How to effectively manage lower urinary tract symptoms?

Question

Hello doctor,

I am a 32-year-old male with some ongoing urinary problems. Over the past 18 months, I have experienced mild to moderate pain and pressure in my bladder. It worsens if I try to hold my urine, and it is almost always noticeable when I have more than 200 ml of urine in my bladder. Hence, I go to the bathroom twice as often as I used to, especially when I try to hydrate well. This discomfort causes me to wake up once or twice a night. I have learned to manage it by not drinking water three to four hours before bed, but I still wake up at least once. Also, I am usually dehydrated by morning, even when I drink three to four liters of water daily. My previous findings are listed below:

A comprehensive blood panel shows no abnormalities.
Glucose levels show no diabetes.
PSA shows no indication of prostate enlargement. No digital rectal examination has been performed.
Urinalysis shows no unusual readings or indications of UTI.
Post-void ultrasound shows no remaining fluid in the bladder.
I do not have any incontinence.
There is no blood in the urine.

Answer 1

Hello,

Welcome to icliniq.com.

The symptoms you have referred to are lower urinary tract symptoms (LUTS). You are having mixed LUTS, which means storage and voiding symptoms. These things at this age are usually due to CP or CPPS (chronic prostatitis or chronic pelvic pain syndrome). You need to visit your local urologist for a digital rectal examination. You need symptomatic treatment with alpha-blockers. In addition, you need pelvic floor muscle training. All these need demonstrations and proper explanations. So physical visit to a urologist is mandatory for further management.

Thank you.