Urination Issues: Seeking Help for Difficulty in Urination

Regarding urinary issues?

Hello doctor, I am 20 years old.
I used to have a habit of holding my urine.
A long time ago, I noticed that I had to strain to urinate.
This has been going on for several years.
I visited a small clinic, but the doctor told me there was no problem [referring to the urinalysis].
However, I still cannot urinate properly.
What could be the issue? What tests should I undergo? Recently, it seems like I am having even more difficulty urinating.
Please help me with this.
You can reply to my email.
Thank you.

Xiao Wei, 20~29 year old female. Ask Date: 2002/09/10

Dr. Chen Xiuyi reply Urology

Hello, Xiao Wei! A urinalysis generally includes urine sediment examination and tests for proteinuria and occult blood.
Based on your symptoms of difficulty urinating, it appears to be caused by lower urinary tract dysfunction.
It may be necessary to arrange for urodynamic testing to assess bladder function and the function of the urethral sphincter.
This type of functional testing can typically be arranged at large teaching hospitals.
Wishing you and your family peace and happiness from the Taoyuan Hospital of the Department of Health, Executive Yuan.
Dr.
Chen Hsiu-Yi.

Reply Date: 2002/09/10

More Info

It sounds like you are experiencing significant difficulties with urination, which can be both physically uncomfortable and emotionally distressing. Given your history of holding in urine and the recent worsening of your symptoms, it is essential to take a comprehensive approach to understand and address your condition.

First, it’s important to recognize that habitual urinary retention, or the practice of holding in urine, can lead to various complications over time. This behavior can cause changes in bladder function, leading to issues such as urinary retention, incomplete emptying, and even bladder overactivity. When you mention that you have to exert effort to urinate, it suggests that your bladder may not be functioning optimally. This could be due to a variety of factors, including muscle dysfunction, nerve issues, or psychological factors related to anxiety about urination.

Since you have already undergone a urine test that came back normal, it might be beneficial to pursue further evaluations. Here are some steps you could consider:
1. Urodynamic Studies: These tests assess how well your bladder and urethra are storing and releasing urine. They can provide valuable information about bladder pressure, capacity, and the flow of urine, helping to identify any functional issues.

2. Ultrasound of the Bladder: An ultrasound can help determine if there is residual urine left in your bladder after urination, which can indicate incomplete emptying.

3. Cystoscopy: This procedure involves inserting a small camera into the bladder through the urethra to visually inspect the bladder and urethra for any abnormalities, such as strictures or inflammation.

4. Neurological Evaluation: Since bladder function is controlled by nerves, it may be helpful to consult a neurologist to rule out any underlying neurological conditions that could be affecting your bladder control.

5. Psychological Assessment: If anxiety or psychological factors are contributing to your urinary difficulties, speaking with a mental health professional could be beneficial. They can help address any fears or anxieties related to urination.

6. Lifestyle Modifications: In addition to medical evaluations, consider making lifestyle changes. This includes practicing regular bathroom breaks to avoid the habit of holding in urine, which can help retrain your bladder. Also, staying well-hydrated can promote better bladder function.

7. Medication Review: If you are taking any medications, it’s worth discussing with your healthcare provider whether any of them could be contributing to your urinary issues. Some medications can affect bladder function and urination.

It’s crucial to communicate openly with your healthcare provider about your symptoms and concerns. If you feel that your current doctor is not addressing your issues adequately, seeking a second opinion from a urologist or a specialist in bladder disorders may provide you with more targeted care.

In summary, your symptoms warrant further investigation to identify the underlying cause of your urination difficulties. By pursuing comprehensive evaluations and considering lifestyle changes, you can work towards finding a solution that improves your urinary health and overall well-being. Remember, you are not alone in this, and there are healthcare professionals who can help you navigate these challenges.

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