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Dr. Tharun
Dr. Tharun, Doctor
Category: Medical
Satisfied Customers: 3720
Experience:  MBBS
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I am 70 and have had a urethral stricture for 45 years. I

Customer Question

I am 70 and have had a urethral stricture for 45 years. I use a catheter daily to dilate and the stricture bleeds. I take tamsulosin. And Finasteride but need to go to the toilet frequently in daytime and up to five times during the night. I don’t empty my bladder when I go to the toilet and achieve this when I use the catheter. When I use the catheter my urinr looks clean but when I am finishing emptying my bladder the catheter drains a yellow looking liquid ( often stained with some blood from the stricture). I am wondering if this septic looking liquid is semen or something more serious that needs investigating. I am very concerned also by my lack of sleep. Can you please advise?
Submitted: 9 days ago.
Category: Medical
Expert:  Dr. Tharun replied 9 days ago.

HI

Welcome to JA and thanks for your question. I am Dr.Tharun and I will be assisting you with your question today. I would like to have some more information regarding your condition.

Do you take any blood thinners ?

Does the catheter go inside easily ?

Do you have burning while passing urine ?

How is your appetite ?

Are you a diabetic ?Do you have fever?

Any prostate surgeries before ?

Do you ejaculate normally ?

Please let me know

Dr.Tharun

Customer: replied 9 days ago.
I do not take .
Blood thinners but do take Lipitor statin 20mg
Catheter goes inside easy.
I have a sensation passing urine but would not call it burning
I have good appetite
I am not a diabetic and do not have fever
The hospital took 44 samples about 6 years ago but did not find any cancer
Customer: replied 9 days ago.
I don’t ejaculate so it is not normal
Customer: replied 9 days ago.
My PSA is currently 3.85
Expert:  Dr. Tharun replied 9 days ago.

Are you sexually active ?

Customer: replied 9 days ago.
No
Expert:  Dr. Tharun replied 9 days ago.

Hi

From the provided information, it doesn't sound like you have an urinary infection. The last portion might be just sedimented urine where debris gravitate. After years of self catheterization , there is bound to be some debri formation as a foreign body is introduced repeatedly. Semen is unlikely when you are sexually inactive. When you are on tamsulosin, you can have retrograde ejaculation - means semen travels back into the bladder and is then expelled with urine. If you are not ejaculating then chances of it being semen is slim.

I would suggest, you can wait and watch than worry about it.

If you have any further queries , please let me know.

Dr.Tharun

Customer: replied 9 days ago.
I am certain no Debra is introduced as a result of catheterisation and this strange liquid is there every day but only shows when my bladder is almost empty. Is there any medical procedures to help me empty my bladder better so I can sleep at night?
Customer: replied 9 days ago.
Should I get the liquid analysed in case it is septic?
Expert:  Dr. Tharun replied 9 days ago.

Debris are not introduced by you - it is increased cell shedding inside the bladder and possible reaction of the bladder mucosa to the catheter.

Drinking less water in evening and night will result in less bladder filling and less number of times you have to go to the bathroom. Night time drainage of the bladder can be done to prevent frequent visits to toilet.

There are drugs which can completely stop urine production at night , but can have severe salt imbalances especially at your age. Usually prescribed drug is desmopressin nasal spray or lingual tablets.

Dr.Tharun

Expert:  Dr. Tharun replied 9 days ago.

There is no harm in analyzing the fluid - but it is unlikely to be septic since you don't seem to have any infective features at all.

Dr.Tharun

Customer: replied 8 days ago.
Sorry I had to interrupt our conversation last night.
I think my frequency might be because:
A) I have cystitis even though I am not showing serious symptoms.
B) I am constantly carrying a third of a pint of urine in my bladder reducing its capacity.Consequently I have some related questions for you
1. If I have cystitis will my body self treat it without medication
2. I know I should drink a lot but Is there anything I can consume to help fight cystitis
3. Are there long term risks ( say to bladder or kidneys) by having cystitis for an extended period
4. Is there a safe operation I could request that will safely weaken the muscle controlling the discharge of urine from my bladder in to my uretha.
Expert:  Dr. Tharun replied 8 days ago.
1 .Cystitis may subdue in course of time. Our body's immunity system will eventually take care of it, if it is a mild infection.
2. Only thing which is recommended is plenty of oral fluids and cranberry juice or extract.
3.cystitis don't have long term risk for kidneys. Bladder can get smaller and contracted with chronic cystitis but is very rare.
4. You can opt for bladder neck incision or trans urethral resection of prostate.