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Urology/penile pain at urination only

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Question
My son is 12 yo for the last 4 months he experiencing pain during urination at the penile tip and in the bladder region. We have seen pediatrician and pediatric urologist. He had 4 negative UTI checks,one course of antibiotics. He also had Renal, Bladder and Scrotal ultrasound: all negative. On physical exam Dr. saw left varicocele which was verified on Scrotal Ultrasound. Urologist did not come up with any answers. My son has been drinking cranberry juice (just in case). I do not see any redness at the tip and he says it's hurts inside. Per Dr. he is on truck with all male development.
Please help!

Answer
One possible cause of pain with urination is a urethral stricture, which is a narrowing of the urethra.  Urethral strictures can be caused of straddle or other trauma, which boys often experience.  A urethral stricture is diagnosed by placing a small telescope inside the urethra connected to a monitor to assess the size of the urethra.  You can learn more about urethral strictures at:

http://www.centerforreconstructiveurology.org/urethral-stricture/

Unfortunately, this is something that may need to be done in the operating room in a child (office procedure in an adult).  I am not saying this test should be done or not as I can not really give that kind of opinion based on an internet request for an answer to a question.  I would just say that this is something to consider.  Best of luck.

Urology

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Joel Gelman, M.D.

Expertise

Urethral Stricture Disease, Peyronie's Disease and disorders of penile curvature, Erectile Dysfunction with a focus on penile implant surgery, Male Incontinence, Hypospadias

Experience

Dr. Gelman is a Board Certified Fellowship Trained expert in Male Reconstructive Urology and the Director of the Center for Reconstructive Urology in the Department of Urology at UC, Irvine Medical Center.

Organizations
American Urologic Association Society of GU Reconstructive Surgeons (Board of Directors) International Sexual Medicine Society Western Section, Americal Urological Association

Publications
Journal of Urology Urology Journal of Endourology

Education/Credentials
Residency in Urology, UCLA, completed 1995 Fellowship in GU Reconstruction, Devine Center, completed 1997

Past/Present Clients
The Center for Reconstructive Urology is a regional, national, and international Tertiary Referral Center for urethral stricture disease, penile curvature, erectile dysfunction, male incontinence, and other surgical disorders of the male urethra and penis. Patients have travelled from 24 different states and other countries to receive care at the Center for Reconstructive Urology. More information can be found at http://www.centerforreconstructiveurology.org

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