Urgency at the Urethral Opening: Causes and Solutions

There is a sensation of urgency at the urethral opening?

Hello Dr.
Lee, at the beginning of this year, I suddenly experienced a strong urge to urinate, which was felt at the urethral opening rather than in the bladder.
The urge was intense and uncomfortable, but I usually don’t have much urine, so I wait until I feel pressure in my bladder before going to the restroom.
At that time, my good friend, who is a traditional Chinese medicine practitioner, suggested that it might be due to my excessive consumption of cold beverages (at that time, I was drinking up to one cup a day).
After taking some herbal medicine and reducing my intake of cold drinks, my condition improved after a few days, and the urge to urinate disappeared.
However, this phenomenon has recurred a few times since then, though not as severely as the first time.
I have already reduced my consumption of cold beverages, so logically, I shouldn't be experiencing this issue.
Each time the urge occurs, it happens after ejaculation, but I don’t masturbate frequently—at most once a day.
Now I’m a bit scared, so I only masturbate every 2-3 days.
I previously had a fungal infection on my glans, and I went to the hospital for a urinalysis in early March, which showed no infection.
It has been about five weeks since then, and I am still applying antifungal cream.
Dr.
Lee, could this urge to urinate be caused by a fungal infection? If it’s not fungal, what could be the problem? How should it be treated? Is there anything I need to pay attention to in my daily life?

Eric, 30~39 year old female. Ask Date: 2020/04/07

Dr. Li Xinyi reply Urology

Your description may indicate poor pelvic circulation or issues related to prostate health.
It's advisable to avoid prolonged sitting or standing.
You might consider trying Kegel exercises or squats; you can find reference videos on YouTube.
Additionally, you can Google foods that are beneficial for prostate health.
Focus on improving your overall health.
Relying on medication may lead to more complications.
However, if symptoms persist, it's important to consult a urologist for an examination and further discussion with your physician.

Reply Date: 2020/04/07

More Info

Understanding the urgency at the urethral opening can be quite complex, as it may involve various physiological and psychological factors. Based on your description, it seems that you are experiencing a sensation of urgency localized at the urethral opening rather than the bladder itself. This can be distressing and may lead to a cycle of anxiety regarding urination.

Possible Causes
1. Irritation or Inflammation: The sensation you are experiencing could be due to irritation or inflammation of the urethra, which can be caused by several factors, including infections (even if your recent tests were negative), sexually transmitted infections, or irritants such as soaps or lotions.

2. Urethral Sensitivity: Some individuals may have heightened sensitivity in the urethral area, which can lead to a feeling of urgency even when the bladder is not full. This could be exacerbated by anxiety or stress.

3. Pelvic Floor Dysfunction: Issues with the pelvic floor muscles can also contribute to urinary urgency. If these muscles are tense or not functioning properly, they can create a sensation of urgency.

4. Dietary Factors: As you mentioned, your friend suggested that consuming cold beverages could be a contributing factor. While there is limited scientific evidence to support this, some individuals report that certain foods and drinks (like caffeine, alcohol, and spicy foods) can irritate the bladder and urethra.

5. Post-Ejaculatory Urgency: It is not uncommon for men to experience a sensation of urgency after ejaculation. This could be due to temporary changes in the pelvic floor or urethral pressure.

Treatment Options
1. Lifestyle Modifications: Since you have already started reducing your intake of cold beverages, continue to monitor your diet. Keeping a bladder diary may help identify any specific triggers related to your diet or activities.

2. Pelvic Floor Exercises: Engaging in pelvic floor exercises, such as Kegel exercises, can strengthen the muscles and potentially alleviate some of the urgency sensations.

3. Medications: If the urgency persists, discussing the possibility of medications with your healthcare provider may be beneficial. Anticholinergic medications can help reduce bladder overactivity, while topical treatments may be prescribed if irritation is suspected.

4. Psychological Support: If anxiety is a contributing factor, cognitive-behavioral therapy (CBT) or relaxation techniques may help manage the psychological aspects of your symptoms.

5. Follow-Up with a Specialist: Given your history of fungal infections and ongoing symptoms, it may be prudent to consult a urologist. They can perform further evaluations, such as a cystoscopy, to rule out any underlying conditions that may not have been detected in previous tests.

Preventive Measures
- Hydration: Ensure you are drinking enough water throughout the day, as dehydration can lead to concentrated urine, which may irritate the bladder.

- Avoid Irritants: Steer clear of known bladder irritants, including caffeine, alcohol, and spicy foods.

- Regular Check-Ups: Regular follow-ups with your healthcare provider can help monitor your symptoms and adjust treatment as necessary.

In conclusion, while your symptoms may have improved with dietary changes, it is essential to remain vigilant and consult with a healthcare professional if the urgency persists or worsens. Understanding the underlying causes and implementing appropriate treatment strategies can significantly enhance your quality of life.

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