Dr. Ankush Jairath
Urology
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Patient's Query
Hi doctor,
I am a 24-year-old male. I have been having trouble urinating. Whenever I urinate I feel like there is a blockage that is preventing all the urine coming out at once. This requires me to wait for a long time and continue pushing the urine out and then at the end I am using my fingers to squeeze the urethra to get out the last. Even after all of that, there continues to be some dribbling of droplets. Also, sometimes after masturbating, I end up having to go every five minutes five to 10 times to let out a few more drops until it is all emptied out. This is something I have been struggling with for quite a while. I showed my doctor and he assigned an antibiotics course that did not make a difference. I suspect it has something to do with semen blocking the flow of urine but I am not sure and cannot find anything related on google. Any advice on this would be appreciated.
Hi,
Welcome to icliniq.com.
Semen blocking the way cannot happen so this much thing is clear. Secondly, for how long you are having urinary symptoms you mention? Do you have any urinary complaints like frequency, urgency, poor stream, nocturia, dribbling, or burning micturation? Does your poor flow of urine settles or become somewhat better when you strain during micturation? I think it can be a stricture disease. Do you have any history of diabetes or hypertension or any medication taken? Which antibiotics did you take? Any history of catheterization or trauma to the penile region?
Patient's Query
Thank you doctor,
These symptoms have been around for three to four years now. I do not remember the antibiotics I took but I have some notable symptoms. There is dribbling even after multiple attempts of pushing out every drop. When urinating, the stream seems to be split into two streams, one bigger one on the top and a smaller one on the bottom, both of which are steady but there is not one combined stream. Near the end when I am pushing out more to make sure I am done, it usually comes out of the bottom stream and not the top since there is not much volume at the end. I do urinate frequently (every two to three hours) but possibly because I drink a lot of water so not sure if there is an issue there. I have no history of diabetes, trauma to the region, or medications.
Hi,
Welcome back to icliniq.com.
Presently according to the history, I recommend you to start tablet Alfuzosin 10 mg for two weeks. If you feel there is no or marginal improvement then I suggest you to have reterograde urethrogram and ultrasound abdomen with PVRU (post void residual urine). I think we have to rule out stricture urethra as only this condition can explain all the symptoms you have. Other can be bladder neck obstruction (less likely) and prostatomegaly (age 24 so highly unlikely).
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Urology
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