Urinary Issues: When to Seek Further Medical Help

Q: Urinary Issues: When to Seek Further Medical Help

Hello, sir： Thank you for your inquiry. <br>I would like to respond to your question and provide the following advice： Based on your description, your symptoms of prostate enlargement seem to be mild, and a normal urine flow would not typically present with significant symptoms.

Benign prostatic hyperplasia? Bladder? Kidneys?

Hello Dr.
Lin,
I am a 49-year-old male and have been experiencing frequent urination for about three years, with occasional nighttime trips to the bathroom, about 1-2 times a week.
Since February of this year, I have felt discomfort in my left groin, lower left abdomen, or bladder area, which feels warm and has a sensation of internal pressure.
This is accompanied by occasional sharp pains and a feeling as if my left testicle is being gently squeezed.

On April 22, I went to the hospital for an examination.
The doctor performed a digital rectal exam, and my PSA levels were normal.
A urine flow test was also normal, but there was some hematuria.
The doctor prescribed a 28-day course of antibiotics.
I have a follow-up appointment for a kidney ultrasound on May 22.
I have been taking the medication until May 3, but my symptoms seem to have not improved at all, and I still feel warmth in my left groin.
It feels like my bladder is having some spasms, and I have very mild soreness in my left lower back.

Should I wait until May 22 for my appointment, or should I consider seeking care at a different hospital? Thank you.

Lao Fang, 40~49 year old female. Ask Date: 2009/05/04

Dr. Lin Hexing reply Urology

Hello, sir: Thank you for your inquiry.
I would like to respond to your question and provide the following advice: Based on your description, your symptoms of prostate enlargement seem to be mild, and a normal urine flow would not typically present with significant symptoms.
Since you have some hematuria, along with left lower abdominal pain or left knee discomfort, it is advisable to undergo a renal ultrasound and intravenous pyelography.
However, if your pain is very mild, you may wait for a scheduled check-up.
Finally, I wish you peace and happiness!

Reply Date: 2009/05/04

More Info

Hello,
Thank you for reaching out with your concerns regarding your urinary issues. Based on the symptoms you've described, it seems that you have been experiencing a range of urinary problems, including frequent urination, discomfort in the left groin and lower abdomen, and occasional blood in your urine. These symptoms can be indicative of several underlying conditions, and it is essential to address them appropriately.

Firstly, the symptoms of frequent urination and discomfort in the groin area could suggest a urinary tract infection (UTI), prostatitis (inflammation of the prostate), or even issues related to the bladder or kidneys. The presence of blood in your urine (hematuria) is particularly concerning and warrants further investigation, as it can be a sign of various conditions, including infections, stones, or even more serious issues like tumors.

You mentioned that you had a digital rectal exam and a PSA test, which returned normal results. While this is reassuring, it does not completely rule out other potential issues. The fact that you are still experiencing discomfort and have not seen any improvement after taking medication for 28 days indicates that your condition may require further evaluation.

Here are some recommendations based on your situation:
1. Follow-Up Appointment: It is crucial to attend your scheduled appointment on May 22 for the kidney ultrasound. This imaging study can provide valuable information about the structure and function of your kidneys and bladder. However, if your symptoms worsen or you experience new symptoms (such as increased pain, fever, or significant changes in urination), you should seek medical attention sooner.

2. Consider a Second Opinion: If you feel that your concerns are not being adequately addressed or if your symptoms persist without improvement, it may be beneficial to seek a second opinion from another urologist. Different doctors may have varying approaches to diagnosis and treatment, and a fresh perspective could lead to new insights.

3. Document Symptoms: Keep a detailed record of your symptoms, including when they occur, their intensity, and any other associated factors (such as dietary changes or stress levels). This information can be invaluable for your healthcare provider in determining the underlying cause of your issues.

4. Hydration and Diet: Ensure you are staying well-hydrated, as this can help flush out potential irritants from your urinary tract. Additionally, consider avoiding caffeine, alcohol, and spicy foods, which can sometimes exacerbate urinary symptoms.

5. Potential Tests: Depending on the ultrasound results, your doctor may recommend further tests, such as a cystoscopy (a procedure to look inside the bladder) or urine culture to check for infections. Be open to these suggestions, as they can help pinpoint the cause of your symptoms.

In summary, while it is essential to wait for your upcoming appointment, do not hesitate to seek immediate medical attention if your symptoms worsen. Your health and comfort are paramount, and it is crucial to advocate for yourself in the healthcare system. If you feel that your concerns are not being taken seriously, pursuing a second opinion is always a valid option.

Take care, and I hope you find relief soon.

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