Persistent Urinary Symptoms: What You Need to Know

Q: Persistent Urinary Symptoms: What You Need to Know

Hello： Treatment for urethritis typically takes about two weeks, and most patients notice an improvement in symptoms within three days, with resolution usually occurring within seven days. <br>However, a small portion of individuals may have difficulty recovering, often due to no

Abnormal urination?

Hello, Doctor.
I am a male and previously experienced burning during urination.
I was checked for gonorrhea, and despite receiving injections and medication, my condition did not improve upon follow-up.
The doctor mentioned that repeated infections might cause urethral stricture.
I was terrified after researching online, so I underwent a cystoscopy.
The doctor said it is not a urethral stricture but that my urethra is completely inflamed.
It seems my bladder is also affected, and I was prescribed medication to take home.
It has been a week, and I have been drinking more than 2500cc of water, but sometimes I still feel something unusual when urinating, usually for the first 3-5 seconds after I start.
Typically, it is at the beginning, and I don't feel anything afterward.
However, there are times when I feel discomfort throughout the entire urination process.
Could this indicate a serious problem? Is there anything that might have been missed during the examinations? The doctor thinks I should not worry, but I am concerned because I had a urine test after receiving the injection, which might have affected the results since I have been dealing with this for six months.
I visited other hospitals in between, but nothing has improved.
I would like to ask the doctor if this could be cancer or if it could develop into cancer.
Would a cystoscopy reveal that? I am really worried; I read online that urethritis can take two weeks to three months to heal.
Am I still in the recovery phase? Although the doctor said not to worry and that there is not much to be concerned about, the lack of improvement with the medication has made me anxious.
I hope the medication is just not strong enough, and that it is not a serious issue.
Please help me with your answers.
Thank you.

leo, 20~29 year old female. Ask Date: 2018/05/21

Dr. Du Shixi reply Urology

Hello: Treatment for urethritis typically takes about two weeks, and most patients notice an improvement in symptoms within three days, with resolution usually occurring within seven days.
However, a small portion of individuals may have difficulty recovering, often due to not fully adhering to lifestyle recommendations.
It is important to drink plenty of water consistently, avoiding large amounts at once followed by periods of little to no intake.
It is not advisable to consume beverages, including alcohol, and spicy foods should be minimized.
Additionally, prolonged sitting should be avoided (do not sit for several hours at a time), and gentle exercise for at least thirty minutes daily is recommended, rather than vigorous exercise.
Adequate sleep is also essential for a quicker recovery.
If you still experience symptoms, a culture test can be performed (though it may be difficult to obtain results after a course of medication).
As for the urinalysis showing no issues, it could be due to the fact that I administered an injection a day prior to the test, which may have affected the results.
Regarding bladder cancer, a cystoscopy will definitely provide information.
If symptoms reappear, I recommend consulting either a urology department or an infectious disease department at a hospital.
It is crucial to avoid any unsafe sexual practices; if you have engaged in such behavior, please seek medical evaluation.
Both external and internal factors must be ruled out for a quicker recovery.
If symptoms do not improve within one to two weeks, consider visiting a medical center.
Wishing you good health.

Reply Date: 2018/05/21

More Info

Hello! It sounds like you’ve been experiencing a lot of distressing urinary symptoms, and I understand how concerning this can be. Let’s break down your situation and address your concerns regarding persistent urinary symptoms.

From what you've described, it seems you have been dealing with a burning sensation during urination, which was initially suspected to be due to a sexually transmitted infection (STI) like gonorrhea. After treatment, you still experienced symptoms, leading to further investigations, including a cystoscopy, which revealed inflammation in the urethra but no strictures. This is a crucial point because inflammation can often cause similar symptoms to those of an infection.

Understanding Your Symptoms
1. Persistent Burning Sensation: The burning sensation you feel, especially at the beginning of urination, can be attributed to urethral inflammation. This inflammation can be a result of several factors, including previous infections, irritation from medications, or even non-infectious causes like interstitial cystitis or pelvic floor dysfunction.

2. Duration of Symptoms: You mentioned that you have been experiencing these symptoms for about six months. It’s not uncommon for urinary tract issues to take time to resolve, especially if there has been significant inflammation. The healing process can vary greatly from person to person, and while some may recover quickly, others may take longer.

3. Hydration: Drinking plenty of fluids, as you have been doing, is essential. It helps dilute the urine and can reduce irritation in the bladder and urethra. However, if you still feel discomfort despite adequate hydration, it may indicate that the underlying issue has not fully resolved.

Concerns About Serious Conditions
Your worries about serious conditions such as cancer are understandable, especially when symptoms persist. However, it’s important to note that:
- Cystoscopy Findings: If the cystoscopy did not reveal any tumors or significant abnormalities, it is a reassuring sign. Cancers of the bladder or urethra typically present with more severe symptoms, including blood in the urine or significant changes in urinary habits.

- Follow-Up Testing: If your symptoms do not improve with the current treatment, it may be worth discussing further testing with your doctor. This could include repeat urine cultures, imaging studies, or even a referral to a specialist in urology or a pelvic pain clinic.

Treatment Considerations
1. Medication: If the current medications are not providing relief, it may be necessary to revisit your treatment plan with your healthcare provider. There are various medications available for managing urinary symptoms, and sometimes it takes a few tries to find the right one.

2. Potential for Chronic Conditions: Conditions like interstitial cystitis can cause chronic urinary symptoms and may require a different approach to treatment, including dietary changes, physical therapy, or other interventions.

3. Psychological Factors: Anxiety about your symptoms can exacerbate the perception of pain or discomfort. It might be beneficial to discuss your concerns with a healthcare professional who can provide support and possibly recommend counseling or stress management techniques.

Conclusion
In summary, while your symptoms are concerning, the fact that you have undergone appropriate evaluations and treatments is a positive step. It’s essential to maintain open communication with your healthcare provider about your ongoing symptoms and any new concerns. If you feel that your current treatment isn’t effective, don’t hesitate to seek a second opinion or ask for further testing. Remember, your health and peace of mind are paramount, and it’s crucial to address any lingering worries you may have.
Take care, and I hope you find relief soon!

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