Dr. Haluk Kulaksizoglu
Urology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 35-year-old male, single, with Familial Mediterranean fever, and I am currently under the supervision of a liver doctor. My symptoms have been occurring after ejaculation, and they include frequent urination, discomfort, and pain between the abdomen and thighs. At times, I experience pain in the thighs and notice redness in the inner side of my thighs and lower abdomen. Additionally, red vertical lines appear on my abdomen when I feel the need to urinate. Furthermore, I have been experiencing cold sensations with occasional trembling and episodes of diarrhea. Recently, I have also noticed a partial lack of sensation in my penis, and it sometimes feels like it is shrinking and becomes heavy. Additionally, I have been dealing with bloating in my stomach, and by the end of the day, I sometimes feel the urge to vomit even when my stomach is empty.
These symptoms have been present for the past 15 years, and when I noticed an increase in the frequency of urination, I consulted a doctor. The doctor prescribed antibiotics, which helped in controlling my urgent need to urinate, but they did not address all of my other problems. For the past year, I have been taking Permixon medication as part of my treatment plan. Despite this, I am still experiencing these symptoms after ejaculation, although I have noticed that the symptoms are less severe when ejaculation occurs without any rubbing of the penis.
Hello,
Welcome to icliniq.com.
What you describe is a combination of symptoms that may or may not be related to each other. The pain, urination, and ejaculation problems, as well as the sensations you feel at the penis area, points to what we call non-bacterial prostatitis or Prostatodynia syndrome. There is no known explanation as to why it happens, but it involves the urinary system, genital system, and the pelvic floor muscles, which may also explain your bowel problems. If there is no bacterial growth in the prostatic secretions and urine, empirical antibiotics usually have only limited effect. I would suggest you have a testosterone analysis, PSA (prostate-specific antigen) testing, urodynamic evaluation of the bladder and urine, and semen culture. But your bowel problems should further be evaluated by a gastroenterologist.
The Probable causes
Investigations to be done
Treatment plan
Patient's Query
Thank you doctor,
I will request from my doctor the testosterone and the PSA test. The urine and semen culture was done, and it was normal. Also, I did the urodynamic, attached a clear scan, and have translated the report here: Genital examination: Good. Rectal examination: Muscle tone inlay. Maximum flow 0.44 fluid ounces per second, volume 11.03 fluid ounces. The flow curve not normal, fragmented. Left over urine 15.26 cubic inches. Not showing DSD, the bracket is synergy. Maximum urine flow: 0.3852 fluid ounces per second (fl oz/sec), volume: 38.64 cubic inches, there is straining. PFS according to is not blocked. BCI = 79 weak. The doctor thinks maybe there is a bladder construction. I hope the translation is clear, and you can find the report result in the attached file. And, I will start to search for the treatment that you suggest.
Hello,
Welcome back to icliniq.com.
Your urodynamics test shows that your muscles around the bladder are not contracting enough to empty the bladder. Since you have a considerable amount left in the bladder, you feel the discomfort in the lower abdomen. Combining these findings with the loss of sensation in the penis, you would also need to have an EMG (electromyography) study to see if there is a problem with the nerves that innervate the genital area and the bladder (pudendal SEP).
Patient's Query
Patient's Query
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Urology
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