Urethral Issues: Causes and Concerns in Urology

Urethral issues

I previously had urethritis for three months, and now I feel better with less frequent urges to urinate.
However, when I do feel the need to urinate, it doesn't flow very smoothly, and I have a dripping sensation.
I usually only go when I feel the urge, and I don't experience a strong urgency.
My urine output isn't low, approximately 100-200 cc, as I drink a lot of water.
I'm concerned about urethral inflammation, so I urinate every two hours.
What could be the reason for this? It feels somewhat normal yet not entirely normal.

Ya Ya, 10~19 year old female. Ask Date: 2015/10/27

Dr. Li Yilun reply Urology

There are many causes of frequent urination.
Based on your description, an infection is a primary consideration; therefore, I would recommend performing a urinalysis to confirm whether there is indeed inflammation.
Depending on the symptoms, antibiotic treatment may be initiated.
If the frequent urination is severe, medications to reduce urinary frequency may also be considered.

If frequent urination persists even after treating an infection, bladder overactivity or other bladder dysfunctions should be considered.
Typically, patients are asked to maintain a voiding diary, which records daily urine volume, frequency, and fluid intake over a continuous period of 48 to 72 hours.
Simple measurements of urine flow rate and post-void residual volume can also be performed to assess basic urinary function for any significant impairments.
However, it is important to note that each patient's condition is different, and it is not possible to determine the diagnosis based solely on your brief description.
Therefore, I emphasize that if symptoms do not improve or worsen, it is advisable to consult a healthcare professional for further evaluation and examination to avoid any delay in diagnosis and treatment.
Physicians often need to conduct a thorough history inquiry, physical examination, and additional tests to establish an accurate diagnosis and treatment plan.

Reply Date: 2015/10/27

More Info

Understanding urethral issues can be quite complex, especially when symptoms persist despite previous treatment. Based on your description, it seems you are experiencing a combination of urinary urgency, incomplete bladder emptying, and possibly some residual sensations from your previous urinary tract infection (UTI). Let’s break down the potential causes and concerns related to your symptoms.

Possible Causes of Your Symptoms
1. Post-Infectious Symptoms: After a urinary tract infection, it is not uncommon for individuals to experience lingering symptoms. This can include a sensation of urgency or incomplete voiding, even after the infection has cleared. The inflammation from the infection can lead to increased sensitivity in the bladder and urethra, causing these sensations.

2. Bladder Dysfunction: Conditions such as overactive bladder (OAB) can lead to frequent urges to urinate, often with a feeling of incomplete emptying. This might explain why you feel the need to urinate every two hours, even if your urine output is not particularly high.

3. Urethral Stricture or Obstruction: If there is any narrowing of the urethra (stricture) or obstruction, it can lead to a weak stream of urine and a sensation of incomplete voiding. This could be a result of previous infections or trauma.

4. Neurogenic Bladder: Sometimes, nerve issues can affect bladder control, leading to abnormal sensations and difficulties in urination. This is less common but worth considering if other causes are ruled out.

5. Psychological Factors: Anxiety about urination, especially after experiencing a UTI, can lead to heightened awareness of bladder sensations. This can create a cycle of urgency and discomfort.

Recommendations for Further Evaluation
Given your symptoms, it would be prudent to seek further evaluation from a urologist. Here are some potential tests and evaluations that may be recommended:
- Urinary Flow Study: This test measures the rate and volume of urine flow, helping to identify any obstructions or issues with bladder function.

- Post-Void Residual Measurement: This involves measuring the amount of urine left in the bladder after urination, which can indicate whether you are fully emptying your bladder.

- Cystoscopy: A minimally invasive procedure where a small camera is inserted into the bladder through the urethra. This can help visualize any abnormalities in the urethra or bladder.

- Urodynamic Testing: This comprehensive test assesses how well the bladder and urethra store and release urine, providing insight into any functional issues.

Lifestyle and Management Strategies
In addition to medical evaluation, there are several lifestyle strategies that may help manage your symptoms:
- Hydration: Continue to drink plenty of water, but be mindful of your fluid intake before bedtime to reduce nighttime urination.

- Bladder Training: Gradually increasing the time between urinations can help retrain your bladder and reduce urgency.

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

- Pelvic Floor Exercises: Strengthening the pelvic floor muscles can improve bladder control and reduce urgency.

Conclusion
Your symptoms of feeling the need to urinate frequently, along with the sensation of incomplete voiding, can stem from various causes, including post-infectious changes, bladder dysfunction, or even psychological factors. It is essential to consult with a urologist who can perform the necessary evaluations to determine the underlying cause and recommend appropriate treatment. In the meantime, implementing some lifestyle changes may help alleviate your symptoms. Remember, you are not alone in this, and with the right approach, improvement is possible.

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