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Urology/difficulty urinating


Hello sir! I am a 19 years old male. From last  one month or so I am having difficulty urinating. My first stream is fine but then I have to sit for a long time for urine to come out in short spurts. Sometimes my urine also splits. There is no burning or pain but general discomfort. After the 1st stream I have to wait and it feels like urine is stuck or moving slowly near the base of my penis and then it comes out.I also feel like I have not emptied my bladder completely.I also get constipated and mild fever at situation gets better or worse.sometimes I can urinate a lot while sometimes very little urine comes out in a slow disrupted stream.I feel that my urethra is hardand it can apply force to squeeze the urine out
I went to a urologist and was examined.ultrasound showed that everything is fine expect that I have been retaining a lot of urine which I shouldnt be at this age. Pot void urine amount was 80cc. Urinanalysis was perfectly normal. So the urologist asked to go for a retrogade urethrogram. The urethrogram was also completely normal and there was no stricture thst gave me a big relief.
So my urologist gave me tamsulosin,serratiopepidase,antibiotics,and laxatives for 10 days and said there is nothing to worry about .but says that if you dont get better then we have to do a cystoscopy .my urologist says that although the urethrogram is normal there might be a little narrowing near the base of my penis which he will widen.
I dont think medicines will help .I have taken a lot of medicines and although they do bring some relief they never solved my condition has been freskimg me out.if everything is fine as the reports have suggested then why am I not getting better.I am under a lot of stress these days.
So basically my question is should I go for  a cystoscopy ? Will they put me to sleep as this procedur is very painful? And if the urethrogram was normal then why does my urolhist think that the base area is a little bit narrowed .is it a stricture?
I dont want to do a cystoscopy because i have read many horror stories about how urethrotomy and dilation dont cure strictures and you have to end up having a urethroplasty.I am under great stress and it has got to a point that i cant sleep at night.I can live with this condition as its pretty manageable but i cant do the painful self-dilation daily.
Is there any way I can avoid this cystoscopy ? I dont think I have a stricture.there has been no injury or infection or anything that could have caused this and besides my reports are normal. So would alternative medicine bring any relief or I have to undergo this painful cystoscopy? And if they find a stricture or narrowing would they perform a urethrotomy or something else to widen it?
Your guidance and help will beuch appreciated as I am under a lot of stress and any assurnace that my condition is not a big relief will bring great relief.


A cystoscopy is reasonable given your lack of response to medications and the lack of any clear evidence of the underlying cause of your problem.  Cystoscopy is generally not painful, but it can be uncomfortable for people in your age group.  It is unclear what alternative medicine might help without a better diagnosis.

As far as treatment, if no stricture or scarring is found then the question is moot.  In general, we don't do additional painful procedures at the time of a diagnostic cystoscopy but you'll need to discuss this with your urologist.

If you are still uncomfortable with this, get a second opinion from another urologist.


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Stephen W. Leslie, MD


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


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.

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

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.

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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