Dr. Ankush Jairath
Urology
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Patient's Query
Hello doctor,
I have always had a weak urine stream. I had medicines several times for bladder infections, never feel like I fully urinate. But lately, I have a bigger issue, I find myself not able to urinate sometimes, I recently realized if I ejaculate then it is worse. Two nights ago, after sex I went to urinate and not a drop, by morning I felt like I was gonna explode so I was headed to the ER when on the way it finally released. I decided to wait till I got home (I am a truck driver) to go see someone, probably tomorrow. I am currently able to urinate. I am a 36-year-old male, been going to the doctor all my life for bladder problems but this too much. Please help.
Hi,
Welcome to icliniq.com.
I have a few queries before jumping on to the conclusion. Have you ever been catheterized? Any history of trauma? smoker? Or any chronic illness (diabetes or hypertension)? Any record of RGU or MCUG or ultrasound is done before? Have you been on any medications for this improper urination other than antibiotics? How many times in the past year did you take antibiotics for a bladder infection? Where do you live? If you have that much recurrent infection why you never get investigated thoroughly until now? Any blood investigations or urine culture done in the past? During sex what happens is bladder neck contracts just before ejaculation so that one can ejaculate properly, but in your case, it does not relaxes due to which you feel retention like condition. Before prescribing your medication I want to know certain answers to the above questions which are very important.
Patient's Query
Thank you doctor,
More information, not sure if this will help. When I was young I had an operation on the tip of my penis, I was told it was to align the urethra at the bottom because it was turned some. I was told that due to that the whole healed up a little smaller than it should be, but doctors have checked it and said it has plenty of room for flow but it is always made me nervous. I have always gone to general doctors for the pain and they ask questions, assumed it was just another infection, I have been checked a couple of times for certain STDs that they thought it could be but always the same response there is an infection so here is antibiotics. Then it gets better for the most part and I go on with my life, it just becomes something I deal with. I am a smoker. I am not a diabetic. Never on anything for any of this besides antibiotics. I do not recall any ultrasounds, x-rays, only given urine samples. I hope this helps.
Hi,
Welcome back to icliniq.com.
What I concluded is that you might have hypospadias (mild) for which you were operated. Now that part is fine. You can still have meatal or sub meatus stenosis because of which there is recurrent UTI (urinary tract infection), weak stream. This part still needs to be investigated. For which I recommend you to get firstly uroflowmetry (which is non-invasive test in this you have to urinate on a machine which determines how you did). Based on that RGU AND MCUG (retrograde urethrogram and micturation cystourethrogram) may be needed. Actually, I want to diagnose the cause of your weak stream and recurrent UTI as if the cause is not removed then there is some kind of recurrence after you stop taking antibiotics. One baseline ultrasound abdomen with PVRU (post-void residual urine) is needed. Meanwhile, you can start tablet Alfuzosin 10 mg HS for 1 month (which I think will take care of flow as well feeling of retention of urine after ejaculation). Hope to hear from you soon after at least ultrasound and uroflowmetry. Continue your antibiotic course which you are taking.
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Urology
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