Urological Issues: Seeking Help for Frequent Urination and Pain

Q: Urological Issues: Seeking Help for Frequent Urination and Pain

Hello： After undergoing urethral reconstruction surgery for hypospadias, if there were no previous symptoms and the urine stream was strong, the current symptoms may not be related to the hypospadias. <br>Hematuria may indicate infection, stones, tumors, etc. <br>If symptoms pers

I'm sorry, but I need more context to provide an appropriate response?

Hello Doctor: I have some questions I would like to ask you.
When I was a child, I underwent urethral reconstruction surgery due to hypospadias.
During elementary school, I frequently experienced the following symptoms, and my parents informed the doctor that drinking more water would help improve the situation, which it did, and I hardly experienced these issues afterward.
At the end of June this year, I had symptoms suggestive of a urinary tract infection, including frequent urination, a burning sensation in the urethra, painful urination, and difficulty urinating, along with a fever.
I took antipyretics and drank plenty of water, and my condition improved.
In early July, I experienced similar symptoms again, but without a fever.
I noticed difficulty urinating and the presence of blood in my urine.
Since it was a holiday, I did not seek medical attention until the next day when I went to a hospital in Taoyuan.
The urine test results were interpreted by the doctor as normal, and I was prescribed antibiotics, which improved my condition.
However, two weeks later, I experienced the same symptoms again, this time more severely, with blood in my urine.
That day, I was in Taichung and sought help at a medical center.
The urine test results indicated inflammation, and my urine sample was cultured, revealing insignificant bacterial colonies (only 5000 colonies, below the threshold of 100,000).
No special treatment was provided, and I was only given medication.
At the end of July, I experienced similar symptoms again and went to a hospital in Taoyuan.
This time, the urine test showed mild inflammation, and I was prescribed medication again.
The most recent occurrence was around mid-August when I visited a medical center in Linkou.
The doctor performed an ultrasound of my kidneys and bladder and informed me that I had small stones in my kidneys, but my bladder was normal.
I was advised to drink more water to facilitate their passage, and no medication or treatment was prescribed.
I still experience occasional flare-ups, but the symptoms are mild, with only a stinging sensation at the end of urination.
I have noticed that my bladder rarely feels full; as soon as I feel the urge to urinate, it becomes urgent (which I believe is referred to as urgency).
Since I have experienced these symptoms too frequently over the summer and have sought medical attention multiple times without any real improvement, I am under significant psychological stress.
I worry about needing to use the restroom frequently when I go out, which makes me hesitant to leave home.
I drink more than 3000cc of fluids daily (including water, soup, and fruits), yet I still feel anxious about flare-ups.
What should I do? The doctor said my bladder is fine, but why do I feel the urge to urinate without a full sensation? Could there be an issue with my artificial urethra? Why are the flare-ups so frequent? I am worried about these issues occurring while I am in the military next month.
Please help me with what I should do.

Xiao P, 20~29 year old female. Ask Date: 2006/09/07

Dr. Chen Xiuyi reply Urology

Hello: After undergoing urethral reconstruction surgery for hypospadias, if there were no previous symptoms and the urine stream was strong, the current symptoms may not be related to the hypospadias.
Hematuria may indicate infection, stones, tumors, etc.
If symptoms persist, it is necessary to seek medical attention and arrange for intravenous pyelography (IVP).
Sincerely, Dr.
Chen Hsiu-Yi, Urology.

Reply Date: 2006/09/07

More Info

It sounds like you are experiencing a complex set of urological symptoms that have been ongoing for quite some time, particularly after your previous surgery for hypospadias. Your symptoms, including frequent urination, burning sensations during urination, and the presence of blood in your urine, can be distressing and significantly impact your quality of life. Given your history and the recurrent nature of your symptoms, it is essential to approach this situation with a comprehensive understanding of potential underlying causes and treatment options.

First, it is important to recognize that your symptoms may be related to several factors, including anatomical changes from your previous surgery, potential urinary tract infections (UTIs), and possibly even bladder dysfunction. The presence of "meaningless" bacteria in your urine culture suggests that while there may be some inflammation, it does not necessarily indicate a significant infection. However, the recurrent nature of your symptoms, especially the blood in your urine, warrants further investigation.

The urgency and frequency of urination you are experiencing could be attributed to a condition known as overactive bladder (OAB). OAB is characterized by a sudden and uncontrollable urge to urinate, often leading to increased frequency and urgency. This condition can be exacerbated by anxiety, which seems to be a concern for you, especially with the upcoming transition to military service. The psychological aspect of your symptoms cannot be overlooked; anxiety can lead to hyperawareness of bodily sensations, which may amplify your perception of needing to urinate.

Given your history of urinary issues and the recent discovery of small kidney stones, it is crucial to address both the physical and psychological components of your symptoms. Here are some recommendations:
1. Follow-Up with a Urologist: Since you have already seen multiple healthcare providers, it may be beneficial to consult with a urologist who specializes in complex urinary issues. They may recommend additional tests, such as urodynamic studies, to assess how well your bladder is functioning and whether there are any underlying anatomical issues related to your previous surgery.

2. Hydration and Diet: While you are already consuming a significant amount of fluids, it is essential to monitor the types of fluids you are drinking. Caffeinated beverages, alcohol, and acidic foods can irritate the bladder and exacerbate symptoms. Consider keeping a bladder diary to track your fluid intake and urinary patterns, which can provide valuable information for your healthcare provider.

3. Behavioral Techniques: Bladder training and pelvic floor exercises (Kegel exercises) can help improve bladder control and reduce urgency. These techniques can be particularly beneficial if you are experiencing symptoms of OAB.

4. Medication: If your symptoms persist, your urologist may consider prescribing medications that help relax the bladder muscle, thereby reducing urgency and frequency. These medications can be effective in managing OAB symptoms.

5. Mental Health Support: Given the anxiety you are experiencing, it may be helpful to speak with a mental health professional. Cognitive-behavioral therapy (CBT) can be particularly effective in addressing anxiety related to health concerns and can help you develop coping strategies for managing your symptoms.

6. Prepare for Military Service: As you prepare for your upcoming military service, consider discussing your medical history with the military medical staff. They may have resources and accommodations available to help manage your symptoms while in service.

In conclusion, while your symptoms are concerning, there are multiple avenues for treatment and management. It is crucial to continue seeking care and advocating for yourself to find a solution that works for you. Your mental and emotional well-being is just as important as your physical health, so addressing both aspects will be key to improving your overall quality of life.

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