Other urinary problems questions

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This is archive material from the MHF's malehealth.co.uk website which is now part of this site in the section Male Health. This page remains on the site as site traffic suggests visitors find this page useful but it may not be up to date. It was last updated in 2003 and so does not conform to the NHS England Information Standard of which the MHF is a member. Up-to-date information on this topic can be found here: Peeing FAQs.

 

Urinary and erectile dysfunction problems

Q . I have been having trouble recently passing blood while urinating. I am in no pain and it does not hurt to urinate. I was wondering what this could mean. I am also having problems in the sexual deparment. Sometimes I can't seem to get my penis hard or while having sex it will not stay hard. Don't know what the problem is here either. Please reply. Thank you very much.

A. Time to go see your GP. The good news is that these things are almost always treatable, but you should not normally pass blood in your urine so get there and get it sorted out. The causes range from infection of the bladder, kidney or testes which is usually painful, to a cancer of the testes which is thankfully very treatable. Obviously it is impossible to give you a definitive diagnosis without examination and history but a trip to your GP sounds like a good idea.

Dribbling and uncomfortable ejaculation

Q . When I take a wee I think I have finished and I tidy my clothes and leave the bathroom then after a little while after I had finished (say 1 min) I find my body leaking/dribbling for a short period of time. Also I have found at the same time that during intercourse when I ejaculate it is not painful, but fairly uncomfortable. Are the two things related (they started at the same time) and what is the cause? Please as I am very concerned.

A. Relax, there are men out here who are so glad you have asked this question. It is called the Shilling sign for the appearance of the stain. These days it could be better called the Euro sign. It is a small amount of urine which leaks out after the muscular contraction of the bladder and sits in a wide part of the urethra (the wide part of the pipe inside the penis). Try giving the base of the penis on the underside just where it meets the abdomen a good squeeze. It should do the trick.

How to stop dribbling

Q . I am a 39 year old healthly male. I do not have any problem urinating, however, no matter how much I shake, I find that a minute or so after I finish, I tend to dribble. Is this common, and what should I do about it?

A. I can just hear men all over the UK saying, 'Yeh, I get that too'. It was once called the Shilling sign because the wet spot on your pants was about the same size and shape of a shilling. These days it would be called the Euro sign. Whatever the name, it is very common and is caused by the retention of a small amount of urine in a wider part of the urethra (the pipe inside the penis). After you have finished, given it a good shake, slap the sides of the urinal to impress the guy next to you, squeeze the base of the underside of the penis just where it joins the abdomen. This will force out that last drop. A sigh of relief goes round Britain!

Could I be giving my girlfriend a urinary infection?

Q . My girlfriend had an urinary infection. She took some pills(prescribed by the doctor) and we stopped having sexual relations for 1 month. Nowadays, we are having sexual relations again (for 2 weeks right now), and she is feeling the symptoms again (she is feeling that she wants to urinate constantly). I would like to know if it is possible that I have the urinary infection and I am passing it to her. If it is possible, how can I know if I have an urinary infection? Because I am not feeling any abnormal or urinary infection symptoms?

A. This is probably the most important question I have been asked for some time as it shows that us men are capable of thinking about our partners as well as sex. You are quite correct. Sexually transmitted diseases which affect women badly don't always have any kind of serious effect on men so they can go unnoticed. A very good example is Chlamydia which causes next to no symptoms in the man other than some irritation on passing water and possibly a discharge from the penis. For women it is a totally different story causing infertility, ectopic pregnancy (where the baby forms outside of the womb, potentially fatal) and pelvis inflammatory disease.

You should have yourself checked immediately to stop the infection, if it exists, from passing backwards and forwards between you. Congratulations on being a real man and not a selfish bastard.

Concern about smell of urine and stress

Q . For the last 2 years I have had urinary problems. The problem is not always there. It started with the need to go to the toilet to urinate quite frequently. I saw my GP who at the time prescribed antibiotics saying that I probably had an infection in my urinary tract, she also booked me in for tests on my prostate. The problem cleared up for a while, the tests showed no enlargement of the prostate. After a few weeks the problem returned, although not with the same ammount of frequency or urgency. I had a mild ache in my kidney area so again I thought it may be to an infection. I tried homeopathy which seemed to work for a while or maybe it was just coincidental. I have gone back for more checks all with negative results, I even had a scan and yet again rectal examination of the prostate. All tests proved negative but the problem came and went. The problem usually came when I was at work. Therefore I tried to put it down to maybe a stressful time at work. I'm usually ok at home. I work shift hours and find the the problem is worse when I'm on early shift. The other problem that I have is a distinct smell of urine. Especially after urinating. Although there is no evidence of incontinance. Do you think taking something like St Johns Wort will help in dealing with the stress at work? I try other de stressing techniques which have some affect. I think if it was not for the smell of urine then I could probably handle the situation but as I work with a number of colleagues then the problem is that of embarressment.

A. From what I can work out you are more concerned over the smell of urine than the symptoms of frequency or urgency. Let's look first at the symptoms. Urine is more concentrated in the morning so it irritates the prostate more and causes the desire to urinate. As the urine passes down the urethra it causes irritation of this very sensitive pipe connecting the bladder to the penis and you feel you must pass water yet again. This wears off as you drink fluids and the urine becomes less concentrated. If your tests are clear for enlarged prostate and infection there is unlikely to be anything else wrong.

Now the smell of urine. You may not be imagining it. The easiest way is to sniff your trousers at the crotch. Unless you have a very long neck this is best done at bedtime when you jettison them. You may suffer from a very common male problem which is very rarely talked about but which causes the 'urine smell'. After you have finished passing water you may notice a small amount of urine 'leaking' after you have returned your penis to its rightful place in your undies. There may even be a small round wet stain formed on your trousers. It used to be called the Dollar or Shilling sign. Now it would be called the Euro sign. You can stop this by firmly squeezing the base of penis just where it meets the groin at the scrotum. Give this a try and get back to me before you consider anything more drastic.

Is urinary pattern normal?

Q . I occassionally get small "leaks" of urine when experiencing the sensation of needing to urinate. At these times the sensation to urinate is quite strong. If I do not urinate at that time then I can quite often go some time before having to do so. Whilst this applies during the day it is particularly strong in the morning when waking (I usually have to go to the toilet once during the night, but never more and sometimes not at all). I think I probably urinate quite frequently (maybe 8 or 9 times per day).I drink regular amounts of water throughout the day, my urine is a regular colour (light yellow/green)and I am not experiencing any other penile or bowel problems. Is this common/usual?

A. I would need more information - not least your age - but from what you tell me I suspect it is nothing to be too concerned about although you may need to see your doctor as I will explain.

You are experiencing urethritis - irritation of the tube (urethra) which passes from the bladder to the tip of the penis. Urine can be slightly irritating to this sensitive pipe especially in the morning when the urine is more concentrated. Too frequent masturbation or sex can increase the sensitivity of the urethra. Unfortunately there are some other causes which are not so pleasant.

Chlamydia infection can cause these symptoms and, although it is virtually harmless for the man, it causes ectopic pregnancies, infertility and can be fatal for women. Urinary tract infections (UTI) are much rarer in men than women but do happen. You need to check this out as it can be a symptom of diabetes. Inflammation of the prostate can also cause these symptoms.

It would be wise to see your own doctor, although meanwhile you should drink a few glasses of cranberry juice each day which will reduce the inflammation.

Urinary tract infection

Q . My father, in Seattle, has had a urinary tract infection for, I think, around a month. He has been to the doctor and was prescribed some medication, in pill format, that is not clearing up the problem.Do you have any ideas, advice, thoughts on what the cause could be?He is a very healthy 76 year old male, active, eats well, does not smoke, occasional glass of wine. If this was an ordinary case of urinary tract infection, shouldn't it have gone away promptly upon taking the medication, what I would think to be antibiotics?Thank you for any input.Becky

A. Urinary tract infections in men are not as common as in women so should be taken seriously just in case they are being caused by something else. As you know it generally happens in women for no good or serious reason.

If he is passing blood or blood clots or has trouble passing water he needs a specialist referral. Prostate enlargement, prostate cancer and polyps in the bladder can all give the symptoms of an infection. They can all act as a focus for infections themselves so it would be worth him asking to see a specialist. Having said all that, some urinary tract infections are notoriously difficult to cure in men. Either way he needs checked out more thoroughly. Frankly I wish I were in Seattle myself, lovely place.

Bladder tumour

Q . I have just been diagnosed with a bladder tumor. Do I have to follow a special diet? Also what sort of pain relief can I take for headaches etc?

A. There are no diets that I am aware of that are specifically beneficial for this problem, nor are there any foods you should avoid. You MUST not smoke any tobacco products as there is clear evidence that smoking is a strong risk factor for recurrence of bladder tumours.

Any painkillers should be suitable for headaches, unless you have any specific drug allergies - for more advice ask your local pharmacist, or your GP.

Burning sensation when urinating

Q . For some months I have experienced a burning when rinating. An urinary annalysis indicated nothing - no infection, no blood etc. What might be some other possible causes? Thank you

A. One simple answer could be that you might not be drinking enough fluids - an easy way to tell is to check the colour of your urine. If it is clear coloured most of the time then you are OK. If it is predominantly an orangey-dark colour then you should try to drink more water. Concentrated urine can burn when you urinate.

Sometimes sexually transmitted diseases (STDs) can cause burning in the urine, and they might not show on an ordinary urine analysis. If you have any reason to think you may have contracted an STD you should visit your local department of genito-urinary medicine (GUM Clinic, listed in yellow pages) for a complete check up.

If the problem persists you might need referral to a urologist - see your GP for more information.

Blood in semen and urine

Q . What can cause blood to be present in semen and in urine?

A. It's difficult to be exact about this - it depends on lots of different things, including your age.

If you have blood in either the semen or the urine you should see your GP for a check up, and I would recommend referral to a urologist for some further investigations to locate the source and cause of the bleeding.

Weakening bladder and wetting the bed

Q . I'm finding that my bladder is weakening year on year. I'm only 22 and have started to get up perhaps twice in the night to urinate and many times in the day, rarely dependant on how much I drink. Also, what's most embarrassing is that after drinking alcohol, as little as 4 pints, I don't wake in the night and wet the bed. I have once seen my doctor, but they just said don't drink so much (difficult at this age) and also tested my urine, which was OK. Can you help before go and see him again? Thanks

A. It's difficult to give you an exact cause, because ideally I would need to examine you, and have the results of certain investigations. I don't think it is normal to have this problem at your age, and I think you should ask your GP to refer you to a urology specialist for further (specialised) investigations. I'm sure the cause could be detected and then it would be easier to suggest a remedy.

What could be obstructing flow of urine?

Q . I am a 29 year old male, with very frequent urination occasionally. Some days as many as 10-15 times. Most of the time only a trickle, but it takes forever and if someone is next to me in the urinal I can forget about expelling my urine. I have also noted that during these times my penis is very irritated and just the other day I notice some discharge after urinating. A warm shower helps me urinate.I have had this problem for years. I have been to a urologist who tells me nothing is wrong and to STD clinics who have not found any STDs. I was told by one urologist that my penis is curved because of scar tissue. I can sometimes feel the fibrous tissue on the right side of my penis. Could this be obstructing my urine flow or is there some bacteria not commonly tested for that causes these symptoms. Sex life not adversely affected.Thank you

A. There are a number of points here:

The fibrous tissue in the penis sounds like possible Peyronie's disease. I would need to examine you to be certain of this. I have put some information about Peyronie's disease in the paragraph below, but you need to

Have this diagnosis confirmed before you make use of the information.

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Peyronie's Disease

Peyronie, who first described the condition, was a french Physician. The cause of the condition is not known although there is some evidence that minor trauma during intercourse may result in the condition later on. What happens is that the affected person develops some fibrous tissue in the corpora cavernosa of the penis - these are two blood filled chambers of the penis which enlarge during erection. These fibrous plaques can be painful, and are typically found on the upper side of the penis. The erection usually curves upwards but may also curve to one or either side. Sometimes it is possible to continue having intercourse, and sometimes not.

Over the course of 18 months or so the condition settles down. Usually the fibrous tissue becomes less painful during this time. Once the curvature of the erection stops getting worse or one of three things may happen:

* The erection may go back to how it was before the condition started

* The erection may remain curved during intercourse, but intercourse is perfectly possible and not painful

* The erection may be too curved to allow intercourse to occur

In either the first or second situation it may be possible to continue as before without treatment. If the erection is too curved to allow treatment then a urologist may be able to perform an operation (known as Nesbitt procedure) to straighten the penis.

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The urinary symptoms you describe do suggest that you have a problem. It is very difficult to make a diagnosis without the benefit of a physical examination report and the results of investigations. I think that you need to see your urologist again to find out what is going on.

If you have a discharge then you could (in theory) have an STD; however, this would seem to be unlikely if you have been given the "all clear" by the STD clinic.

I don't think that the curvature of the penis will be affecting the flow of urine.

Dark urine

Q . My urine has been very dark yellow for over a year. It does not seem to matter how much I drink - 5 litres a day and it's still dark. Could this be another problem apart from dehydration? I live in a hot climate but am otherwise in good health.

A. You are quite correct to suspect dehydration as it is the most common cause of dark urine. Hence the darkness of it in the early morning after not drinking all night. If you are working in a very hot environment and sweating a great deal, 5 litres a day may still not be enough.

The pigment which causes the darkness can come from the breakdown products produced by the liver as it gets rid of worn out haemoglobin. Anything which upsets the work of the liver in this task can lead to dark urine. If this is bad enough your skin can also take on a light orange/yellow tinge.

You can tell the difference between it and a sun tan or if you have Black or Asian skin by looking at the whites of your eyes in the mirror. Various liver problems can give this result. Hepatitis simply means 'inflammation of the liver' and can be caused by alcohol abuse, viruses (Hep A B C etc), the failure of the liver cells to grow properly. You need to have a simple blood and urine test performed by your doctor sooner rather than later.

Occasional pain and blood on urinating

Q . In the past few years I have experienced a problem that comes about every five to six months. The problem is when I go to urinate I feel a sight pain. It is not a burning sensation, but it is almost like a cutting or tearing pain. The urine stream flows normally, but it seems as it flows something is tearing or cutting on the inside. The place where I feel the pain is near the tip of my penis. The result of the pain is always the same. The result is always a small amount of blood that comes out after urination is complete. As stated earlier this only happens every few months. I am a married man who has remained faithful since the wedding day. I also had only two previous sexual partners before I was married. I also must add that I remained abstinent three years prior to marriage. I am sort of worried. I don't want to find out I have prostate cancer or some other major problem. I also do not want to find out that I have a chance of not being very successful in getting my wife pregnant. Lastly, I am 23 years of age, 5'10.5", and a healthy 260lbs.

A. Let's get rid of the real nasties first. It is unlikely to be either penile, prostate or testicular cancer. You may have a recurrent urinary tract infection. It is worth getting this checked at the local GUM clinic and ask them to check for diabetes at the same time as this condition is linked with recurrent infections.

It may simply be small stones being passed from the bladder. They tend to be sharp edged and can cause the pain as they move down the inside of the penis. An X ray may show these although they are generally harmless. Alternatively, you may be experiencing muscle spasm which can occur after frequent intercourse. This stimulates the urethra causing inflammation.

Bladder stones

Q . I have been told that I have bladder stones. Please advise cause and treatment.

A. Bladder stones are very common and can simply be stones which have passed down from the kidneys. They don't usually cause any trouble but occasionally they might obstruct the outlet from the bladder. If you are having trouble with infections of the bladder they can act as a focus making infection more likely. The vast majority will pass themselves and you may feel discomfort as you pass them, it can even cause some bleeding.

Increasing your intake of fluids, avoiding dehydration and cutting down on foods containing oxalic acid (rhubarb) from which the stones are often made, can all help prevent stones and help in getting rid of them. If they are becoming a nuisance, they can be removed by passing a device not unlike those gadgets we use for picking up screws in awkward places, up the urethra into the bladder and removing them. Only very large stones need surgical removal.

Frequency

Q . I have been urinating quite frequently at night time. I am a bit worried. Sometimes I go four to five times. There are times I feel the urge to go after just a couple of minutes coming back from urinating. It always happens at night. I would like to know if something is wrong with me.

A. There is probably nothing seriously wrong with you but the reason for your nocturnal trips to the small room may depend to some extent on your age. Prostate enlargement, which increases with age, can gradually obstruct the pipe from the bladder causing both a poor flow and a feeling of not having passed water enough. This is particularly bad at night. It tends to affect men in their later life over the age of 50 years.

You should tell your doctor as it is emminently treatable and needs to be sorted out from the more serious condition of prostate cancer which mimics it. Bladder infections will also cause a feeling of needing to pass water but there is usually a burning sensation as you do so. Drinking alcohol, tea or coffee immediately before retiring is a common cause and obviously the most easy to rectify. On balance, I feel you should consult your own doctor.

Epididymitis?

Q . Recently it has become a little painful to pass water. Is this common and what could the reason be? I recently went to the doctor who mentioned that I may have epididimytis and am currently waiting for an ultrasound. Would this have anything to do with it?

A. There are (in theory) many reasons why you may have pain passing water. One possibility is that you may have a urine infection. This is uncommon in men and when it is proven to occur it is usually advisable to have investigations done to find out why.

Epididymitis would not cause this symptom - however, if you have had a urine infection this may have led to the development of infection or inflammation in the epididymis which is known as epididymitis. In this sense the two maybe related.

The scrotal ultrasound will help to make a diagnosis on any problems within the scrotum, but you should clarify with your doctor what is thought to be the cause of your urine symptoms. It may be that further investigations will be required.

Stinging when urinating after sex

Q . Since I was a teenager sometimes after sex I get a very bad stinging sensation and feel I want to pass water. I sit on the toilet for ages before this passes, and it stings when I pee.

A. Relax, because you are experiencing a very common and normal reaction. During sex the prostate is stimulated along with the pipe — the urethra - which goes from the bladder to the tip of the penis. This pipe carries both sperm and urine, although not supposedly at the same time. The stimulation of ejaculation along with the physical trauma sensitises this pipe and the prostate causing a mild inflammation. As a result you feel as though you need to pass water. When you try so hard it makes the whole thing worse by further sensitising the urethra setting up a vicious circle.

Next time do not go to the toilet and wait instead. Go only once and no matter how much it stings just hold on for a while. The pain will go away and settle. If you experience this without having sex, and especially if there is any discharge of green or yellow pus, you may have a sexually transmitted infection and should attend your GUM clinic. They will see you with no name and no-one else including your GP will be any the wiser.

 

Page created on May 13th, 2003

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