Urination Issues: Causes and Solutions for Men

The urinary issues that have been troubling me for a long time?

When I go out with friends and we use the restroom together, I notice that they urinate quickly and seem to shake off very little before leaving.
However, I always have to shake for a long time to completely dry off after urinating, and sometimes I even have to squeeze a few times; otherwise, if I make a sudden movement later, I might leak urine.
Could this be related to my phimosis (tight foreskin)? Or could it be a sign of an underlying condition? If so, could you tell me what conditions might be involved, such as urinary tract infections? Or could it be related to frequent masturbation, which I do about 2 to 3 times a week? Thank you.

Xiao Ma, 20~29 year old female. Ask Date: 2012/04/02

Dr. Xu Weikai reply Urology

Hello, the shaking at the end of urination is unrelated to the foreskin.
If you feel that your urination is slower than others, you can undergo a uroflowmetry test.
This provides a more objective assessment and is useful for clinical evaluation.
Sometimes, it may be due to insufficient physical activity.
It is recommended to exercise at least three times a week for a minimum of 40 minutes each session.
If there are any unclear points, feel free to ask again for further discussion and research.
Answers found online should only be used as a reference; if necessary, it is important to seek medical attention at a healthcare facility.
This response is from Dr.
Hsu Wei-Kai, Chief of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2012/04/02

More Info

Understanding urination issues can be complex, especially when it comes to men experiencing symptoms like difficulty in completely emptying the bladder, dribbling after urination, or changes in urinary frequency. Based on your observations and concerns, several factors could contribute to your situation.

Possible Causes of Urination Issues
1. Anatomical Factors:
- Phimosis: If you have a condition known as phimosis (where the foreskin cannot be fully retracted), it could potentially affect urination. This might lead to a less efficient stream or difficulty in fully emptying the bladder, as the foreskin could create a blockage or cause discomfort.

- Prostate Issues: In men, an enlarged prostate (benign prostatic hyperplasia, BPH) can lead to urinary retention, increased frequency, and dribbling. This is more common as men age but can occur in younger men as well.

2. Neurological Factors:
- Conditions affecting the nerves that control bladder function can lead to issues with urination. This includes conditions like multiple sclerosis or diabetes, which can cause nerve damage.

3. Infections:
- Urinary tract infections (UTIs) can cause symptoms such as urgency, frequency, and discomfort during urination. While UTIs are more common in women, men can also experience them, especially if there are anatomical issues or if they are sexually active.

4. Behavioral Factors:
- Frequent masturbation, while generally not harmful, can lead to temporary changes in sensitivity or function if done excessively. However, 2-3 times a week is typically considered normal and should not cause significant issues.

5. Psychological Factors:
- Anxiety or stress can also play a role in urinary function. If you feel anxious about urinating in public or around friends, this could lead to a psychological block that affects your ability to urinate normally.

Recommendations for Management
1. Hydration: Ensure you are drinking enough water. Dehydration can lead to concentrated urine, which may irritate the bladder and increase the urge to urinate.

2. Pelvic Floor Exercises: Kegel exercises can strengthen the pelvic floor muscles, which may help with urinary control. These exercises involve repeatedly contracting and relaxing the muscles used to stop urination.

3. Medical Evaluation: It is crucial to consult a healthcare provider for a thorough evaluation. They may recommend:
- Urinalysis: To check for infections or other abnormalities.

- Ultrasound: To assess the bladder and prostate.

- Urodynamic Studies: To evaluate how well the bladder and urethra are functioning.

4. Avoid Irritants: Certain foods and drinks, such as caffeine, alcohol, and spicy foods, can irritate the bladder and exacerbate symptoms.

5. Proper Hygiene: If phimosis is a concern, maintaining proper hygiene is essential to prevent infections. In some cases, circumcision may be recommended if phimosis is causing significant issues.

Conclusion
Your experience of needing to "shake" or "squeeze" to fully empty your bladder is not uncommon among men, but it can indicate underlying issues that should be addressed. While it may not be solely due to phimosis, it is essential to rule out other potential causes, including prostate issues or infections. Consulting with a urologist will provide you with a clearer understanding of your symptoms and appropriate treatment options. Remember, urinary health is an important aspect of overall well-being, and seeking help is a positive step towards resolution.

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