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What kind of specialist should i contact?

Posted by jamesgs1 @jamesgs1, Oct 26, 2023

i am a 79-year-old male, i had prostate cancer in 2001 and again in 2005 (2005 prostate was frozen), because of radiation treatments in 2001 (bladder decinagrated), had to have my bladder removed and have a urinary stoma in its place.
around six months ago i started having a discharge from my penis, because i don’t have a bladder my penis opens up into my peritoneal cavity, if i do anything strenuous i produce blood in the peritoneal fluid, the only way i can control this problem is to use maxi pads in my underwear, which i must change four or five times a day. I also have a distinct pain in my lower right quadrant of my stomach.
my urinary physician wants to cauterize the opening between my penis and my peritoneal cavity, if he does this, where does the fluid go,
how is the fluid removed?
what kind of specialist should i contact.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Oct 26, 2023

Hi @jamesgs1, welcome. Given your history with prostate cancer and that you have a urostomy, I moved your question to both the Prostate Cancer support group and the Ostomy support group. I think others may have thoughts to share with you. I'm tagging @katydid77 @jshollett @hodagwi to see if they have thoughts to add.

You said that you are seeing a urinary physician. I assume this doctor is a urologist, which is the specialist I would've recommended for your situation. You may also wish to speak with an ostomy nurse.

James, am I understanding correctly that you currently have a stoma (opening) in place but you are not using it to pass urine. Is that correct? My understanding is that once you have a urostomy as your doctor suggests, you pass urine through an opening (stoma) into a bag that you wear at all times to catch the urine as it leaves your body. That would be a good question to confirm with your doctor.

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1 reply
jshollett | @jshollett | Oct 26, 2023

See your Ostomy Nurse now.
She will direct you to the proper urologist. What you are experiencing is wrong.
The stoma should be your main discharge pipe.
Seems out of the ordinary

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jamesgs1 | @jamesgs1 | Oct 26, 2023
In reply to @colleenyoung "Hi @jamesgs1, welcome. Given your history with prostate cancer and that you have a urostomy, I..." + (show)
@colleenyoung

Hi @jamesgs1, welcome. Given your history with prostate cancer and that you have a urostomy, I moved your question to both the Prostate Cancer support group and the Ostomy support group. I think others may have thoughts to share with you. I'm tagging @katydid77 @jshollett @hodagwi to see if they have thoughts to add.

You said that you are seeing a urinary physician. I assume this doctor is a urologist, which is the specialist I would've recommended for your situation. You may also wish to speak with an ostomy nurse.

James, am I understanding correctly that you currently have a stoma (opening) in place but you are not using it to pass urine. Is that correct? My understanding is that once you have a urostomy as your doctor suggests, you pass urine through an opening (stoma) into a bag that you wear at all times to catch the urine as it leaves your body. That would be a good question to confirm with your doctor.

Jump to this post

I had a stoma since 2005 and pass urine through it into a bag that i wear all the time, my urinary physician wants to cauterize the opening between my penis and my peritoneal cavity, if he does this, i presume the fluid in my peritoneal cavity will build up, my GP said if that be the case it would have to be extracted with a needle and syringe often. my GP could not make any suggestions on who to see.

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jamesgs1 | @jamesgs1 | Oct 26, 2023

yes! my urologist wants to cauterize the opening between my penis and my peritoneal cavity. In other words, close off the exit of fluid through my penis.

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mccsjm | @mccsjm | Oct 26, 2023

Sounds like you are having excessive (more than physiological amount) peritoneal fluid, also known as ascites. Many potential causes for ascites, but most common ones are related to the digestive system. You're also having a pain in the lower right quadrant, which could be the cause. I feel you need to have some lab tests of the fluid and abdominal CT as soon as possible to find out what's causing all these. I would consult a gastroenterologist or internist.

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1 reply
jamesgs1 | @jamesgs1 | Oct 26, 2023
In reply to @mccsjm "Sounds like you are having excessive (more than physiological amount) peritoneal fluid, also known as ascites...." + (show)
@mccsjm

Sounds like you are having excessive (more than physiological amount) peritoneal fluid, also known as ascites. Many potential causes for ascites, but most common ones are related to the digestive system. You're also having a pain in the lower right quadrant, which could be the cause. I feel you need to have some lab tests of the fluid and abdominal CT as soon as possible to find out what's causing all these. I would consult a gastroenterologist or internist.

Jump to this post

thank you, i had not thought of a Gastroenterologist orInternist.
best regards
James G. Smith II

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amyb5 | @amyb5 | Nov 1, 2023

Maybe a second opinion from another urologist too?

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