Urinary Issues: Seeking Help for Frequent Urination and Premature Ejaculation

Hello, Dr. Chang?

Dr.
Chang, I have been troubled by one issue for a long time.
I often feel the urge to urinate, and after I finish, I still feel the need to go again.
Sometimes, there is residual urine that leaks from the glans, causing a slight dampness in my underwear.
Additionally, my sexual performance is not satisfactory, as I ejaculate quickly, which is commonly referred to as premature ejaculation.
I am wondering if this is related to a kidney issue or a urethral problem.
I have consulted many hospitals without improvement.
What should I do? Thank you.

Xiao Di, 30~39 year old female. Ask Date: 2003/09/19

Dr. Zhang Chengye reply Urology

Please visit the urology outpatient clinic for consultation.

Reply Date: 2003/09/19

More Info

It sounds like you are experiencing a combination of urinary issues and concerns related to premature ejaculation, which can be quite distressing. Let's break down your symptoms and explore potential underlying causes and treatment options.

Understanding Your Symptoms
1. Frequent Urination: The sensation of needing to urinate frequently, even after having just urinated, can be indicative of several conditions. It could be related to bladder overactivity, urinary tract infections (UTIs), or even prostate issues in males. The feeling of residual urine, where you feel like you still have to urinate after using the restroom, can also be a sign of bladder dysfunction or obstruction in the urinary tract.

2. Residual Urine: The sensation of urine remaining in the bladder after urination, along with the leakage of small amounts of urine, could suggest a problem with bladder emptying. This might be due to weak bladder muscles, nerve issues, or an obstruction in the urinary tract.

3. Premature Ejaculation: This condition is often characterized by ejaculation that occurs with minimal sexual stimulation before, during, or shortly after penetration. It can be influenced by psychological factors, such as anxiety or stress, as well as physiological factors.

Potential Causes
- Bladder Overactivity: This condition leads to an increased urge to urinate frequently. It can be caused by various factors, including nerve damage, infections, or irritants.

- Urinary Tract Infection (UTI): UTIs can cause frequent urination, urgency, and a feeling of incomplete bladder emptying. They are more common in women but can occur in men as well.

- Prostate Issues: In men, an enlarged prostate can lead to urinary symptoms, including frequent urination and a sensation of incomplete emptying.

- Nerve Damage: Conditions that affect nerve function, such as diabetes or multiple sclerosis, can impact bladder control and function.

- Psychological Factors: Stress and anxiety can contribute to both urinary issues and premature ejaculation. Psychological factors can lead to heightened sensitivity and a reduced threshold for ejaculation.

Treatment Options
1. Medical Evaluation: Since you have already consulted multiple healthcare providers without improvement, it may be beneficial to seek a specialist, such as a urologist, who can perform a comprehensive evaluation. This may include urine tests, imaging studies, and possibly urodynamic testing to assess bladder function.

2. Behavioral Techniques: For premature ejaculation, techniques such as the "stop-start" method or pelvic floor exercises (Kegel exercises) can be helpful. These methods can help you gain better control over ejaculation.

3. Medications: Depending on the diagnosis, medications may be prescribed. Anticholinergic medications can help with bladder overactivity, while selective serotonin reuptake inhibitors (SSRIs) are sometimes used off-label to treat premature ejaculation.

4. Lifestyle Modifications: Reducing caffeine and alcohol intake, managing stress through relaxation techniques, and maintaining a healthy lifestyle can also help alleviate symptoms.

5. Counseling or Therapy: If psychological factors are contributing to your symptoms, speaking with a mental health professional can be beneficial. Cognitive-behavioral therapy (CBT) can help address anxiety and improve sexual function.

Conclusion
Your symptoms are complex and may require a multifaceted approach to treatment. It is essential to work closely with healthcare professionals who can provide a thorough evaluation and tailor a treatment plan to your specific needs. Don't hesitate to seek a second opinion or ask for referrals to specialists who can offer more targeted care. Remember, you are not alone in this, and effective treatments are available to help improve your quality of life.

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