Urgent Urination After Peeing: Urological Issues

Experiencing a strong urge to urinate even after finishing urination?

Hello Dr.
Chen, I am Mr.
Sun's son (asking on behalf of my father).
He has a history of colon cancer, which metastasized to the lymph nodes two years ago.
He has also had kidney stones, but both conditions have been managed with surgery and chemotherapy.
Now, I have some urinary issues to consult with you, and I would appreciate your answers and suggestions.
Before the Lunar New Year this year, my father suddenly complained of severe abdominal pain and had not had a bowel movement for many days.
His abdomen and left kidney area were extremely bloated and painful.
I took him to the emergency department at Far Eastern Memorial Hospital, where he was given pain relief and sent home, but the problem remained unresolved.
After the holiday, we returned to National Taiwan University Hospital (as he had previously been treated there, but due to the urgent situation during the holiday, Far Eastern was closer to home).
The doctors at NTU arranged a series of examinations and ultimately discovered a malignant tumor approximately 2.8 cm near the artery by the ureter.
The tumor's pressure was compressing the ureter, preventing urine from draining from the left kidney, resulting in hydronephrosis and pain.
The doctors advised against surgery due to the associated risks and instead placed a nephrostomy tube to drain urine from the left kidney, recommending chemotherapy first.
About a month ago, the nephrostomy tube was removed and replaced with a self-funded double-J stent placed inside the ureter to keep it open.
After the procedure, my father felt okay, with only slight discomfort.
However, recently he has been experiencing a sensation of incomplete bladder emptying, especially at night.
He often feels a sudden urge to urinate but only passes a small amount, and after finishing, he still feels the need to urinate.
His bladder feels full, but he cannot urinate comfortably, although there is no pain during urination.

Could this situation be due to a bladder infection, a kidney infection, or related to the previously placed double-J stent? Or could it indicate a worsening of the tumor?

Mr. Sun, 50~59 year old female. Ask Date: 2016/04/06

Dr. Chen Wenming reply Urology

The condition needs to be evaluated by a specialist physician.

Reply Date: 2016/04/06

More Info

Urgent urination after peeing can be a distressing symptom, especially in a patient with a complex medical history like your father. Given his history of colon cancer, lymph node metastasis, and kidney stones, it's essential to approach this situation with a comprehensive understanding of potential underlying causes.

The symptoms your father is experiencing—feeling the need to urinate urgently, the sensation of incomplete bladder emptying, and the discomfort associated with these urges—could be attributed to several factors. One possibility is bladder irritation or inflammation, which can occur due to a urinary tract infection (UTI) or cystitis. However, in the context of your father's medical history, particularly the recent placement of a double-J stent, this could also be a significant contributing factor.

Double-J stents are commonly used to relieve obstruction in the urinary tract, but they can lead to various side effects, including urinary urgency, frequency, and discomfort. The presence of the stent can irritate the bladder lining, leading to symptoms that mimic those of a UTI. It's also worth noting that stents can sometimes become encrusted with minerals or develop biofilms, which could further exacerbate urinary symptoms.

Another consideration is the possibility of tumor recurrence or progression. Given that a malignant tumor was previously identified near the ureter, there is a concern that it could be causing additional obstruction or irritation. Tumors can lead to changes in urinary patterns, including urgency and incomplete emptying, especially if they are affecting the bladder or urethra.

In terms of differential diagnosis, it is crucial to rule out a urinary tract infection, especially since your father has experienced significant changes in urinary habits. A urinalysis and urine culture would be beneficial to determine if an infection is present. If an infection is ruled out, further imaging studies, such as an ultrasound or CT scan, may be necessary to assess the status of the kidneys, ureters, and any potential tumor growth.

Given your father's complex medical history, it is also essential to consider his overall health status, including any potential side effects from chemotherapy or other treatments he has undergone. Chemotherapy can sometimes lead to changes in bladder function or increase susceptibility to infections.

In summary, the urgent urination and sensation of incomplete bladder emptying your father is experiencing could be related to several factors, including:
1. Irritation from the Double-J Stent: This is a common cause of urinary urgency and discomfort in patients with stents.

2. Urinary Tract Infection: A UTI could cause similar symptoms and should be ruled out with appropriate testing.

3. Tumor Recurrence or Progression: Given his cancer history, it is essential to monitor for any signs of tumor growth that could be affecting urinary function.

It is crucial for your father to follow up with his urologist or oncologist to discuss these symptoms in detail. They may recommend further diagnostic tests to clarify the cause of his symptoms and determine the best course of action. Managing these symptoms effectively is vital for maintaining his quality of life, especially considering his ongoing treatment for cancer.

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