Urine Stream Shape: Is It Normal or a Sign of Urethral Stricture?

The diameter of urine stream?

Hello, Dr.
Hsu.
I would like to ask you about a problem I've been experiencing.
I have had some issues with frequent urination and not feeling completely empty after urination (although I do drink water regularly).
Sometimes I think it might be due to stress.
Two years ago, I visited a urology clinic, and my urinalysis results were normal, so I didn't pay much attention to it afterward.
However, recently I've noticed some intermittent bladder discomfort, although the frequency isn't very high.
Last week, I went to the hospital to see a urologist, who mentioned that my anxiety might be a contributing factor.
I also had a urinalysis done, but I haven't checked the results yet.

Recently, while urinating, I noticed that my urine stream appears to be flat and columnar but does not split.
The stream is generally straight, but sometimes a few drops come out after I finish urinating.
Is this normal? Should urine always be cylindrical? I found some information online about urethral stricture and would like to know how to determine if I might have this condition.
Thank you.

Lun, 20~29 year old female. Ask Date: 2012/04/11

Dr. Xu Weikai reply Urology

Hello, you have urethral stricture and need to undergo urethroscopy for a more accurate diagnosis.
If you have any further questions, feel free to ask, and we can discuss and research together.
Information from the internet should only be used as a reference; if necessary, you should seek medical attention at a healthcare facility.
This response is provided by Dr.
Hsu Wei-Kai, Director of the Urology Department at Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2012/04/11

More Info

Understanding the shape of your urine stream can indeed provide insights into your urinary health, and it’s good that you’re paying attention to these details. The shape of the urine stream can vary for several reasons, and while a cylindrical shape is often considered normal, variations can occur without necessarily indicating a problem.

Normal Urine Stream Characteristics:
Typically, a healthy urine stream is expected to be a steady, cylindrical shape. However, it can sometimes appear flat or even splintered, especially if there are temporary factors at play, such as hydration levels, bladder fullness, or even the position of the body while urinating. If your urine stream is consistently flat or has a different shape, it may warrant further investigation.

Potential Causes of Altered Urine Stream:
1. Urethral Stricture: This condition involves a narrowing of the urethra, which can lead to a reduced urine stream. Symptoms may include a weak stream, difficulty starting urination, or a feeling of incomplete bladder emptying. If you suspect a stricture, a urologist can perform a urethroscopy to visually inspect the urethra and confirm the diagnosis.

2. Bladder or Prostate Issues: Conditions affecting the bladder or prostate, such as benign prostatic hyperplasia (BPH) in men, can also lead to changes in urine flow. These conditions can cause symptoms like frequent urination, urgency, and a feeling of incomplete emptying.

3. Nervous System Factors: Stress and anxiety can impact bladder function and may lead to symptoms like urgency or frequency. It’s worth noting that psychological factors can sometimes mimic physical issues.

4. Infection or Inflammation: Urinary tract infections (UTIs) or urethritis can cause changes in urination patterns, including discomfort and altered stream shape. If you experience any pain, burning, or unusual discharge, it’s essential to consult a healthcare provider.

When to Seek Medical Attention:
Given your history of frequent urination and the recent observation of a flat urine stream, it would be prudent to follow up with your urologist. They may recommend tests such as a urine flow study, which measures the rate and volume of urine flow, or imaging studies to assess the urinary tract's anatomy.

Conclusion:
While variations in urine stream shape can be normal, persistent changes, especially when accompanied by other symptoms like pain or a feeling of incomplete emptying, should be evaluated by a healthcare professional. It’s essential to communicate all your symptoms clearly to your doctor, as this will help them make a more accurate diagnosis. Remember, early detection and intervention can significantly improve outcomes for any underlying conditions.

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