Prostate Issues and Kidney Pain: Treatment Insights

Prostate and kidney inflammation (or urinary tract stones)

Hello Dr.
Hsu,
After our last consultation, I followed your advice and went to the outpatient clinic.
I told the doctor directly that I have a history of benign prostatic hyperplasia and am currently experiencing difficulty urinating.
The doctor prescribed me a one-week course of medication—Uroflow (UFIEF cap 4mg)—and said to take it for a week to see how it goes.
Can I expect any improvement in my symptoms after one week of taking the medication for my prostate?
I also informed the doctor that I often experience pain in my left lower back, which is quite distressing.
I had a history of urinary stones ten years ago, and five years ago, a urologist at "Sheng-Tao Hospital" performed a detailed renal ultrasound and indicated that everything was normal at that time.
Recently, due to the persistent lower back pain, I suspected it might be caused by a lumbar spine injury or scoliosis.
I went to Shin Kong Hospital for an X-ray examination (under the care of the chief physician), and they said everything was fine.
Therefore, I suspect that the pain might be related to urinary obstruction leading to kidney changes or inflammation, which could be causing the constant discomfort in my left lower back.
When I explained this situation to the doctor, she surprisingly suggested that I see a nephrologist for further examination.
This is something I have not experienced before, as my previous conditions were always managed by urology.
I am a bit confused and anxious about why I need to see a nephrologist.

So, I would like to ask for your clarification and guidance on the following:
1) Can medication for the prostate help reduce the enlargement or improve abnormal urination symptoms?
2) If I have urinary stones, can medication alleviate the discomfort in my lower back?
I greatly appreciate your ongoing guidance and valuable opinions.
Thank you!

Lai Weng, 70~79 year old female. Ask Date: 2015/09/16

Dr. Xu Weikai reply Urology

Hello, this type of medication can show initial effects in about 3-5 days.
If there is no improvement after a week, it may be necessary to change to another medication.
In cases of kidney infection, in addition to pain, there is usually a high fever, which makes diagnosis relatively straightforward.
As for nephrology, it emphasizes detailed scans of the kidneys, such as early kidney lesions, changes in the glomeruli, or other subtle structural changes, including diabetic kidney damage.
In contrast, urology typically focuses on larger structural changes in the kidneys, such as stones, tumors, or hydronephrosis.
Certain medications can reduce the size of the prostate.
Small urinary stones may not require surgical intervention and can be managed with medications to assist in their passage or dissolution.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses should only be used as a reference; it is still necessary to seek medical attention at healthcare facilities when needed.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/09/16

More Info

Hello! Thank you for reaching out with your questions regarding prostate issues and kidney pain. It’s understandable to feel concerned about your symptoms, especially given your medical history. Let’s break down your questions and provide some insights based on current medical knowledge.

1. Can prostate medication reduce enlargement and improve urinary issues?
The medication you mentioned, UFIEF (which contains the active ingredient Silodosin), is an alpha-blocker commonly prescribed for benign prostatic hyperplasia (BPH), or prostate enlargement. Alpha-blockers work by relaxing the muscles in the prostate and bladder neck, which can help improve urine flow and reduce symptoms such as difficulty urinating, frequent urination, and urgency. Typically, patients may start to notice improvements within a week of starting the medication, but it can take longer for the full effects to be felt. It's important to follow your doctor's instructions and report any side effects or lack of improvement after the initial treatment period.

2. Can kidney stones cause lower back pain, and can medication help?
Given your history of kidney stones, it’s plausible that your current left-sided back pain could be related to kidney issues, especially if there is a blockage or irritation in the urinary tract. However, if imaging studies like X-rays and ultrasounds have shown no abnormalities, it may be worth considering other causes of your pain, such as musculoskeletal issues or nerve-related problems. Medications for kidney stones typically focus on pain relief and may include nonsteroidal anti-inflammatory drugs (NSAIDs) or other analgesics. If there is a concern about kidney function or potential infection, your doctor may recommend further evaluation by a nephrologist (kidney specialist) to ensure comprehensive care.

3. Why refer to a nephrologist?
Your doctor’s suggestion to see a nephrologist is not uncommon, especially if there are concerns about kidney function or if your symptoms persist despite treatment. Nephrologists specialize in kidney-related issues and can provide additional insights or tests that may not be within the scope of a urologist’s practice. This referral can help ensure that any underlying kidney problems are addressed, particularly given your history of kidney stones.

4. Managing your symptoms:
In addition to medication, lifestyle modifications can also play a significant role in managing both prostate and kidney health. Staying well-hydrated, maintaining a balanced diet, and avoiding irritants such as caffeine and alcohol can help alleviate urinary symptoms. Regular exercise can also improve overall health and potentially reduce discomfort.

5. Monitoring and follow-up:
It's crucial to keep an open line of communication with your healthcare providers. If your symptoms persist or worsen, or if you experience new symptoms such as fever, chills, or significant changes in urination, it’s essential to seek medical attention promptly. Regular follow-ups can help monitor your condition and adjust treatment as necessary.

In summary, the medication prescribed for your prostate issues can indeed help improve urinary symptoms, and it’s essential to give it some time to work. If your back pain continues or worsens, further evaluation by a nephrologist may provide valuable insights. Always feel free to discuss your concerns with your healthcare provider, as they can tailor their recommendations based on your specific situation. Thank you for your questions, and I wish you the best in your treatment journey!

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