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Urology/Male Urethral Pain -- 8+ weeks still no resolution

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Cathy Ward wrote at 2009-01-13 12:16:34
My husband is going through the same thing.  It is so frustrating for him.  He feels like he is going crazy sometimes.  The doctors can't determine a cause other than it is mental.  I'm finding that hard to believe.  We have been searching the internet for answers now.  I will use some of Dr. Leslie's suggestions to continue our search.  Should you find out the answer to your problem, please let us know.  Thank you.

Cathy, the concerned wife.


FC wrote at 2009-09-09 20:18:00
I have had the exact symptoms that you described.  I am a couple of years older than you but have never had an issue like this.  I recently lost my job and could see it coming for about 4 weeks before it happened.  My symptoms started about 2 weeks before I was fired and I am believing that stress has much to do with my problems.  I am starting a workout regime to get rid of excess stress and see how that works.  Best wishes to you!!


npdrifter wrote at 2009-12-03 21:35:41
I also have had the exact same symptoms as the rest of you and it is getting very old.  This has been going on for several months and I have been on several different meds with not much of a change.  my stress levels have been through the roof as I lost my job in July and the symptoms started not long after that.  I am thinking it has to be stress related but not sure.  I am going to start an exercise routine and taking some herbals that are supposed to help the prostate. They are much cheaper and i think they are better than all the different medications the doctors keep pumping through me.  will follow up in a few weeks.  Best wishes to all!!  


ConcernedCitiZen wrote at 2010-02-26 18:55:21
Hi, (This is going to be a long history, there is some resemblance, so bare with me)



Incident 1:

I also have a problem with my prostate and/or urethra. My symptoms started when I had a bladder infection out of the blue (according to my urologist we men are not supposed to get it at all). I didn't even know that I had a bladder infection, no painful urination, only a severe fever and tiredness. Later it spread to my kidneys (my back hurt). That was about the time when I realized if I didn't go to see the doc I would not make it. (A bad flaw of men: relentlessly refusing to go to the doc). He prescribed antibiotics (Ciprobay 1 week prescription) and diclofenac. I healed fine and was symptomless for about a month. Afterwhich I had a UTI or bladder infection (this time it burned during urination). Prescribed antibiotics again, not Ciprobay.



Note: each time the only test for UTI and/or bladder infection was a test for blood in my urine. So there is no indication if it was only inflammation or infection, although the fever indicates that it was infection.



Incident 2:

A few months later I started having a pain in my upper thigh of right leg. When I pressed hard on my leg where I felt the pain it didn't hurt, my conclusion was that it was a referred pain. During the time I was under severe stress. Later on the pain spread to my abdomen (in the region of my appendix). If a stretched my abdomen by standing upright and placing my right heel flat on the floor a bit behind my pelvis and arching my back it seemed to release the pain and tension for a while. Having a bowel movement also seemed to help. At one stage I had a slight diarrhea due to drinking a litre of cranberry juice since I read that this helps for urinary problems, the abdominal pain was gone for the rest of the day. This carried on for about a week. After which I started having a burning sensation during urination. Went to see the doc and guess what: bladder infection, the doc prescribed Ciprobay and Scopex compound (for abdominal cramps). I went for a follow up to make sure there is no blood left in my urine and I was clean. I told the doc I still had pain in my abdomen. He said that I should stop taking the Scopex and prescribed LP299 (a probiotic), but said that I should only get the LP299 if I still have the pain 3 days later. The abdominal pain resided, so I didn't get the prescription. Later on it came slightly back though, but I noticed that warm baths helped and that it was worse later in the day than in the mornings.



By this time I started reading up on the net what could be the cause of all this due to my frustration. The fact that warm baths helped to relieve the pain let me conclude that it was maybe prostatitis. Which was a bit weird because I was only 23 at the time. After the third time I had bladder infection I started to notice that after urination it felt as if there was a few droplets of urine stuck in my urethra (better in the morning, worse at night).



Incident 3:

About three months after incident 2 the abdominal pain really flared back and went to see the doc. He sent me to get a sonar at the hospital since he thought it was my appendix. The radiologist's report said that there was no sign of fluid or swelling of my appendix (in fact they couldn't even identify the appendix). What was abnormal though was a swelling of my left fossa (a lymph node). This let me conclude that the pain in my leg/groin was also due lymph nodes. I said that i think it is my bladder and/or prostate again since I had similar symptoms during incident 2 and the fact that warm baths helped. The lymph node swelling also indicated that there is an infection somewhere in my body which it is trying to fight. A urine sample indicated that there was indeed blood (although little, since the doc's comment was that he agreed that there was a "slight infection in my prostate"). Though he didn't give me a rectal examination.



Incident 4:

One I evening I was working late (by the way Iím an engineer too :), after I was too tired to carry on I went to bed. As I lied down and started to relax I realized my back hurt in the region of my left kidney. I lay there in a kind of hypnotic state throughout most of the night in extreme pain, although eventually I fell asleep. The next morning I was fine but remembered the pain of the previous night. I reckoned the kidney stone must have passed and was getting a bit worried if it would hurt when I urinated, luckily it didn't. It either must have been a very small kidney stone or I imagined it. So I started reading up on what causes kidney stones. Turns out that soy is one of the foods which could be responsible. I used a soy supplement in the form of a milkshake. At some point in time I think it was during incident 3 and 4 I had cloudy urine. So I stopped the soy supplement completely. I tried the soy supplement a few times afterwards but could literally feel a sort of pain/pressure in my kidneys. I didn't go to the doctor for this.



Incident 5:

About 2 months after incident 4, I had a really, really bad burning sensation during urination which subsided about an hour or  so afterwards. Went to the doctor as I thought that it was a really serious UTI. Once again only a weekís prescription of antibiotics (not necessarily Ciprobay, the doctor is aware about antibiotic resistance). By this time I was really fed up and asked for a recommendation to a urologist which he finally agreed to (it wasn't the first time I asked for his recommendation letter so I can go to the specialist).



One thing that I'm really cross with the doctor(s) is that everywhere I read about UTI and bladder infections on the net and the pamphlets which come along with the antibiotics it recommended that a 4-6 week course should be taken. When I was a young boy I used to get a sore through almost every month or two months. The doctors just kept on prescribing a course of antibiotics. Eventually I arrived at a doctor which had some brains and he gave me some long lasting penicillin injections every three months for a year. When he stopped I didn't get ill again for quite a few years! Even when I got ill my body was able to heal itself sufficiently, although for the odd few times I did go to the doctor he asked if I want the injections again, as if he was scared that it could come back. Unfortunately he later chose another profession.





Urologist visit and tests:

The urologist did a sonar on my first visit after I urinated into a cup which is placed on an electronic scale. The sonar revealed that there remained urine in my bladder. Apparently it should empty completely. After which he showed me the recording of the electronic scale:  grams/second (or whatever the unit was) on the y axis and time on the x axis curve, the curve had a ramp then reached a plateau and then ramped down similarly to the rising ramp. Apparently a normal curve should keep on ramping up and then suddenly drop to zero (although from a fluid dynamics point of view that is impossible and his explanation was oversimplified). Also I had a very full bladder by the time I urinated into the cup. I think that this might have been due to the bladder sphincter being stressed out by having to hold it in until it was my turn. So the sphincter could not relax completely and it regulated the urine flow like a valve (which makes kind of sense since if the peak flow rate would have been reached due to the initial pressure the resulting turbulent flow would not be good for a prostate in any case). But my peak rate was too low in any case according to him. He asked what I thought about the stream and I replied that it was average. Afterwards I started noticing more how the stream flows and realized that it varied quite a lot. Sometimes it was way better (I called it a 'model urination': a ramp and sudden stop) and sometimes it was way worse. He sent me for a blood test, x-rays, a CT scan and a urodynamic test. He also gave me a rectal exam, although I donít think they all know what to look for. I recently read an article published in the 'CALIFORNIA AND WESTERN MEDICINE' journal where the author admits himself that he recently realized that he was doing the rectal examination wrong! It takes practice (and long fingers) to notice if the seminal vesicles are swollen (vesiculitis) for instance (a side effect of prostatitis).



The blood test was to check if there were still any infections or other abnormalities with my immune system. The x-rays were to check if there might be something wrong with my back (maybe a nerve being pinched which causes the sphincter not to function correctly). The CT scan was to check my kidneys and the urodynamic test is to check the volume/pressure ratio of the bladder, during the insertion of the catheter they can also detect if there is a serious stricture of the urethra. B.T.W. the catheter hurts like hell and it feels like you want to urinate all the time.



Nothing wrong with my kidneys or my back. The urodynamic test results I donít understand, although it revealed for a second time that my bladder does not empty completely. Nothing was flagged as serious in the blood test (no STI possible either).

The doctor prescribed Avodart (Dutasteride) which is for BPH although he said that my prostate is definitely not swollen which is kind of weird. The dutasteride prevents testosterone from transforming into dihydrotestosterone (which can cause the prostate to grow to large, which is more applicable for men over their 40s). If the meds doesn't help after six months Iím going to get a cystoscopy. The urologists preliminary conclusion was that my urinary sphincter is over active which causes the urine to pinch of too early. The urine which stays behind and the bacteria in it give the bacteria population a better chance to grow, resulting in infection (my theory, according to him it only causes inflammation). I also forgot to mention in this post that I developed lower back pain during the time of all the bladder infections. This may also be due to prostatitis. I recommend everyone to read the article from the 'CALIFORNIA AND WESTERN MEDICINE' journal: 'BACKACHE DUE TO SEMINAL VESICULITIS AND PROSTATITIS' by MILEY B. WESSON, M. D.



Everyone with prostate and urinary problems do not lose hope or get hysterical. Keep on browsing the web and try to learn more about your condition. See if anyone else have similar symptoms and check if the docs actions makes sense or whether he is not a quack.  


A Fellow Pain Friend wrote at 2010-02-28 01:54:08
Try looking into pelvic pain, you may have trigger points causing the pain. There is a great book called "A Headache in the Pelvis" get it. Stanford Protocol, it may be the answer you've been looking for.  


JT2102 wrote at 2010-03-07 23:08:35
While this is no answer to your question. I just post because I came across your post while researching since I've been having a similar problem with urination. And I'm only 25! Being unable to clinch that last bit of urine out. I insisted to the doctors that I felt it was prostate related but they just bushed me off after my 15 minute visits and told me it was all in my head. I still feel like there is a problem. If they ever figure out what your case is. Lemme know. I feel like it could be similar to my case.


H2012 wrote at 2010-04-23 02:00:52
I'm experiencing the same phenomena as the original poster: persistent aching urethra with dribbling etc.. I'm only 20. Just went through the same battery of tests for UTI, STDs (despite being monogamous as well) and it was all negative. I'm a pre-med at a top college just coming into the end of my hardest year of undergrad, so there's stress... but I've been stressed out at other points without such symptoms. I find it quite hard to believe that serious urethral pain and persistent mild urinary... wierdness... is all mental.



I got a referral to see a urologist, but I'm afraid that this will just be a fruitless search with lots of inconvenient if not harmful testing. If anyone seen symptoms resolve over time without treatment, please give us an update.


drgumble wrote at 2011-08-30 02:17:57
You have interstitial cystitis - it is a female issue but about 10% of men have this condition. I am one of them. It took 3-4 years and many urologist to get a Dx. Check with the ICA website


treyhorse wrote at 2011-09-30 02:07:36
believe it or not, you just might have a yeast infection ? The symptoms match up and antibiotics will only make it worse.  


ed wrote at 2014-02-12 07:32:48
Sounds like paraurethra cysts which will have to be drained or removed and in some cases can be helped with the proper anti inflamitorys good luck


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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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