Urethral Issues: Is Your Anatomy Affecting Urination?

Issues related to the urethra?

I saw a doctor over a year ago because I noticed a thin membrane in the upper middle part of my urethral opening.
The doctor examined it and said it was just a ligament above the urethral opening and that it was nothing to worry about.
However, sometimes when I wake up in the morning with an erection, I find it difficult to urinate; it feels very tight and not smooth.
But if I don't have an erection, everything is fine, just like usual.
It's only when I have an erection for a long time or right after ejaculation that I feel urinary flow is not smooth.
Is this related to what I mentioned earlier? Does this mean my urethral opening is smaller? If it doesn't cause any obstruction, is it still okay? I've been troubled by this for a long time.
Please, doctor, I hope you can answer.

oners, 10~19 year old female. Ask Date: 2004/10/24

Dr. Lai Ronghao reply Urology

Hello! During an erection, the diameter of the urethra decreases, leading to increased resistance, which can cause a sensation of difficulty during urination.
If you experience difficulty urinating even when not erect, you should seek medical attention for a solution.
This is a response from Dr.
Lai Rong-Hao, attending physician of the Urology Department at Hsinchu Hospital, Ministry of Health and Welfare.

Reply Date: 2004/10/24

More Info

Understanding urethral issues can be quite complex, especially when anatomical variations are involved. Based on your description, it seems you have a unique anatomical feature where there is a thin membrane or band above the urethral opening. While your doctor has indicated that this is not a cause for concern, it is understandable that you might still have questions regarding how this could affect your urination, particularly during erections or after ejaculation.

Firstly, it is important to recognize that the anatomy of the urethra and surrounding structures can indeed influence urinary function. The urethra is a tube that carries urine from the bladder to the outside of the body, and any anatomical variations can potentially affect the flow of urine. In your case, the presence of a band or membrane could theoretically create a slight narrowing of the urethral opening, which might explain the difficulty you experience when trying to urinate during an erection or after ejaculation.

When you experience an erection, the body undergoes various physiological changes. The blood vessels in the penis fill with blood, causing it to become firm and erect. This process can also put pressure on the urethra, particularly if there is any anatomical variation. If the urethra is slightly narrowed due to the band you mentioned, this could lead to a feeling of tightness or difficulty when trying to urinate. Similarly, after ejaculation, the urethra can be sensitive, and any existing anatomical variations may exacerbate feelings of discomfort or difficulty in urination.

Regarding your concern about the size of your urethral opening, it is possible that the presence of the band could create a functional narrowing, even if it is not significant enough to cause obstruction. If your doctor has assessed that this anatomical feature does not pose a risk or cause obstruction, it is likely that your urinary issues are not severe. However, if you continue to experience discomfort or difficulty, it may be worthwhile to seek a second opinion or further evaluation from a urologist. They can perform tests such as a urethral dilation or a cystoscopy to assess the urethra's patency and determine if any interventions are necessary.

In summary, while your anatomical variation may contribute to the sensations of tightness and difficulty in urination during specific circumstances, it is essential to consider the overall context of your urinary health. If your symptoms are manageable and do not significantly impact your quality of life, they may not require treatment. However, if you find that these issues persist or worsen, it is advisable to consult with a healthcare professional who specializes in urology for a more thorough evaluation and tailored advice. Remember, open communication with your healthcare provider is crucial in addressing any ongoing concerns you may have regarding your urinary health.

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