I am passing urine with little strain. Why?

Patient's Query

Hi doctor,

I am 40 years old. From last two days I am suffering from frequent urination during day time with little bit burning sensation. My blood sugar and BP are normal. Urine flow is not so strong. I used to urine by pressing the penis and this is not the first time. As far as I can recall it from age 20, I am often suffer with the same issue. Please suggest me.

Answer

Dr. Geetha Priyadarsini Kamminana

General Medicine Internal Medicine

Hi,

Welcome to icliniq.com.I have some more queries about your complaints.

Do you have any nocturia that is do you have any disturbed sleep due to increased frequency of urination during nights?

Any difficulty in passing urine or any hesitancy to start or any straining during urination?

Do you have any dribbling of urine at the end of urination or is the volume of urination increased?

How is the stream, normal flow or thin? When did the burning micturition start?

Do you have any abdominal pain and history of recurrent fevers? Have you ever been evaluated for prostate size in the recent past?

Do you feel incomplete after emptying of the bladder?

As male urethra is S shaped some urine gets trapped and milking often clears the trapped urine at the end of urination.

The complaints you have quoted may fit into one of the below.

Recurrent UTI (urinary tract infection).
Urethral stricture.
Urethral diverticulum.
Benign prostatic hyperplasia (BPH).

BPH usually occurs after 50 years, which is not in your case as you are having these for the last 20 years.

Recurrent UTI is a consideration which can be ruled out by CUE (cumulative urinary excretion).

For strictures and diverticulum you need catheterization to rule out or radiographic evaluation of urethra with contrast like retrograde cystourethrogram and ultrasound.

I would advise you to avoid dairy.

Investigations to be done:

1. CUE.
2. Ultrasonography of abdomen with focus on prostate and post volume.

Regarding follow up:

Revert back with the answers to the above questions to an internal medicine physician online.---> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

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Patient's Query

Thank you doctor,

I do not have nocturia and there is no difficulty in passing urine. I do not strain during urination and there is dribbling of urine at the end of urination. I do not have any hesitancy and not evaluated for prostate size. The urine stream is thin and burning micturition is episodic. Abdominal pain is not there and no history of recurrent fever. At the end, I feel complete emptying of the bladder, but after a while later I feel bladder is full. I can hold urine for a few hours, but slight pain will be felt. Initially, I used to take chandanasava syrup and got better results. At the end, I press the penis to empty the bladder.

Answer

Dr. Geetha Priyadarsini Kamminana

General Medicine Internal Medicine

Hello,

Welcome back to icliniq.com.

Well, that rules out prostrate and puts you more towards.

You have recurrent UTI, cystitis and urethritis? Your urethral stricture needs to be ruled out.

Have you ever been catheterized that is tube ever been passed into your urinary bladder for collecting urine? If yes, that rules out the possibility of urethral stricture as catheterization requires patent penile urethra.

Have you ever had urinary incontinence like an escape of urine while laughing, coughing and getting down stairs?

I suggest you to go for CUE along with the urine leukocyte esterase test.

USG abdomen with focus on bladder thickness and a note on post-void volume.

Increased frequency may also be due to overactive bladder and have more water and a liquid diet.

I suggest you to have cranberry juice and lemonade that helps you to fight UTI.

Do pelvic floor exercises like Kegel exercises and breathing exercises in yoga to strengthen your floor muscles.

Revert back with answers to the above question to an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

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Patient's Query

Thank you doctor,

Am I suffering from UTI? Is the treatment going in the right direction? Please suggest me.

Answer

Dr. Geetha Priyadarsini Kamminana

General Medicine Internal Medicine

Hello,

Welcome back to icliniq.com.

Please do send your reports for my judgement.

Revert back with the reports to an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

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Patient's Query

Thank you doctor,

I have attached my reports. Please go through.

Answer

Dr. Geetha Priyadarsini Kamminana

General Medicine Internal Medicine

Hello,

Welcome back to icliniq.com.

Well, your urine appears to be clean and does not show any evidence of acute infection.

May be you are symptomatic like increased frequency, urgency and fever, which have urged your treating physician to treat it as UTI.

As reports are not always accurate and symptoms always speak truth. Do follow the prescription and it will help you.

In particular Urispas-LL (Flavoxate) helps you to decrease urinary frequency. It is a smooth muscle relaxant and Alkasol syrup helps you to clear the infection along with antibiotics. Consult your specialist doctor, discuss with him or her and take the medicine with their consent.

Do drink lots of water and have cranberry juice and lemonade.

For further information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

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