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Urology/urinary problem


QUESTION: hello! I am a 19 years old male.from last 1 month i am having problems in urinating.the first stream is fine but then i have to sit for a while for urine to come in short intervals. It feels like urine is stuck somewhere at the base of my penis and i have to relax and wait for it to come out. Also after urination I have a feeling that I havent emptied my bladder completely.
I also have a weird discomfort in my penis. It sometimes feel tight and hard even when flaccid and burns when i touch my feels like some vein or nerve is damaged. There is also some buzzing and tingling.
Urinalysis,retrogade urethrogram and ultrasound are normal and my doc told me that you will get better by medicine but its been a month and i havent got any better.the tab tamsulosin helps in the flow of urine but no complete relief.
What could this be? If its not a stricture then why do i experience blockage in urination?
Is it because of some nerve problem? And will I ever get complete relief from it?

ANSWER: A slam

Prostatitis is one disorder that can cause this but we do not have a confirmed diagnosis so it is not possible to reliably predict your recovery. Consider getting an opinion from a tertiary care university medical center. Good luck.

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QUESTION: Im 19.I was told by my urologist that Im too young to have any problems with urologist thinks there might be a mild stricture that the urethrogram failed to detect which he would attempt to dilate.
Could cystoscopy diagnose prostatis as Im having one soon?

ANSWER: Aslam:

Cystoscopy does not normally diagnose prostatitis, but it can certainly identify strictures and other anatomical issues so it's reasonable.

---------- FOLLOW-UP ----------

QUESTION: Hello dr. Stephen,I just had a cystoscopy few hours ago and my urologist found severe inflammation of urethra so I am actually diagnosed to have acute urethritis
Though I am happy that I dont have any stricturont have any strictures but I am shocked to hear that Urethritis was causing all these voiding problems.
My urinalysis didnt show any signs of infection,is it possible that some infections dont show on urinalysis

Also I have been on many antibiotics like cipro,cefixime,moxiflaxcin for nearly a month and they do help but they didnt get rid of the infection.
I read somewhere that antibiotics usually clear up urethritis in a few days so Why didnt I respond to treatment effectively.

My urologist currently prescribed me sporaflaxcin, tamsolin, some cranberry pills and laxatives for 14 days and then he would put me on a low dose.
Can I expect to get complete relief from these medications? Im sorry for asking so many questions and consuming your time but Im a sensitive guy who never had any medical issue before this. I hope you'll understand


Yes; not every infection shows up on a urinalysis which is why we sometimes do the cystoscopy.  Not every infection or germ will be sensitive to any given or particular antibiotic.  For example, many urethral infections will not respond to to medications you've been on which are more often used for bladder and prostate infections.  

Sporfloxacin is a fluorquinolone antibiotic similar to cipro and moxiflaxin.  It has been withdrawn from the US market due to heart rhythym problems and light sensitivity.  It makes little sense to me to use a similar antibiotic to what has failed in the past.  A trial of a tetracycline antibiotic like doxycycline might be a better choice.

Tamsulosin is reasonable as it helps with urinary flow.  An anti-inflammatory like aleve or ibuprofen might be useful as well.  I doubt the cranberry pills will help much.

Hopefully you'll see some relief.  If not, consider a second urology opinion.


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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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