Struggling with Urination Delays: Urological Issues

Q: Struggling with Urination Delays: Urological Issues

Hello： Based on your description, your mental health status and psychiatric medications can affect urination. <br>Since your tests are normal, I recommend that you pay attention to your fluid intake, aiming for about 2000cc per day. <br>Avoid drinking sugary beverages, and mainta

Urinary issues, such as prolonged waiting to urinate?

Hello Doctor: Recently, I have been experiencing a significant delay in the urge to urinate.
Although I do have the urge and can urinate, it takes a very long time to actually do so.
Sometimes, the feeling of needing to urinate seems to recede.
This started about five days after I began taking medication for anxiety and panic disorder.
Additionally, my bowel movements have not been as regular as before; I used to have a smooth bowel movement every morning, but I thought this was just a temporary side effect.
However, the situation has worsened, and now I find it very difficult to urinate while standing, often having to wait a long time or being unable to do so at all.
It is particularly challenging to urinate at night or during the first trip to the bathroom in the morning, requiring me to sit on a stool for an extended period before I can relieve myself.
This is a complete change from my previous ability to urinate whenever I felt the need, even if the volume was small.
After two weeks, I discussed changing my medication with my psychiatrist, but I forgot to mention the issues with my bowel movements being infrequent and difficult.
The doctor kindly adjusted my medication, switching from "Liyou" (which I suspect may not be the issue, but was changed anyway) to "Shanduofan" (to be taken at bedtime), while continuing with "Fuermian" (at bedtime), "Anbang" (with meals), and "Xinlv" (with meals).
To rule out any medication-related issues, I also consulted a urologist who performed a urinalysis, X-rays, and a contrast-enhanced X-ray (where contrast was injected and images taken every ten minutes).
All results came back normal.
Therefore, I am currently hopeful that the medication change will lead to improvements, and I have been prescribed "Huilu Lijing D" dissolvable tablets and "Keli Weibaot" tablets, which I hope will help.
I have also been drinking plenty of water to monitor my urination.
Now, three days into the medication change, the improvement has been very slow.
I still find it difficult to urinate while standing, but I can do so more easily when sitting on a stool.
However, urinating once at night and during the first trip to the bathroom in the morning remains problematic.
Could you please advise me on my current situation? Is it best to continue observing the situation gradually? I am quite distressed by the inability to urinate quickly at night and the long wait in the morning.
I would appreciate your help.

A Wei, 30~39 year old female. Ask Date: 2021/09/15

Dr. Du Shixi reply Urology

Hello: Based on your description, your mental health status and psychiatric medications can affect urination.
Since your tests are normal, I recommend that you pay attention to your fluid intake, aiming for about 2000cc per day.
Avoid drinking sugary beverages, and maintain a light diet.
Engage in at least a few minutes of exercise daily.
In addition to the help from urological medications, patience is also necessary.
Once balance is achieved, you should experience better urination.
Wishing you good health.

Reply Date: 2021/09/15

More Info

It sounds like you are experiencing significant challenges with urination, which can be distressing and frustrating. Based on your description, it seems that your urinary difficulties began after starting medication for anxiety and panic disorders. This is not uncommon, as certain medications can have side effects that affect urinary function.
The symptoms you describe, such as delayed urination, difficulty initiating urination, and the sensation of urgency that does not lead to immediate relief, can be indicative of several underlying issues. These may include medication side effects, anxiety-related muscle tension, or even bladder dysfunction. It's important to consider that the urinary system is influenced by both physical and psychological factors, and anxiety can exacerbate urinary symptoms.

Since you have already consulted with a urologist and undergone various tests, including urinalysis and imaging studies, it is reassuring that these tests returned normal results. This suggests that there are no significant anatomical abnormalities or infections contributing to your symptoms. However, the fact that you are still experiencing difficulties indicates that further evaluation may be necessary.

Here are some considerations and recommendations for your situation:
1. Medication Review: Since you suspect that your medication may be contributing to your urinary issues, it is crucial to maintain open communication with your psychiatrist or prescribing physician. They may consider adjusting your medication regimen further or exploring alternative treatments that have fewer side effects related to urination.

2. Behavioral Techniques: Techniques such as bladder training or pelvic floor exercises may help improve your urinary function. Bladder training involves gradually increasing the time between urinations to help retrain your bladder. Pelvic floor exercises (Kegel exercises) can strengthen the muscles involved in urination and may help with both urgency and retention issues.

3. Hydration and Diet: Staying well-hydrated is essential, but be mindful of your fluid intake, especially before bedtime, to minimize nighttime urination. Additionally, certain foods and beverages (like caffeine and alcohol) can irritate the bladder and exacerbate symptoms, so consider moderating these.

4. Anxiety Management: Since anxiety can play a significant role in urinary symptoms, continuing to address your anxiety through therapy or relaxation techniques may be beneficial. Mindfulness, deep breathing exercises, and cognitive-behavioral strategies can help manage anxiety and its physical manifestations.

5. Follow-Up: Given that your symptoms are persisting, it may be beneficial to schedule a follow-up appointment with your urologist. They may want to explore further diagnostic options, such as urodynamic studies, which assess how well your bladder and urethra are functioning.

6. Patience and Monitoring: As you continue to adjust to your new medication, it is essential to be patient. It can take time for your body to adapt, and symptoms may fluctuate during this period. Keeping a diary of your urinary patterns, fluid intake, and any associated symptoms can provide valuable information for your healthcare providers.

In summary, while it is understandable to feel frustrated with your current situation, continuing to monitor your symptoms and maintaining open communication with your healthcare team is crucial. They can help you navigate these challenges and find the most effective strategies to improve your urinary function. Remember, you are not alone in this, and there are solutions available to help you regain your comfort and confidence.

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