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    Pain / burning sensation while urination after TURBT
    An_191895 posted:
    30-Male: I started having unrination problems and after a scopy, my urologist said there is some kind of tumor which is blocking urine flow and also was the cause of my increased frequency. So surgery was performed (TURBT). The tumor was non-cancerous something 'cystis cystisis'. One thing my doctor pointed out was that he had to dialate (i guess urethra a bit) because it was too narrow for the surgical scope.
    But after the surgery this pain / burning sensation started during start and during stop of voiding. I visited my urologist and he asked me to wait for 2-3 months to make sure the bladder is comletely healed. But it didn't improve and so he performed cystoscopy again about 5 months after TURBT and said bladder is fine and also the prostate. But he included 'may be' it is that section which he had to dialate is causing that pain. He wasn't sure and said he wouldn't suggest any further action unless it (the pain) is really bothering me.

    It has been about 2 and half months since that scopy and I still feel the pain sensation. I know it is not natural and don't want to live with that whole my life. I am going to see him again next week but I have these questions if some expert can share their thoughts on it.

    1: What if my urologist again suggest another surgery?

    2: If the second surgery is for that dialated part will it come under his responsibility (cost wise as well) because the pain wasn't there before surgery? I have insurance but still I have paid more 3K so far including my deductible, out-of-pocket and uncovered portions.

    3: Should I consult another urologist? My only concern is he/she would again suggest cystoscopy, which isn't fun. Though I wouldn't mind that to get rid of this pain.

    4: Any other options?

    Any suggestions will be helpful to me. Thanks for your time.
    Diane K Newman, RN-C, MSN, ANP responded:
    1. I do not think that another surgery will get rid of your pain. You may want to wait longer and see if it goes away or see another urologist.

    2. I would not suggest more dilation as that could worsen your pain. See another urologist.

    3. Yes. See another urologist.

    4. I think I would wait longer and see if the pain lessens.
    An_191896 replied to Diane K Newman, RN-C, MSN, ANP's response:
    Thanks Diane for the reply.
    Yes, actually I have been waiting for about 8 months since my surgery and my doctor said normal recovery is about 8-10 weeks. My major conern is to make sure something hasn't been overlooked and don't want to end up with something serious by ignoring it.

    I saw my doctor again and he prescribed me flomax for couple weeks to see if it isn't the prostate that is causing the pain.
    He said there is no infection and he actually don't know what exactly is causing that.
    But he is suggesting a VCUG as next step in case the medication doesn't help. This procedure might help to see if there are any issues along the urethra.

    Do you have any thoughts suggestions on this VCUG?

    Again thanks for taking time to reply.
    Diane K Newman, RN-C, MSN, ANP replied to An_191896's response:
    I think that VCUG would be the next step if you are still having pain. It is an x-ray that shows you kidneys, bladders and urethra as you are urinating and will find any problem you have that may be causing your pain.

    I would also ask your doctor if he thinks you may have a urethral diverticulum . This can also cause pain.
    An_191897 replied to Diane K Newman, RN-C, MSN, ANP's response:
    Thanks Diane.

    The medication didn't help and I am going to see my doctor next week and go with VCUG. I will discuss about urethral diverticulum with him. I will postback how things go.

    Thanks for your time.
    An_191898 replied to Diane K Newman, RN-C, MSN, ANP's response:
    Hi Diane,
    Had VCUG done and everything seems normal. No urethral diverticulum or anything else. So my doctor is at loss why there is burning sensation and start problem. He is suggesting to go to pelvic physical therapist (hope I got that right). May be some spasming issue or something at spincture, I have no idea.
    Any inputs or suggestions?

    Thanks for your time.

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