A pt 78 years old suffering from Nocturia,Hesitancy,Urgency.He is also suffering from sugar and BP problem.Due to this his sleep remains very disturbed.His prostate has enlarged upto 17.5cc.But he clearly avoids surgery.Please discuss about this problem which seriously affects his health

1 Like


Control DM..UTI..It can be overflow incontinence due to BEP..May have diabetic neurpathy also causing urinary symptoms..Can advice surgery after full fitness.. Otherwise urimax .4mg might help..

Fully agree with the reply sir

median lobe may be enlarged , causing such problem, so Mr Rajesh we are not confusing you,rather sharing with you our knowledge & experience & also we learn always from ideas of different persons and we are always in a learning phase

Hyperglycemia should be controlled by oral hypoglycemics if possible otherwise think about insulin according to basal dose of long acting insulin (50% of caculated insulin)and rest 50 % short acting insulin In three pre meal divided doses .sir pt's urine report is not showing ketone bodies status manage it accordingly it may be a cause of restlessness, Uti should be accessed and should be treated. serum electrolytes may be a cause of restlessness ,tab Urimex D Od should be given . monitor the cardiac functions as Bp,Hr, etc

First... patient complains is nocturia with urgency. take a details history of the problems. list the other associated complains like dysuria, urinary stream, urine colour... also about bowel habits/lower back pain.. the possible etiological complains - fever , leg swelling , also about anemia symptoms... Then list out the previous medication list look if he was put on any thiazide diuretics. assessment of the renal function in view of DM , HTN. urinary ketone , culture and sensitivity. PSA in view of his age.. CBC for anemia basic ECG & Echo for cardiac assesment * nocturnal polyuria may also be a symptoms of cardiac failure.

1.prostate is normal,but post void residual urine volume is not mentioned. 2.FBS 301, hence possibility of UTI is high .....C/S of urine required. 3.start antibiotic after culture report. 4.control sugar aggressively. 5.treat BP, if uncontrolled. 6.look for co-morbid depression, if present treat with SSRI. 7.Give a short course of anxiolytics.

17.8 cc is not BPH. He should be thoroughly investigate by the team of physician, endocrinologist and urologist. Investigation include Cbc, urine c/mimax and culture, psa, sugar levels, RFT, Usg kub with pvr. After all these investigation treatment can be advised.

First his hyperglycaemia needs to be controlled and BP brought to target level. He needs Tamsulosin and Dutasteride .If his sugars are high he may also have A UTI

Symptoms s/O Prostatomegaly Poor DM control plan Good DM control.. insulin Alfa blockers Silodocin Antibiotics please do PSA URINE C/S R.F.T. .....

Plz don't create a confusion for a medical student,otherwise u give a standard reference for ur arguments.

vridhi vadhika vati 2bd kachnar guggal 2bd Neo tab 2bd (charak ) Ural BPH cap (vasu )2bd amreeplus granules 2tsf twice with one glass of water before meals arjunarishtha 10ml ashwgandhrishta10ml balarishta10ml twice a day with water

Load more answers

Cases that would interest you