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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 65266
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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friend had impact fracture last september.48 yrs of age. fractured

Resolved Question:

friend had impact fracture last september.48 yrs of age. fractured hip. had to be cathetarized. urine retention. since had prostate tests,cystoscopy,and kidney tests-all okay still waking 10 times each night but passing very little urine and suffering impotence. bladder infection at moment. consultant very vague and thinking cause is due to already diagnosed diabetes type 2 although no previous problems. GP prescribed macrodantin and advised by consultant to continue for further 3 months. is there anywhere else to go for further medical advice as this has been going on since september thank you
Submitted: 3 years ago.
Category: Medical
Expert:  DrRussMD replied 3 years ago.
Hello from JA
Your friend needs a cystoscopy to look into the bladder.
Yes it can be the diabetes, but that would indicate diabetes not under control.

I would want to rule out anatomic problems in the urethra or bladder.
Stricture for example.

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Customer: replied 3 years ago.

Have stated that cystoscopy was carried out and no problem diagnosed Diabetes under control but no satisfactory conclusion

Expert:  DrRussMD replied 3 years ago.
Any findings on cystoscopy, and did they to urodynamic studies...how does the bladder empty etc?
Customer: replied 3 years ago.

urodynamic studies carried out but the nurse that carried it out appeared unsure and carried it out again and then said it was "ok"

Expert:  DrRussMD replied 3 years ago.
Do you know what the post void residual is?
Customer: replied 3 years ago.

nurse said that 62ml was still withheld

Expert:  DrRussMD replied 3 years ago.
OK
That is not bad.
So no severe obstruction.
I would tend more to go with diabetic neuropathy affecting the bladder.
Do you know what your friends hemoglobin A1C is?
Customer: replied 3 years ago.

urine microscopy 5642 abnormal. urine microbiology report; white cells 100 by 10 (6) L red cells 97 by 10 (6) L Epitheliel cells- none pure growth of >10(8) cgi/l staphylococcus aureus

Expert:  DrRussMD replied 3 years ago.
Shows blood and possible infection.
But staph is usually a contaminant.
Not a clean sample would be my view.
I would have it repeated.
You can't tell anything else with a simply urinalysis like this.
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Customer: replied 3 years ago.

Do not know what to do next. As i explain consultant not helpful and GP signed off friend from work for a further 4 weeks but still no conclusion of if the impact fracture may have caused it and how this is going to be resolved. To be honest, no one seems to be interested and this is going on and on. Any advice please?

Expert:  DrRussMD replied 3 years ago.
I would control diabetes tightly.
I would have an assessment of the lower spine....possibly an MRI.
Possibly see a nephrologist as well.
Use reply to let me know if you have further questions. [click reply to expert].
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DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 65266
Experience: Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
DrRussMD and 2 other Medical Specialists are ready to help you
Customer: replied 3 years ago.

Thank you so much Doctor. Could you please tell me how we go about this please? The impotence is not helping either and he really wants an end to it all and just get back to work and get back to normal.

Expert:  DrRussMD replied 3 years ago.
Ask your GP for the referrals.
Physical medicine specialist.
Nephrologist.
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Customer: replied 3 years ago.

Thank you. Just one last question please.How long does this normally take and how long before he may see any improvement?

Expert:  DrRussMD replied 3 years ago.
impossible say at this point
Customer: replied 3 years ago.
Relist: Other.
sorry wrong click will dr thomas still answer my question
Expert:  DrRussMD replied 3 years ago.
Hello
What questions remain for you?
Customer: replied 3 years ago.

Thank you very much Doctor. I'm trying to support my friend especially as he has a very distinct accent and i feel that he hasn't been very well supported. I don't really understand the complications myself but thank you very much for your time and advice and you definitely have helped. Hopefully we will get a resolution from the GP and be able to go forward. Thank you.

Expert:  DrRussMD replied 3 years ago.
anytime
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Customer: replied 3 years ago.


No Doctor. If needed i will definitely use this service again and ask to be in contact with you. Given confidence and contacting my mate now to let him and his family know to stay positive and they have support. Please could you reply so I can give give you perfect rating.

Customer: replied 3 years ago.
Relist: Other.
hi dr thomas Please could you reply as soon as you can so i can relay your info thanks
Expert:  Dr. David replied 3 years ago.
This is Dr. David

I see you relisted the question for other experts to help

I believe the other expert is offline at this point.

the most common cause of frequent urination for men is from a benign enlarged prostate gland. a cystoscopy would not tell how large the prostate gland is.

there are medications which can help shrink the prostate (avodart, finasteride) and help improve urine flow (flomax, hytrin) which can help decrease how frequently he is urinating at night time.

these medications usually work.

he will most likely need to see his GP or a urology expert to get him started on these medications to help him not urinate so frequently
Customer: replied 3 years ago.

can dr thomas please reply so i can leave feedback please thanks