Urinary Concerns: When to Seek Medical Advice

I would like to ask a question to the doctor?

Hello, I have some questions for the doctor.
Sometimes after urinating, I feel like I might drip onto my underwear, or when I wake up, it seems like I might have had a nocturnal emission.
There are times when I change my underwear four times a day.
I personally feel that I have a cleanliness obsession and worry that this might lead to infections in my genital area.
Even when I use the toilet at home, I throw toilet paper to avoid splashing water and getting myself dirty.
However, because of this, my family asked me today if I am using drugs, since I change so many times.
When I explained, they just told me not to actually use drugs and to talk to them if I have any problems.
It seems they don’t understand why I change so often, and I feel really innocent...
I’m definitely not using drugs.
Does my behavior really seem like that? 😅 But I remember seeing a public service announcement at school that said urinary incontinence means you would be urinating continuously every 30 minutes, and it wouldn’t just have this symptom, right? Being scolded makes me doubt myself because I don’t know how to explain my situation...
even though there’s nothing wrong.
I’d like to ask the doctor what I should do, because I feel shy about discussing nocturnal emissions, and when my underwear gets a little wet, I change it at home, but at school, I just have to endure it.
Also, is it really okay if water from the toilet splashes onto my skin?

Jack, 10~19 year old female. Ask Date: 2020/11/02

Dr. Hong Yuanbin reply Internal Medicine

Hello, the government has been promoting that ketamine can cause bladder fibrosis, leading to frequent urination, so it's understandable that your family members might overreact.
However, nocturnal emissions are a normal physiological phenomenon, and changing underwear the next day is very reasonable.
This point should be understandable when communicating with male elders in your household.
As for frequently replacing underwear due to minor urine stains, it is indeed unnecessary.
You might try to divert your attention and not focus so much on the issue of underwear.
If you find it difficult to control, you can seek treatment at a psychosomatic clinic, where some medications can help you.
Additionally, a little water from the toilet splashing onto the skin is indeed not a concern.
Thank you for your question.

Reply Date: 2020/11/02

More Info

When it comes to urinary concerns, it's essential to understand the signs that warrant medical attention. Your situation, which involves experiencing dribbling after urination and concerns about nocturnal emissions (often referred to as "wet dreams"), can understandably lead to anxiety, especially if you feel it impacts your hygiene and daily life.

Firstly, let's address the dribbling after urination. This can be a common issue, particularly in males, and can be caused by several factors, including weak pelvic floor muscles, prostate issues, or even the way urine is expelled. If you find that this is a persistent issue, it would be wise to consult a urologist. They can perform a thorough evaluation, which may include a physical examination, urine tests, and possibly imaging studies to rule out any underlying conditions.

Regarding nocturnal emissions, it's important to note that this is a normal physiological occurrence, especially in adolescents and young adults. It can happen due to various reasons, including hormonal changes and sexual arousal during sleep. If this is infrequent and not accompanied by other troubling symptoms, it is generally not a cause for concern. However, if you feel that it is excessive or causing you distress, discussing it with a healthcare provider can help clarify any misconceptions and provide reassurance.

Your concerns about hygiene and cleanliness are valid, especially if you have a tendency towards obsessive-compulsive behaviors regarding cleanliness. It’s crucial to maintain good hygiene, but excessive worry about cleanliness can sometimes lead to unnecessary stress and anxiety. If you find that your thoughts about cleanliness are interfering with your daily life or causing you distress, it might be beneficial to speak with a mental health professional. They can help you explore these feelings and develop coping strategies.

As for your family’s comments regarding your hygiene habits, it’s essential to communicate openly with them about your concerns. Explain that your frequent changes of underwear are due to your worries about cleanliness and not due to any substance use or other issues. Education about urinary health and hygiene can help alleviate misunderstandings.

Regarding your question about toilet water splashing onto your skin, while it's generally not harmful, maintaining good hygiene practices is always advisable. If you are concerned about cleanliness, consider using toilet seat covers or ensuring that the toilet is clean before use.

In summary, if you are experiencing persistent urinary issues, it is advisable to seek medical advice. A healthcare professional can provide a proper diagnosis and treatment plan tailored to your needs. Additionally, if your concerns about cleanliness and hygiene are affecting your mental well-being, consider reaching out to a mental health professional for support. Remember, it’s essential to prioritize both your physical and mental health.

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