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22 Apr 2003

Narrowing of Urethra
Dear Doc

I am a female in my twenties and have had difficulty urinating for the past several months. As an example I would urinate the most three times a day (even after drinking more than 2 litres water a day) and it come out very slowly,almost just dribbling form.There is no burning sensation,no blood in the urine and all tests for signs of infection have come out clear.

The urologist performed an urethrotomy and a cystoscopy and mentioned to me that my bladder was quite swollen.The urologist has diagnosed that my pelvic muscles are not functioning resulting in the narrowing of the urethra and has prescribed xatral for me. i have been on this drug for the past 5 weeks. Initially I was taking one a day but and I would urinate approx. 8 /9 times a day. However after two weeks the difficulty in urinating came back. I am now taking it twice a day and feel alot better. But I am only urinating about 5 times a day.(same amount of water consumption). I also suffer from severe constipation which was one of the things the doctor wanted to correct. But the medication I have been placed on hasnt really solved the problem.

I am concerned that once I am off this drug the problem will recur. The doctor has mentioned to me that if in two weeks the problem has not been solved,he would need to operate.

My concerns are as follows :
- what are the side effects of xatral ;
- would I be able to give birth the natural way;
- could this problem recur ( especially as I am urinating at a reduced rate - eight times vs 5 times now)
- Is this a problem that i should be concerned about?What is the worst that can happen if I opt not to go for the operation;
- are there any natural methods I could opt for?

Kind regards

Answer 413 views

01 Jan 0001

Dear Gino

You need a urodynamic study to assess how well you bladder is contracting. We need a bladder diary to measure the volume of fluid consumed and urine passed. Remember you perspire about a litre a day and loose fluid in the stooles as well, so the amounts will not match. We also need a flow rate and results of an inspection of the urethra. A good urologically directed neurological examination needs to be performed, as well as a full pelvic digital examination, to exclude any masses. An ultrasound of the pelvis should also be done to exclude pelvic masses. After one has this information, one can make a full assessment.

Xatral is usually only prescribed for men and not woman. It has been tried in woman with varying success.
Provided everything else is normal you should be able to give birth naturally.
I cannot comment if it will recur.
You need more information and full details of any operation to be performed, with all potential complications and side effects before considering any operation.


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