Q. I have occasional urinary incontinence with multiple streams and high pressure. Why?

Answered by
Dr. Samer Sameer Juma Ali Altawil
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 05, 2020 and last reviewed on: Aug 29, 2020

Hello doctor,

I have occasional urine incontinence. Urine flows in different directions and drops on my legs. I have persistent high pressure, weak erection and quick ejaculation. And also have difficulty concentrating on tasks for a long time.



Welcome to

Incontinence of urine and multiple streams with high pressure are consistent with urethral stricture. It is narrowing of the urethra causing the above mentioned symptoms. Enlarged prostate can also cause the same issue but less common with multiple streams like this.

Tests need to be done are:

1.Urine analysis and culture (as urethral stricture might cause infection).

2. Ultrasound KUB (kidney,ureter and bladder) (stricture can also cause bladder stone).

3. PSA (blood test for prostate cancer for individuals above 50 years).

4. Uroflow and bladder scan.

Flexible cystoscopy might be required after uroflow results.

Regarding reduced erections and premature ejaculation, that might be due to reduced testosterone or secondary to other medical problems like diabetes or hypertension or its medications. Please get done testosterone levels.

Thank you doctor,

Test results:

Urine analysis culture:

Appearance - clear.

Colour - amber.

PH - 7.0.

Sugar - normal.

SG - 1.020.

Ketones, blood, bilirubin, urobilinogen, ascorbic acid and nitrite - Nil.

Urine culture yielded no growth after 48 hours of incubation at 37 degrees.

PSA - 0.2NG/ml (normal 0 - 4.0ng/ml).

The symptom is urine drops on my feet and scatters sideways instead of straight. Also, I have frequent night urination.



Welcome back to

Thanks for providing me with test results. The picture is more clear now. Prostate enlargement is the probable cause.

Please start tablet Tamsulosin 0.4 mg once at night with a small sip of water. This medicine makes it more easy to pass urine.

Follow up after one week to update me about whether there is any improvement.

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