Persistent Urethral Pain: Causes and Treatment Options

Q: Persistent Urethral Pain: Causes and Treatment Options

168： Hello. <br>● Question 1： What medication should be used to treat a common urinary tract infection caused by drinking alcohol and staying up late? How long does the treatment usually last? This question is somewhat strange because drinking alcohol and staying up late should n

The unusual condition has neither worsened nor improved for about two months?

Dear Director Hsu, please help me.
Could you kindly clarify questions 1 and 2 for me? Thank you very much! This is the first time in my life that I have experienced urethritis.
I have had urine tests seven times and blood tests, all of which came back normal.
I have seen five urologists; some said I have small ulcers, others attributed it to drinking and staying up late, and some said it was caused by using a penile ring during exercise, while my external genitalia appeared normal.
Why does it still hurt about 2 centimeters from the urethral opening? The pain has lasted for two months.
● Question 1: For ordinary urethritis caused by drinking and staying up late, what medication should I use for treatment? How long will the treatment period be?
● Question 2: I am currently taking a medication I bought from the pharmacy called Mefenamic Acid, along with a prescription for Ketorolac from one of the doctors.
I experienced improvement in 1 to 3 days, but on the fourth day, it feels like the symptoms are subtly returning.
Am I using the right medication with Mefenamic Acid? How long should I continue using this medication? I have already taken three types of anti-inflammatory medications: 12 tablets of an unnamed medication prescribed by a doctor, 12 tablets of Ketorolac, and 14 tablets of Mefenamic Acid over the course of about 7 days.
● Condition: Sometimes it doesn't hurt when I touch it, while other times it hurts particularly when pressed hard.
There is a stinging sensation, and sometimes it feels like it's getting better, but then it flares up again.
I used to avoid antibiotics at all costs, but the pain led me to take them.
I feel a bit better, but after a few days, the pain returns, and then I feel better again, only for the pain to come back after a few days.
It seems particularly painful when my penis shrinks.
The pain is not in the urethra; it feels like it's outside the urethra.
I don't feel anything special when urinating, but taking a hot shower significantly alleviates the pain.
I used to have a habit of exercising regularly, and before exercising, I often used a penile ring for about 1 to 2 hours.
I had previously experienced vague pain and itching in that area, but I ignored it, and it eventually resolved on its own.
Could this be related to my current issue? (I usually drink about half a bottle of over 35% alcohol daily and have a habit of staying up late.)
Three weeks ago, I had surgery to remove kidney stones, and I have since quit drinking and have not exercised, getting about 8 hours of sleep each night.
Is this issue related to that? However, my condition has neither worsened nor improved over the past two months.

168, 30~39 year old female. Ask Date: 2005/06/01

Dr. Xu Weikai reply Urology

168: Hello.
● Question 1: What medication should be used to treat a common urinary tract infection caused by drinking alcohol and staying up late? How long does the treatment usually last? This question is somewhat strange because drinking alcohol and staying up late should not directly cause a urinary tract infection.
Long-term irregular lifestyle can lead to a decline in the body's immune system, allowing external pathogens to invade, which may result in an infection.
If the infection happens to affect the urethra, it becomes a urinary tract infection.
The treatment duration for a typical urinary tract infection can range from 3 days to 12 weeks, depending on the type of bacteria involved; however, most treatments are sufficient around 3 weeks.
Nevertheless, even after the bacteria are eradicated, discomfort may persist because some bacteria can cause changes such as urethral fibrosis, leading to new urinary issues.
In such cases, antibiotics are generally unnecessary and ineffective.
The body must heal gradually, allowing the tissues to recover.
● Question 2: I am currently taking a medication called Memantine that I purchased from a pharmacy, along with a prescription for Keterolac from one of my doctors.
I noticed improvement within 1-3 days, but on the 4th day, it seems like symptoms might be returning.
Am I using the right medication with Memantine? How long should I continue using it? The timing for using antibiotics depends on the severity of the urinary tract infection.
In other words, it should be based on the results of urine culture; for example, if bacteria A is present, we would use a medication effective against bacteria A, and the duration of use would depend on the resistance of bacteria A.
As for which antibiotic is better, clinical physicians will consider the clinical symptoms, making it difficult to determine which is superior.
The timing for discontinuing medication must also align with clinical symptoms; generally, one should not stop medication lightly, as this could lead to serious consequences.
If bacteria are not completely eradicated, previously used medications may become ineffective, leading to what is known as antibiotic resistance.
Urology Department Director, Hsu Wei-Kai, responds on behalf of the Taitung Hospital, Department of Health, Executive Yuan, and expresses concern for you.

Reply Date: 2005/06/01

More Info

Understanding persistent urethral pain can be quite complex, especially when multiple factors may contribute to the symptoms. Based on your detailed description, it seems you have been experiencing urethral pain for about two months, with various medical opinions and treatments attempted. Let's break down your questions and concerns.

Question 1: Treatment for Urethritis Due to Alcohol and Lack of Sleep
Urethritis, which is inflammation of the urethra, can indeed be influenced by lifestyle factors such as alcohol consumption and sleep deprivation. While these factors may not directly cause urethritis, they can weaken the immune system and make one more susceptible to infections.
For treating urethritis, the specific medication depends on the underlying cause. If a bacterial infection is suspected, antibiotics are typically the first line of treatment. Common antibiotics for uncomplicated urethritis include:
- Azithromycin or Doxycycline for Chlamydia
- Ceftriaxone for Gonorrhea
- Metronidazole or Tinidazole for Trichomoniasis
The duration of antibiotic treatment usually ranges from 7 to 14 days, depending on the specific infection and the antibiotic used. If your symptoms are due to non-infectious causes, such as irritation from alcohol or other irritants, then avoiding these triggers and possibly using anti-inflammatory medications may help.

Question 2: Efficacy of Self-Purchased Medications
You mentioned using "美滿徽素" (likely a brand name for an antibiotic or anti-inflammatory) and "苦樂息卡音" (which may refer to a different medication). It's crucial to ensure that these medications are appropriate for your specific condition.
If you have been taking these medications for about a week and have experienced some improvement, it suggests that they may be effective. However, if you notice a recurrence of symptoms after initial improvement, it may indicate that the underlying issue has not been fully addressed.
It's essential to consult with a healthcare provider about the appropriateness of these medications, especially since you have already tried multiple antibiotics. They can help determine if you should continue with the current regimen or switch to something else.

Additional Considerations
1. Lifestyle Modifications: Since you mentioned a history of alcohol consumption and lack of sleep, it would be beneficial to maintain a healthier lifestyle. Reducing alcohol intake, ensuring adequate sleep, and managing stress can significantly impact your overall health and may help alleviate symptoms.

2. Physical Activity: While you have stopped exercising post-surgery, gentle physical activity can improve circulation and overall well-being. However, avoid any activities that may exacerbate your symptoms.

3. Follow-Up Care: Given the persistence of your symptoms, it may be wise to seek a follow-up with a urologist or a specialist in pelvic pain. They may recommend further diagnostic tests, such as urine cultures, imaging studies, or even cystoscopy, to rule out other conditions like interstitial cystitis or pelvic floor dysfunction.

4. Pain Management: If you experience significant pain, discussing pain management strategies with your healthcare provider is essential. This may include medications, physical therapy, or other interventions.

5. Communication with Healthcare Providers: When discussing your symptoms with doctors, be clear about the frequency, intensity, and nature of your pain. Mention any patterns you observe, such as pain during certain activities or after specific triggers. This information can help them make a more accurate diagnosis.

In conclusion, persistent urethral pain can stem from various causes, including infections, lifestyle factors, and possibly anatomical issues. A comprehensive approach that includes medical treatment, lifestyle changes, and ongoing communication with healthcare providers is essential for managing your symptoms effectively.

Similar Q&A

Persistent Urethral Pain: Exploring Possible Causes and Solutions

I have been experiencing a sharp pain inside my urethra, specifically towards the front of my penis, since May of last year. One morning, after urinating, I suddenly felt a wave of pain, and since then, the sharp pain has persisted without relief. The appearance is normal, and th...

Dr. Chen Jiansheng reply Urology
Hello, sir: For urethral pain that is unresponsive to medication, consideration can be given to performing a urethroscopy to investigate the underlying cause. Chen Jian-sheng, Department of Urology, Hsin-Ying Hospital.

Understanding Persistent Penile Pain: Causes and Treatment Options

Dear Dr. Hsu, 1. In mid-August, I experienced frequent urination and pain during urination, so I visited a family medicine clinic. 2. The doctor prescribed a first-line antibiotic and Uroprin (UROPRIN). After taking it for three days, the frequent urination subsided, but I still...

Dr. Xu Weikai reply Urology
Hello, it's difficult to determine your situation. However, if the clinician suspects nerve tension, it indicates that all tests and examinations are normal. Engaging in more physical activity and soaking in hot springs can help accelerate local blood circulation, which shou...

Unexplained Urethritis: Persistent Pain and Discomfort Solutions

Hello Dr. Wang, I have experienced a burning sensation during urination and pain at the urethral opening three times in the past two months. However, each time I have undergone urinalysis, the results have been normal, and no infection has been identified, yet I continue to exper...

Dr. Wang Weijie reply Internal Medicine
Dear Ms. Wu, Thank you for your letter. A urinary tract infection (UTI) occurs when bacteria invade the urinary system, leading to infection. Common symptoms include: 1. A burning sensation, pain, difficulty urinating, frequent urination, nocturia, cloudy urine, or hematuria dur...

Persistent Urinary Discomfort: Seeking Solutions for Urethral Sensations

1. I have a frequent urination problem. 2. I feel like there is urine trapped inside my penis, which is very uncomfortable and affects my sleep. It feels like the sensation of needing to urinate at the urethral opening is constant. Doctor's solution: The doctor prescribed me...

Dr. Liu Mingyue reply Urology
Hello: Drink plenty of water, and your urine should be light yellow or clear. Avoid sitting for long periods, and engage in moderate exercise for 30 minutes each day. Wishing you good health!