Urination Issues: Causes, Treatments, and When to Seek Help

Q: Urination Issues: Causes, Treatments, and When to Seek Help

Hello： If multiple urine tests are normal, there should be no inflammation. <br>For abnormal urination, a consultation with a urologist is necessary. <br>Currently, it is important to maintain normal fluid intake, hydrate evenly, engage in gentle exercise, and limit beverage cons

Urinary obstruction

Dear Director,
I have been experiencing very weak urine flow and infrequent urination for over two months now.
Initially, I thought it was due to kidney stones, as I have a history of them.
I went to a traditional Chinese medicine shop to get herbs to help expel the stones and also took capsules to aid urination.
My urination seemed normal for a while, so I stopped taking the medication.
However, after some time, my urine flow decreased again.
I visited a clinic to test for hematuria, and the results came back normal.
Then I went to a gynecology clinic, where the doctor noted that my bladder was very tender during the pelvic exam.
The doctor diagnosed me with urethritis.
On my third follow-up visit, I was told it was cystitis, and I was prescribed medication along with capsules to help with urination.
However, I did not see any improvement.
Eventually, I developed a slight fever and a sore throat, which led me to suspect I might have COVID-19.
I performed a self-test, and it was negative.
Recently, I visited a urology department at the hospital, where I underwent a urinalysis, and again, everything was normal.
The doctor prescribed more medication to assist with urination.
However, I still wake up in the morning with weak urine flow.
I started drinking 1500cc of water every afternoon, which resulted in urinating about two to three times, but while the initial flow was somewhat better, it still feels abnormal compared to what I consider normal.
The final part of urination is still very little and weak.
Could you please advise if I should continue taking the urination medication prescribed by the hospital? What could be the underlying issue, and what further tests should I undergo? Was it appropriate for me to see a urologist, or could this still be cystitis? I am truly feeling overwhelmed by this urination issue.

amy, 30~39 year old female. Ask Date: 2022/07/24

Dr. Li Minghui reply Urology

Hello: If multiple urine tests are normal, there should be no inflammation.
For abnormal urination, a consultation with a urologist is necessary.
Currently, it is important to maintain normal fluid intake, hydrate evenly, engage in gentle exercise, and limit beverage consumption.
Wishing you good health.

Reply Date: 2022/07/24

More Info

It sounds like you are experiencing significant urinary issues that have been ongoing for over two months. Given your history of kidney stones and the recent diagnoses of urinary tract infections (UTIs) and bladder inflammation, it is understandable that you are feeling frustrated and confused about your condition.

Understanding Your Symptoms
1. Urinary Frequency and Volume: The fact that you are experiencing a reduced urine output and infrequent urination can be indicative of several underlying issues. These could range from urinary tract infections (UTIs), bladder inflammation (cystitis), or even complications related to kidney stones.
2. Diagnosis of UTI and Cystitis: Your visits to the gynecologist and urologist have led to diagnoses of urethritis and cystitis. Urethritis is an inflammation of the urethra, often caused by infections, while cystitis refers to inflammation of the bladder, which can also be due to infections or irritants. The discomfort you felt during the internal examination could be a sign of inflammation in these areas.

3. Normal Urinalysis: The fact that your urinalysis has come back normal is a positive sign, as it suggests that there may not be a significant bacterial infection at this time. However, it does not rule out the possibility of inflammation or other non-infectious causes of your symptoms.

Treatment Considerations
1. Medications: You mentioned that you have been prescribed medications to help with urination. It is essential to follow your doctor's instructions regarding these medications. If you are unsure about their effectiveness or if you are experiencing side effects, it is crucial to communicate this with your healthcare provider.

2. Hydration: Increasing your fluid intake, as you have done by drinking 1500cc of water in the afternoons, can help improve urine output. However, it is also important to balance this with your body's needs and any recommendations from your doctor.

3. Further Testing: Since your symptoms persist despite treatment, it may be beneficial to undergo further testing. This could include:
- Ultrasound: To check for any structural abnormalities in the kidneys or bladder.

- Cystoscopy: A procedure that allows the doctor to look inside the bladder and urethra for any abnormalities.

- Urodynamic Studies: These tests measure how well the bladder and urethra are storing and releasing urine.

When to Seek Help
If your symptoms do not improve with the current treatment or if you experience worsening symptoms such as increased pain, fever, or blood in your urine, it is essential to seek medical attention promptly.

Conclusion
You are on the right track by consulting with a urologist, as they specialize in urinary tract issues. It is also advisable to keep a detailed record of your symptoms, fluid intake, and any medications you are taking, as this information can be helpful for your healthcare provider in determining the best course of action.

If you continue to feel uncertain about your diagnosis or treatment plan, seeking a second opinion from another urologist or a specialist in urinary disorders may provide additional insights and reassurance. Remember, your health is paramount, and advocating for yourself is an important part of the healthcare process.

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