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Urology/Slightly Burning Sensation in Centre of Bladder/Pelvic Region

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QUESTION: Hello Dr. Suppe,

I'm male,African,39 yrs. On 20th October,I felt a burning sensation in my bladder/pelvic region. The sensation was fleeting and thinking that it would vanish without much ado,the rest of the day went by without my noticing it again.However,when I paid more attention from the next day,I noticed the feeling remained.Its like a slight burning in the centre of my bladder but not persistent throughout the day-it comes and goes but is noticeably pronounced when am about to sleep at night and morning after I have my first urination;when it goes,I feel nothing but when it comes,it lingers for some minutes and is very uncomfortable.My urine culture test for infection returned negative;there's no urethral pain/discomfort anytime I urinate and there's no urine retention. Last time I had sex was 20months ago but I masturbate about twice a week. Our family doctor prescribed only the use of "Sodamint" saying antibiotics or any other strong drug is unecessary since my urine test is negative.  


I've read many of your responses on this forum and seen such worrying things as cancer,fibrolgymia,prostate cancer,UTIs,bladder stones. Hopefully doctor,I  don't have anything so potentially serious or longterm.Its been about 11 days now without relief.

Please doctor kindly benefit me with your experience and suggest what I could possibly do.

Best regards,
Ojo

ANSWER: Ojo,
In your situation I would be less than concerned about bladder cancer because there is rarely burning sensations as a symptom, if no blood in the urine analysis then OK but if you are a smoker the risk elevates significantly. There may be an irritant that you could be ingesting like a citrus, acidic, caffeine or food that might be the cause of this. Some men in rare situations have a condition called IC (intracystial cystitis). The condition like I said is unusual in men but not unheard of. Fibromyalgia is a condition coined when a physician can not find a cause for patients with strange pain syndromes that have zero correlations to anything they take , eat or have a history for. The pain is real but the source is undiagnosed so neuropathy agents like Neurontin (gabapentin) and pregabelin (Lyrica) are prescribed to disrupt the signal of the pain pathway. I recommend a test for cystitis , the urologist will look inside of the bladder with a flexible cystoscope for redness and irritation, they may also infuse potassium chloride in the bladder because IC will have a great deal of burning upon contact with potassium chloride. There is a rescue solution of 2% lidocaine that is quickly infused after the pain reaction takes place. This can rule out or confirm IC.  

Other than that if all is negative you can try a drug for IC called Elmiron to see if it helps. The other choice is Uribel, Uricit-K, and Pyridium which are drugs that help with bladder irritation and spasming. I welcome an answer if any of these ideas are helpful for you because the only way I can better my patient care is to know when something is effective. I hope I was able give you some avenues to work with your treating physician in resolving the discomfort. Have a wonderful day !

---------- FOLLOW-UP ----------

QUESTION: Hello Dr. Suppe,

I promised to get back to you on the lab result.Finally, i received my abdominal scan report on Monday, 12th Dec and the report is that i have a "moderately enlarged prostate". Based on this, my GP doctor prescribed Cifexime antibiotics, Diclofenac and Aminnoacids Vitamin syrup. I've been using these drugs since Monday, 12th and i must say that i noticed a reduction of the dull aching in the pelvic/bladder region. Only thing i noticed is that my urine turned a yellow golden color while using the drugs but nothing more. Hopefully, as i finish the drug course yesterday i will listen intently to my body if its finally gone otherwise i approach the doctor again.

Once again, a great many thanks for your help.


Best regards,
Ojo.

Answer
Ojo,
I was wondering if you had a urine analysis to prove infection was there ? If not then antibiotics serve no purpose. Diclinofac is an anti-inflammatory drug and this either way is a good choice to reduce swelling and irritation. Amino acids and vitamins are nice but there is no data to show effectiveness in prostatitis or cystitis recovery. I am glad your feeling a bit better. I will conclude that none of the prescribed meds can hurt you so keep taking as your doctor prescribed and drink lots of water. This should improve nicely. Have a good holiday season. Thomas

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Thomas A Suppe RDMS CLT

Expertise

Invervential urologic radiology , urologic laser surgery, cryotherapy of the prostate and kidney, extracorporal shockwave lithotripsy, holmium laser lithotripsy, urodynamics (video-non video),male infertility, erectile dysfunction, Peyronies disease, hypogonadism ,kidney stones, prostate cancer detection, BPH, voiding dysfunction, bladder cancer and continent diversions.

Experience

For the past 20 years performing intervential and diagnostic uro-radiology for a multitude of urologic surgeons from New York, New Jersey, Lousianna and Texas. Founder of DMS medical LLC introducing the Texas Medical Center to the first high power Green Light laser for the treatment of BPH just after its release by the FDA from Laserscope and its sucessful trials at the Mayo Clinc.

Organizations
American Registery of Diagnostic Medical Sonographers (ARDMS), American Urologic Assocoation (AUA), American Medical Systems (AMS) Laserscope,Oncura, Allergan and Auxilliam pharmaceuticals.

Publications
Comprehention of Urologic Ultrasonography for the Resident Physician (Journal of Urology 2012), Author of the syllabus for the uro-radiology residency course at The Scott Dept of Urology at Baylor College of Medicine Houston Texas (2010 to present). Past Clinical Studies: Principal radiology investigator Allergan Inc for "The treatment of BPH with intra-prostatic injections of Botox" with Larry I Lipshultz MD 2011-2012, principal radiology investigator for Allergan Inc for "The treatment of Peyronies disease by intra-lesional penile injections of Botox" with Mohit Khera MD MBA MPH (2011-2012). Current studies: Principal investigator of "Blood pressure risk factors of intra cavernosal injections of Trimix and PGE1 during Penile Duplex's.

Education/Credentials
BS from Ramapo College of NJ, Registered diagnostic medical sonographer with the ARDMS, 2 year fellowship of Uro-Radiology and intervential sonography at Baylor College of Medicine Houston TX, laser safty officer in state of Texas and certified in KTP, Holmium and Lithium Tri-boride laser systems from Laserscope San Jose, California and American Medical Systems Minnatonka Minnasota, trained and certified by Oncura Inc Isreal in ultrasound guided argon cryotherapy of the prostate and kidney.

Awards and Honors
Honorary instructor of GU ultrasound course 2012 international meeting of the American Urologic Association. Author of the the AUA course for "Ultrasonography of the Testes and Scrotum" 2012.

Past/Present Clients
Baylor College of Medicine (BCM) Lousianna State University (LSU), LSU Medical Center Shreeveport LA, The Methodist Hospital Houston Texas, St Lukes Episcopal Hospital Houston Texas, Memorial Herman Health Systems Houston Texas, Palestine RMC Texas, Doctors Regional Hospital Corpus Christi Texas, Valverde Regional Medical Center DelRio Texas, Current instructor/technologist for two internationally recognized urologists : Larry I Lipshultz MD and Mohit Khera MD, MBA, MPH at Baylor College of Medicine. I served as intervential sonography consultant for Oncura Inc cryotherapy systems. Former lead trainer for Urosource mobile medical services , training new surgeons in PVP or photo-selective vaporization of the prostate for BPH, BNCs and urethral stricture vaporization.

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