Urological Issues: Seeking Effective Treatment for Urinary Problems

Medical consultation for urinary tract infection?

I experienced urinary retention after taking cold medication, which led me to visit the emergency room where a catheter was inserted to relieve my urinary blockage.
After the catheter was removed, I noticed that after ejaculation, I would feel pain and a sense of fullness in my prostate.
While ejaculation itself is not painful, I sometimes experience a warm sensation, and at other times, I feel normal or have pain.
How should I treat this condition? I live in a remote rural area with only two urology clinics.
One doctor prescribes antibiotics every time I visit without conducting any tests.
I asked the doctor about my lack of improvement after a month, but he insisted that antibiotics were the only option, or I could undergo shockwave therapy, claiming that shockwave therapy is the only effective treatment.
The other doctor told me that the symptoms could only be guessed at and suggested trying medications to see if they work, with no other options available.
Are their treatment approaches correct? I have been struggling with this for six months with no improvement at all.

Shui Xiansheng, 30~39 year old female. Ask Date: 2021/11/08

Dr. Li Xinyi reply Urology

It sounds like prostatitis, which can indeed be challenging to treat in certain cases.
Your situation may be one of those, requiring a patient physician to carefully monitor and adjust the treatment approach, as well as the patient's effort to cooperate and maintain good communication with the doctor.
If you feel that you cannot communicate clearly with your physician, it might be advisable to seek a second opinion.
Online inquiries may not be helpful.
Extracorporeal shock wave therapy, like oral antibiotics, may be beneficial, but it is not guaranteed to be effective.

Reply Date: 2021/11/08

More Info

It sounds like you are experiencing a complex set of urological issues that have been quite distressing for you. From your description, it seems that you have had difficulty urinating, pain in the prostate area, and varying sensations of heat and discomfort. These symptoms can be indicative of several underlying conditions, including prostatitis, urinary tract infections (UTIs), or issues related to the bladder or urethra.

First and foremost, it is crucial to understand that while antibiotics can be effective for bacterial infections, they are not a one-size-fits-all solution. If you have been on antibiotics for an extended period without improvement, it may suggest that your condition is not purely bacterial or that the specific bacteria causing your symptoms are resistant to the antibiotics you have been prescribed. This is a common issue in urology, where recurrent infections can lead to a cycle of antibiotic use without resolution of symptoms.

The fact that you experienced urinary retention after taking cold medication suggests that certain medications can have side effects that impact urination. Many over-the-counter cold medications contain antihistamines, which can lead to urinary retention, especially in individuals with pre-existing prostate issues. This could explain the initial episode that led to catheterization.

Regarding the pain you feel after ejaculation, this could be a sign of prostatitis, which is inflammation of the prostate gland. Prostatitis can be acute or chronic and can present with a variety of symptoms, including pelvic pain, urinary difficulties, and sexual dysfunction. Chronic prostatitis, in particular, can be challenging to treat and may require a multifaceted approach, including lifestyle changes, physical therapy, and sometimes medications that are not antibiotics.

The treatment options provided by the urologists you consulted seem limited. While shockwave therapy (often referred to as lithotripsy) can be beneficial for certain conditions, it is not universally effective for all urological issues, particularly those related to prostatitis or chronic pelvic pain syndrome. It is concerning that one doctor is insisting on a specific treatment without conducting a thorough evaluation or considering other potential diagnoses.

Here are some steps you might consider taking:
1. Seek a Second Opinion: If possible, consult with another urologist who may have a different approach to your symptoms. A fresh perspective can sometimes lead to new insights and treatment options.

2. Comprehensive Evaluation: Request a comprehensive evaluation that includes a urinalysis, urine culture, and possibly imaging studies like an ultrasound or MRI to assess the prostate and bladder. This can help rule out structural issues or other conditions.

3. Consider Non-Antibiotic Treatments: If prostatitis is suspected, treatments may include anti-inflammatory medications, alpha-blockers (which can help relax the bladder neck), pelvic floor physical therapy, and lifestyle modifications such as dietary changes and stress management techniques.

4. Monitor Symptoms: Keep a detailed diary of your symptoms, including when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare provider in diagnosing and treating your condition.

5. Explore Alternative Therapies: Some patients find relief through complementary therapies, such as acupuncture or biofeedback, which may help manage chronic pain and discomfort.

6. Educate Yourself: Understanding your condition can empower you to advocate for yourself in medical settings. Resources from reputable medical organizations can provide valuable information about urological health.

In conclusion, while it can be frustrating to deal with ongoing urological issues, it is essential to pursue a thorough evaluation and consider a range of treatment options. Your symptoms deserve careful attention and a tailored approach to achieve relief and improve your quality of life.

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