Patient's question:
43 years old this year, had the problem of frequent urination since young, about 20 years.Doctor's answer:
After reviewing your condition description, the symptoms are indeed non-structural. It seems your quality of life has been significantly affected, and it is crucial to seek treatment as early as possible.It is unlikely to be a bacterial infection issue; it is more likely a functional problem. This condition can indeed be challenging to diagnose and treat, but initial screening tests are still necessary to narrow down the scope of the disease. Currently, I lean toward the possibility of pelvic floor dysfunction, which could be accompanied by prostatitis and pelvic floor muscle spasms, though interstitial cystitis cannot be ruled out either.
1. I recommend starting with a flow rate test, post-void residual urine test, five tumor cell screenings in urine, and three to four tuberculosis screenings in urine. Additionally, a plain X-ray and MRI of the lumbar spine are essential. These tests must be completed before you come in, and please bring all the results with you so I can review them.
2. You can take one tablet of Docusate per day, one to two tablets of Amitriptyline at bedtime, and one tablet of Famotidine per day. Let’s wait and see how effective this is after one month. Your condition may be treatable with a bladder pacemaker, but we typically start with conservative medication treatment first. If that doesn’t work, we may then consider a pacemaker. However, this will require a longer period of validation. I hope you understand. Of course, if the cost is not an issue and you prefer not to wait too long to see results, we can discuss alternative options.