Urinary Issues: Tips for Managing Discomfort and Frequency

May I ask the doctor?

Doctor, I have a question.
Every time I have a bowel movement at home, I experience intermittent urination.
After finishing, I rinse my bottom with water, and I often feel the urge to urinate again.
Sometimes the urine volume is quite large, while other times it is minimal, just a few drops.
After urinating, I feel less pressure in my bladder, but I often have a sensation of residual urine, and I feel the need to urinate again, unlike before when I felt a sense of relief and comfort after urination.
Additionally, the opening of my urethra feels very tight, and I have to push it open and apply some water to prevent the urine from splitting.
Last month, I visited a doctor due to hematuria, and after a urinalysis, everything was normal.
No further tests were conducted, and I was not prescribed antibiotics; the doctor advised me to monitor the situation.
I also asked the doctor about the issues I mentioned, and he suggested that it might be related to autonomic nervous system problems, as I am not yet of an age where prostate enlargement is common.
He recommended that I practice tightening and relaxing my pelvic floor muscles to ensure that the muscles are relaxed during urination for a more complete voiding, which could help reduce frequency.
I would like to ask the doctor if there are any other methods to improve this situation.
I have started drinking cranberry juice in hopes of alleviating these symptoms.
Please help clarify my concerns, thank you, doctor.

Niming, 30~39 year old female. Ask Date: 2010/02/26

Dr. Xu Weikai reply Urology

Hello, it seems to be a problem with the autonomic nervous system.
You should try to relax a bit.
Additionally, you can train your bladder by drinking water at fixed intervals and urinating at scheduled times.
For example, drink 100cc of water every hour and urinate every two hours.
This training can help coordinate the nerves to a better level in about 1-2 weeks.
I hope these suggestions are helpful to you.

Reply Date: 2010/02/26

More Info

Understanding urinary issues can be quite complex, especially when symptoms like frequent urination, discomfort, and a feeling of incomplete emptying arise. Based on your description, it seems you are experiencing a combination of urinary frequency, urgency, and possibly some degree of urinary retention or dysfunction. Let's break down your symptoms and explore potential management strategies.

Symptoms Overview
1. Frequent Urination: This can be caused by various factors, including urinary tract infections (UTIs), bladder overactivity, or even anxiety and stress. Given that you mentioned a history of blood in your urine, it’s essential to rule out any underlying conditions.

2. Feeling of Incomplete Emptying: This sensation can be frustrating and is often associated with bladder dysfunction. It can occur due to various reasons, including bladder outlet obstruction, detrusor muscle weakness, or even psychological factors.

3. Urinary Discomfort: Pain or discomfort during urination can indicate inflammation or irritation in the urinary tract. This could be due to infections, stones, or other irritants.

4. Blood in Urine: While your recent urine tests came back normal, persistent hematuria (blood in urine) warrants further investigation to rule out conditions like kidney stones, tumors, or other urinary tract issues.

Management Strategies
1. Pelvic Floor Exercises: As your doctor suggested, pelvic floor exercises (Kegel exercises) can help strengthen the muscles involved in urination. This can improve bladder control and reduce the feeling of urgency. Focus on contracting the pelvic muscles for a few seconds and then relaxing them. Aim for several repetitions throughout the day.

2. Bladder Training: This involves gradually increasing the time between urinations to help train your bladder to hold more urine. Start by delaying urination for a few minutes when you feel the urge, and gradually increase this time.

3. Dietary Adjustments: You mentioned drinking cranberry juice, which is often recommended for urinary health. While it may help prevent UTIs, it’s essential to maintain a balanced diet. Avoid irritants such as caffeine, alcohol, and spicy foods, which can exacerbate urinary symptoms.

4. Hydration: Ensure you are drinking enough fluids throughout the day. However, try to limit fluid intake in the evening to reduce nighttime urination.

5. Stress Management: Since your doctor indicated a potential link to autonomic nervous system issues, consider incorporating stress-reducing techniques such as mindfulness, yoga, or deep-breathing exercises. Stress can significantly impact bladder function and exacerbate symptoms.

6. Follow-Up with a Specialist: If symptoms persist despite these interventions, consider seeking a referral to a urologist. They may recommend further tests such as a bladder function study or cystoscopy to evaluate the bladder and urethra more thoroughly.

7. Medication: If bladder overactivity is confirmed, medications such as anticholinergics or beta-3 agonists may be prescribed to help manage symptoms.

Conclusion
Managing urinary issues often requires a multifaceted approach. While lifestyle changes and exercises can significantly improve symptoms, it’s crucial to maintain open communication with your healthcare provider. Regular follow-ups and possibly more specialized testing can help identify any underlying conditions that may need to be addressed. Remember, you are not alone in this, and many people experience similar issues. With the right strategies and support, you can work towards improving your urinary health and overall well-being.

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