Urethral Pain: Causes and Treatment Options

Q: Urethral Pain: Causes and Treatment Options

Hello： The information provided here is for reference only and cannot replace a physician's examination. <br>Following the treatment for inflammation based on the second urine test, if symptoms persist after completing the medication, please return for a follow-up to check for an

There is often a subtle stabbing pain at the urethral opening?

Hello Doctor, I have had a habit of masturbation since I was 16 years old (about once or twice a day, but over 90% of the time it's just once).
A couple of weeks ago, one morning, I woke up and, before urinating, I engaged in masturbation.
During ejaculation, I experienced an unprecedented sharp pain at the urethral opening.
That day was strange because, after ejaculation, when I went to urinate, it came out very quickly instead of the usual gradual flow.
Throughout that day, I continued to experience frequent sharp pain at the urethral opening.
The next morning, during my first urination, I even felt a burning sensation at the urethral opening.
I went to a urologist that morning and had a urinalysis, but the doctor said there were no abnormalities and that everything looked clean.
Ultimately, I was prescribed Uroprin to take home.
After taking Uroprin, the frequency of the sharp pain at the urethral opening decreased, but I developed another issue of sensitivity (the sensitivity involves one to several drops of urine leaking from the urethral opening after urination, with noticeable dripping and sometimes accompanied by a slight sharp pain).
This combination of pain and sensitivity persisted for a week.
After a week, I returned to the urologist, this time seeing a different doctor, and I underwent another urinalysis.
The doctor noted that my urinalysis showed a slight increase in inflammatory response compared to the previous week, but overall, there were still no significant findings.
I was prescribed doxycycline.
As of today, I still occasionally experience sharp pain, but the sensitivity issue has improved somewhat.
However, whenever I feel the urge to urinate, I experience significant discomfort and pressure at the lower edge of my bladder.
Could you please help me understand what might be causing this and what kind of treatment I may need?

Aidesen, 10~19 year old female. Ask Date: 2021/09/19

Dr. Du Shixi reply Urology

Hello: The information provided here is for reference only and cannot replace a physician's examination.
Following the treatment for inflammation based on the second urine test, if symptoms persist after completing the medication, please return for a follow-up to check for any ongoing inflammation.
In daily life, be sure to drink plenty of water, limit spicy and irritating foods, avoid alcohol, and refrain from holding in urine.
Wishing you good health.

Reply Date: 2021/09/19

More Info

Urethral pain can be a distressing symptom that significantly impacts daily life. Based on your description, it appears that you have been experiencing urethral pain and sensitivity following a period of sexual activity and subsequent ejaculation. This pain, along with the urgency and discomfort during urination, can be attributed to several potential causes.

Possible Causes of Urethral Pain
1. Urethritis: This is an inflammation of the urethra, which can be caused by infections, including sexually transmitted infections (STIs) such as gonorrhea or chlamydia. Even if initial tests do not show abnormalities, it is possible for urethritis to be present without clear signs in urine tests.

2. Post-Ejaculatory Pain: Some individuals experience pain after ejaculation, which can be due to inflammation or irritation of the urethra. This may be exacerbated by frequent sexual activity or masturbation.

3. Bladder Irritation: Conditions such as interstitial cystitis or bladder overactivity can lead to discomfort and urgency, which may be perceived as urethral pain.
4. Prostatitis: Inflammation of the prostate gland can cause pain in the urethra, especially during urination or ejaculation.
5. Physical Irritation: Activities such as vigorous sexual activity or masturbation can lead to temporary irritation of the urethra, resulting in pain and sensitivity.

Treatment Options
1. Antibiotics: Since you have been prescribed doxycycline, it suggests that your doctor is considering a bacterial infection as a possible cause. It is essential to complete the full course of antibiotics as prescribed, even if symptoms improve.

2. Pain Management: Medications such as phenazopyridine can help alleviate urinary pain and discomfort. Over-the-counter pain relievers like ibuprofen or acetaminophen may also be beneficial.

3. Hydration: Increasing fluid intake can help dilute urine and reduce irritation in the urinary tract.

4. Avoiding Irritants: It may be helpful to avoid caffeine, alcohol, and spicy foods, which can irritate the bladder and urethra.

5. Follow-Up Testing: If symptoms persist despite treatment, further evaluation may be necessary. This could include urine cultures to check for specific pathogens, imaging studies to rule out anatomical issues, or referral to a urologist for specialized care.

6. Behavioral Modifications: Reducing the frequency of sexual activity or masturbation may help alleviate symptoms. Additionally, practicing good hygiene and ensuring adequate lubrication during sexual activity can prevent irritation.

When to Seek Further Help
If your symptoms do not improve or worsen, it is crucial to return to your healthcare provider. You may want to discuss the possibility of further testing, such as:
- Urethral Swab: To check for STIs that may not have been detected in urine tests.

- Cystoscopy: A procedure that allows direct visualization of the urethra and bladder to identify any abnormalities.

- Urodynamic Studies: To assess bladder function and identify any issues with urine flow.

Communicating with Your Doctor
When you visit your doctor, it is essential to communicate clearly about your symptoms, their frequency, and any changes you have noticed. You can ask questions such as:
- "What are the possible causes of my symptoms?"
- "Are there any additional tests we should consider?"
- "What treatment options are available if my symptoms persist?"
By being proactive in your healthcare, you can work collaboratively with your provider to find an effective treatment plan that addresses your concerns. Remember, persistent urethral pain is not something to ignore, and seeking timely medical advice is crucial for your health and well-being.

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