think, only medically.
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This is always a possibility but you usually need repeated trauma to cause stricture or scar tissue. For example, I have a patient who is an instructor in bicycling in Canada and he has severe ED. He's been cycling for 10 years and ....no stricture! No pain! No PNE either. Go figure!
This communication provides general information, and is not a substitute for face-to-face medical care. A doctor-patient relationship should not be assumed by the reader.
Jordan Dimitrakov, M.D., Ph.D.
No there was no trauma. It did not even hurt. There are no problems with voiding, the problem is just impotence along with frequency. I have red a lot prevous letter and about impotence and nerve damage. I was wondering if there is nerve damage from prostatitis causing my ED, will this be a permanent life problem for me, or will the nerves heal up themselfes, or what can be done? My impotence is really servere.
I also was wondering. About the risks of cystoscopy? I have red about that complications such as infection, scarring of the urethra and so on I have also seen that "injury to the penis" is a possible complication. This sounds very scary. What type of injury? Is it permanent? Should I be on antibiotic when cystoscopy is done? And for how long? Is it necessary to be on antibiotic, I am kind of allergic to antibiotic, so if I could avoid them it would be good, but I don't want infection either. What can be done to make the procedure as safe as possible from infections without antibiotic?
Why are you always trying to be antagonistic? Do you have a degree in medicine or medical background?
No, Dr., you know that I dont have a dregree in medicine and I hope it is not necessary.
And it is not a question of antagonism. It is not even an antithesis.
I found out that people sometimes want more than one answer.
And I just wanted to give Wally my answer, if it is allowed. Nothing else.
