Left Side Back Pain and Urinary Symptoms: A Medical Inquiry

Urinary system and left flank pain?

Dear Doctor: My situation began with a feeling of frequent urination that lasted for two days.
On the third day, after I got up in the morning and urinated for the first time, I felt the urge to urinate again, accompanied by a sensation of bladder distension and pain in my abdomen, but I could not urinate.
After half an hour, I started experiencing severe pain in my lower back, which felt like cramping.
Later, since I had to attend class, I searched online for information and assumed I had urethritis, so I bought medication from a pharmacy and took it myself.
After about two hours, the pain subsided, and I felt much better.
I continued taking the medication for two days, but during this time, I felt intermittent pain in the posterior part of my penis every ten seconds.
On the third day, after not taking the medication, I felt the urge to urinate again by noon, but I could not.
I drank a lot of water, but the urine output was minimal.
After ten minutes of this sensation, my lower back started cramping again, and despite taking the pharmacy medication, the pain persisted for eight hours before it finally subsided.
I felt that this was not right, so I went to the urology department.
They only tested my urine and performed a prostate examination through my rectum, stating that I had mild urethritis, but did not check for urinary stones.
After seeing the doctor, I went home and took the medication immediately, but after three hours, the pain returned and was very intense, lasting for nine hours.
I am very scared because I experience mild pain in my penis every ten seconds and severe pain in my lower back.
However, during the examination, light tapping on my back did not increase the pain, so the doctor said it was not kidney pain.
Which specialty should I consult next, and what could my symptoms indicate? Should I be hospitalized? The pain medication does not seem to help.

Liao Xiaobao, 20~29 year old female. Ask Date: 2008/12/07

Dr. Wu Jiyu reply Internal Medicine

1.
Consider consulting another urologist.

2.
Consider prostatitis.

3.
Ultrasound can be used to rule out stone issues.

Reply Date: 2008/12/07

More Info

Your symptoms of frequent urination, lower abdominal discomfort, and severe left-sided back pain are concerning and warrant further investigation. Based on your description, it seems you are experiencing a combination of urinary and musculoskeletal symptoms that may be interrelated.

Frequent urination, especially when accompanied by a feeling of urgency and discomfort in the bladder area, can indicate a urinary tract infection (UTI) or bladder irritation. The fact that you experienced severe back pain following these urinary symptoms raises the possibility of a more complex issue, potentially involving the kidneys or the urinary tract.
The pain you describe as "cramping" in your lower back could be due to several factors. One possibility is that it could be related to kidney stones, which can cause severe pain in the back and sides, often radiating to the lower abdomen and groin. Although your doctor did not find evidence of kidney stones during your examination, it is important to note that not all stones are detectable through standard imaging techniques. If you continue to experience severe pain, it may be worth discussing further imaging studies, such as a CT scan, with your healthcare provider.

Another consideration is the possibility of a kidney infection (pyelonephritis), which can occur when bacteria ascend from the bladder to the kidneys. Symptoms of a kidney infection often include fever, chills, nausea, and severe back pain, along with urinary symptoms. If you develop any of these additional symptoms, it would be crucial to seek immediate medical attention.

Given that you have already seen a urologist and received a diagnosis of mild urethritis, it is essential to follow up on this treatment. If the prescribed medications are not alleviating your symptoms, you should return to your healthcare provider for a reassessment. It may be necessary to explore other potential causes of your symptoms, including musculoskeletal issues, such as muscle strain or injury, which can also manifest as back pain.

In terms of managing your symptoms, staying well-hydrated is important, but if you find that drinking water does not lead to urination, you should inform your doctor. Pain management is also crucial; if over-the-counter pain medications are ineffective, your doctor may consider prescribing stronger analgesics or anti-inflammatory medications.

If your symptoms persist or worsen, or if you experience new symptoms such as fever, chills, or significant changes in your urinary habits, it is advisable to seek immediate medical attention. You may need to visit an emergency department or a specialist who can provide a more comprehensive evaluation and treatment plan.

In summary, your symptoms could be indicative of a urinary tract issue, potential kidney involvement, or musculoskeletal pain. It is essential to maintain open communication with your healthcare provider, advocate for further testing if necessary, and seek immediate care if your condition deteriorates.

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