Urinary issues
I would like to ask the doctor a question.
Recently, sometimes when I urinate, if I exert pressure on my abdomen, I experience a sharp pain at the urethral opening.
However, this does not happen every time, and I do not feel pain when urinating while standing.
This occurs every time in the evening.
About six months ago, while I was working, I suddenly felt an itch in my urethra, so I went to see a doctor.
However, the urinalysis results were normal, and there was no examination of the prostate or anything similar.
I would like to know if this could possibly be due to prostatitis or something related?
Xiao Xuan, 20~29 year old female. Ask Date: 2021/07/07
Dr. Li Xinyi reply Urology
If you suspect a urinary tract infection, you should go to the hospital for a urine test to confirm the diagnosis.
However, based on your description, it sounds somewhat like neuropathic pain.
I recommend drinking plenty of water to ensure a daily urine output of 2000cc.
Whenever you feel the urge to urinate, do not hold it in; go to the restroom.
Then, monitor any changes in your symptoms.
Reply Date: 2021/07/07
More Info
Urinary pain can be a distressing symptom that significantly impacts one's quality of life. Understanding the potential causes and solutions for urinary pain is essential for effective management and treatment. Based on your description, it seems you are experiencing intermittent sharp pain at the urinary opening, particularly when exerting pressure during urination. This pain is not consistent and does not occur when urinating in a standing position, which adds complexity to the situation.
Possible Causes of Urinary Pain
1. Urethritis: Inflammation of the urethra can cause pain during urination. This condition can be due to infections, sexually transmitted infections (STIs), or irritants. Although your urine tests came back normal, it’s possible that a mild infection or irritation could still be present.
2. Prostatitis: In men, inflammation of the prostate gland (prostatitis) can lead to urinary symptoms, including pain during urination. This condition can be acute or chronic and may not always show clear signs in standard urine tests. Symptoms can include pelvic pain, difficulty urinating, and pain during ejaculation.
3. Bladder or Urethral Stones: Stones can form in the bladder or urethra, leading to pain during urination, especially when pressure is applied. If you have a history of urinary stones, this could be a potential cause.
4. Interstitial Cystitis: This chronic condition causes bladder pressure, bladder pain, and sometimes pelvic pain. Symptoms can vary widely and may include pain during urination or a frequent urge to urinate.
5. Nerve Irritation or Damage: Sometimes, nerve issues can lead to sensations of pain or discomfort in the urinary tract. This could be due to previous injuries or conditions affecting the pelvic region.
6. Muscle Tension: Pelvic floor muscle tension can also lead to pain during urination. Stress and anxiety can contribute to muscle tightness, which may manifest as urinary discomfort.
Recommended Solutions and Next Steps
1. Consult a Urologist: Given your symptoms and the fact that they have persisted, it would be prudent to consult a urologist. They can perform a thorough examination, including a digital rectal exam to assess the prostate, and may recommend further tests such as a urine culture, ultrasound, or cystoscopy to visualize the urinary tract.
2. Keep a Symptom Diary: Documenting when the pain occurs, its intensity, and any associated activities (like physical exertion or stress) can help your doctor understand the pattern and potential triggers of your symptoms.
3. Hydration: Ensure you are drinking enough water, as proper hydration can help dilute urine and reduce irritation in the urinary tract.
4. Avoid Irritants: Certain foods and beverages, such as caffeine, alcohol, spicy foods, and artificial sweeteners, can irritate the bladder. Keeping a food diary may help identify any dietary triggers.
5. Pelvic Floor Exercises: If muscle tension is suspected, pelvic floor exercises (like Kegel exercises) may help relieve discomfort by strengthening and relaxing the pelvic muscles.
6. Stress Management: Since stress can exacerbate physical symptoms, consider incorporating stress-reducing techniques such as mindfulness, yoga, or deep-breathing exercises into your routine.
7. Follow-Up Testing: If initial tests do not reveal a clear cause, further testing may be necessary. This could include imaging studies or specialized tests to evaluate bladder function.
Conclusion
Urinary pain can stem from various causes, and it is crucial to approach this symptom comprehensively. While prostatitis is a possibility, other conditions may also be at play. A thorough evaluation by a healthcare professional is essential to determine the underlying cause and develop an appropriate treatment plan. Do not hesitate to advocate for yourself during medical visits, and ensure that all your concerns are addressed. Your well-being is paramount, and understanding the root of your symptoms is the first step toward relief.
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