Urinary Issues: Insights on Symptoms and Treatments

Could you please clarify your question regarding urinary issues?

Hello doctor, I apologize for having many questions.
Three months ago, I had sexual intercourse with a sex worker, and I used a condom.
Two months ago, I experienced urgency to urinate, and even after urinating, I would still feel a drip.
I visited a doctor, and my urinalysis came back normal.
I drank water to check my urine flow rate, which was also normal, but the post-void residual urine volume was quite high.
The doctor prescribed Solifenacin to help relax my sphincter.
However, after taking it, I sometimes wake up in the morning to find a few drops of clear, viscous fluid on my underwear, resembling mucus.
The doctor said that was not a concern.
Last month, my post-void residual urine was around forty-something, but last week, that sensation returned.
Whether standing or sitting, I feel like I'm dripping urine, and sometimes when I check, there’s nothing, but I still have the sensation of incomplete voiding.
Recently, I've also felt a burning sensation at the urethral opening, almost like it's chafed.
Could this be caused by excessive masturbation, or is there another reason? If I were to do another urinalysis and urine culture for gonorrhea, non-gonococcal urethritis, and Chlamydia, would that be effective? It's not that I don't trust the doctor who examined me; I just want to seek more opinions and advice.
After feeling like I'm getting better, the sensation of residual urine has returned, which is quite frustrating.
I apologize for bothering you, and thank you.

xiao san, 20~29 year old female. Ask Date: 2009/12/21

Dr. Xu Weikai reply Urology

Hello, you can perform a urine culture to check for bacteria and determine whether there is an infection or if the symptoms are caused by psychological factors.
Generally, the sensation of residual urine is mostly due to cold weather or urinary tract inflammation.
A urine culture can be conducted for diagnosis.

Reply Date: 2009/12/21

More Info

It sounds like you are experiencing a complex set of urinary issues that have been ongoing and are causing you significant distress. Based on your description, you have symptoms such as urgency, a sensation of incomplete emptying, and discomfort at the urethral opening. You also mentioned a history of high residual urine levels and the use of medications like tamsulosin to help relax the urinary sphincter.
First, it's important to understand that urinary symptoms can arise from various causes, including anatomical issues, infections, or even psychological factors. Given your recent sexual encounter, it is wise to consider the possibility of sexually transmitted infections (STIs) such as gonorrhea, chlamydia, or ureaplasma, especially since you are experiencing discomfort and changes in urination. Testing for these infections, as well as a urinalysis and urine culture, is a prudent step to rule out any underlying infections that could be contributing to your symptoms.

The sensation of dripping urine and the feeling of incomplete voiding can be frustrating. It is possible that the high residual urine levels you mentioned are due to a combination of factors, including the relaxation of the bladder neck from medications like tamsulosin, which can sometimes lead to a feeling of incomplete emptying. Additionally, if you are experiencing irritation or inflammation of the urethra, this could contribute to the discomfort and the sensation of dripping.

You also mentioned that you have been experiencing a "burning" sensation at the urethral opening, which could indicate irritation or inflammation. This could be due to several factors, including frequent masturbation, which can cause temporary irritation, or it could be a sign of an underlying infection or inflammation. If you suspect that your symptoms are related to irritation from masturbation, it may be helpful to reduce the frequency and see if your symptoms improve.

In terms of treatment, it is essential to follow your doctor's recommendations and continue monitoring your symptoms. If you are experiencing persistent discomfort or changes in urination, it may be beneficial to revisit your healthcare provider for further evaluation. They may consider additional tests, such as imaging studies, to assess for any anatomical issues or bladder dysfunction.

Regarding the medications you are taking, tamsulosin is generally well-tolerated, but it can have side effects such as dizziness or retrograde ejaculation. If you notice any new or worsening symptoms after starting a new medication, it is crucial to discuss these with your doctor. They can help determine whether your current medication regimen is appropriate or if adjustments are needed.

Lastly, if your symptoms persist despite medical treatment, or if you find that anxiety about your urinary symptoms is affecting your quality of life, it may be beneficial to consult with a mental health professional. Anxiety can exacerbate physical symptoms, and addressing any underlying psychological factors may help improve your overall well-being.

In summary, it is essential to continue working closely with your healthcare provider to address your urinary symptoms. Testing for STIs, monitoring your medication effects, and considering both physical and psychological factors will be crucial in finding a resolution to your concerns. Don't hesitate to seek a second opinion if you feel it would provide you with more clarity and reassurance.

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