HomeAnswersInternal Medicineurinary tract infectionI have frequent urination with a burning sensation. Why?

I am passing urine with little strain. Why?

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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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Published At June 16, 2016
Reviewed AtJanuary 17, 2024

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.

Hi,

Hi,

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

- Do you have any nocturia, meaning do you experience disturbed sleep due to increased frequency of urination at night?

- Are you experiencing any difficulty in passing urine, hesitancy to start, or straining during urination?

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

- How would you describe the stream of urine, is it normal flow or thin? When did the burning during urination start?

- Are you experiencing any abdominal pain or a history of recurrent fevers? Have you been evaluated for prostate size recently?

- Do you feel a sense of incompleteness after emptying your bladder?

In males, the urethra is shaped like an 'S', and some urine can get trapped. Milking the urethra often helps clear the trapped urine at the end of urination.

The symptoms you have described could be associated with one of the following conditions:

1. Recurrent urinary tract infection (UTI).

2. Urethral stricture.

3. Urethral diverticulum.

4. Benign prostatic hyperplasia (BPH).

BPH typically occurs after the age of 50, which does not seem to be the case for you as you have been experiencing these symptoms for the last 20 years.

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

To investigate strictures and diverticulum, catheterization or radiographic evaluation of the urethra with contrast, such as retrograde cystourethrogram and ultrasound, may be required.

I would advise you to avoid dairy products.

Please provide further information or consult a healthcare professional for a detailed evaluation and appropriate management.

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.

              1. Recurrent UTI (urinary tract infection).
              2. Urethral stricture.
              3. Urethral diverticulum.
              4. Benign prostatic hyperplasia (BPH).
              5. 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.

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.

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

Patient's Query

Thank you doctor,

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

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

Patient's Query

Thank you doctor,

I have attached my reports. Please go through.

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

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Geetha Priyadarsini Kamminana
Dr. Geetha Priyadarsini Kamminana

Internal Medicine

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