Urethral and perineal spasms, burning sensation during urination, frequent but minimal urination while bathing?
Hello, doctor.
Previously, I experienced pain during ejaculation after holding my urine, which was accompanied by nocturia.
After some time, it improved, but I still had a slight burning sensation when urinating and felt the urge to urinate but could only pass a small amount (especially while showering).
I later consulted a doctor, and before that, I underwent a urinalysis and an ultrasound (the device was placed on my lower abdomen, and I wasn't sure what it was checking for).
The doctor informed me that my test results were normal and did not believe there would be any prostate issues at my age.
However, it has been almost a year and a half since my visit, and I still occasionally experience a burning sensation when urinating, along with spasms in the perineum and especially at the urethral opening, which feels somewhat inflammatory, though I'm not certain.
Now, if I ejaculate more than twice a week or consecutively, I feel the urge to urinate the next day for one to three days, but I can only pass a small amount.
Occasionally, the spasms in the perineum and urethral opening persist for a week.
Sometimes, I use a thin cotton swab dipped in aloe vera gel to apply to the urethral opening, hoping it would help.
Doctor, do I need to abstain for a while?
Niming, 20~29 year old female. Ask Date: 2024/06/30
Dr. Sun Hongshun reply Urology
Hello: As you mentioned, it is very likely to be "prostatitis." However, I still recommend seeking medical treatment and undergoing examinations.
Given your age, benign prostatic hyperplasia is unlikely, but prostatitis is not uncommon.
I hope this information is helpful to you.
Reply Date: 2024/06/30
More Info
Urethral discomfort can be a complex issue, often stemming from various underlying causes. Based on your description, it seems you have been experiencing symptoms such as burning during urination, a sensation of incomplete voiding, and discomfort in the perineal area and urethra. These symptoms can be indicative of several conditions, including urinary tract infections (UTIs), prostatitis, or even pelvic floor dysfunction.
Possible Causes of Urethral Discomfort
1. Urinary Tract Infection (UTI): UTIs are common and can cause burning sensations during urination, frequent urges to urinate, and discomfort in the lower abdomen or perineal area. Even if your initial tests came back normal, it’s possible for a UTI to develop later.
2. Prostatitis: Inflammation of the prostate gland can lead to similar symptoms, including pain during urination, pelvic pain, and discomfort in the urethra. Given your age, while the doctor may not have found issues with your prostate, it could still be a contributing factor.
3. Pelvic Floor Dysfunction: This condition can result in muscle tightness or spasms in the pelvic region, leading to discomfort and urinary symptoms. This might explain the "twitching" sensation you described.
4. Urethral Stricture: A narrowing of the urethra can cause difficulty in urination and discomfort. This is less common but can occur due to previous infections, trauma, or inflammation.
5. Sexual Activity: Frequent ejaculation can sometimes lead to temporary discomfort or inflammation in the urethra, especially if there is any underlying irritation or infection.
Management Tips
1. Hydration: Ensure you are drinking plenty of fluids. This can help dilute your urine and may alleviate some of the burning sensations.
2. Avoid Irritants: Stay away from caffeine, alcohol, spicy foods, and acidic foods, as these can irritate the bladder and urethra.
3. Pelvic Floor Exercises: Consider pelvic floor physical therapy. Strengthening and relaxing the pelvic floor muscles can help alleviate discomfort and improve urinary function.
4. Medication: If you experience frequent UTIs or prostatitis, your doctor may prescribe antibiotics or anti-inflammatory medications. Discuss this with your healthcare provider if you suspect an infection.
5. Avoid Self-Treatment: While using aloe vera may seem soothing, inserting anything into the urethra can lead to irritation or infection. It’s best to avoid such practices unless advised by a healthcare professional.
6. Sexual Activity: If you notice a correlation between sexual activity and your symptoms, it may be beneficial to reduce frequency temporarily to see if your symptoms improve. However, complete abstinence is not always necessary unless advised by a doctor.
7. Follow-Up: Since your symptoms have persisted, it’s crucial to follow up with your healthcare provider. They may recommend further tests, such as a cystoscopy, to visualize the urethra and bladder directly.
Prognosis and Considerations
The prognosis for urethral discomfort largely depends on the underlying cause. If it is due to a UTI or prostatitis, appropriate treatment can lead to significant improvement. If it is related to pelvic floor dysfunction, physical therapy can be very effective.
In terms of long-term management, some individuals may need to adopt lifestyle changes or ongoing therapy to manage symptoms effectively. Regular follow-ups with your healthcare provider are essential to monitor your condition and adjust treatment as necessary.
In conclusion, while your initial tests were normal, persistent symptoms warrant further investigation. It’s essential to communicate openly with your healthcare provider about your ongoing discomfort and any changes in your symptoms. This will help ensure you receive the most appropriate care and management for your condition.
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