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Urology (Expert Forum)
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Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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by ffargo, Jul 22, 2003 12:00AM
Two years ago I had anal sex which has caused all kinds of problems. Trauma? I’m not sure ....or the problems may have nothing at all to do with that event. But, I’ve been having lower abdominal pains for years. The internal medicine said sounds like I have irritable bowl syndrome. One thing that is happening is i'm having a very hard time having an orgasm! Is there any mechanical reason for this? Also I’ve had in the recent past spasms in the intercostals area. One time I had this spasm both sides of my entire chest. Worst pain that I ever had...I couldn’t walk and lasted for hours. Recently i’ve been having pain after i urinate over the pelvic bone. Over the bladder area. I had to urinate and had pain in the bladder from holding the urine back for so long. After I went to the bathroom I had the same pain for a few hours. Are all these symptoms spasms? A brief history. I had a colonoscopy which was normal. All my hormones are normal. I’m having a cat scan tomorrow of the abdominal pelvic area. I had a prostate exam for STD and cultures, which were normal. I had a swab of the urethra which was normal. Is there any reason for the problem having an orgasm? It is work to have one masturbating. This has been the only way that I can have one. I used to be able to have one during sex but that has all changed.
Doctor's Answer
by Kevin Pho, MD, Jul 22, 2003 12:00AM
, Jul 22, 2003 12:00AM
Hello - thanks for asking your question.
Without examining you it will be impossible to say what is going on. You state that the prostate exam, STDs, colonoscopy, hormones are all normal.
One consideration would be a more thorough exam for prostatitis. This would include prostatic massage for fluid and cultures. If positive, treatment for chronic prostatitis may last as long as 12 weeks. I would also consider a transrectal ultrasound to evaluate if there are any abscesses associated with the prostate.
As for the problems urinating, there are several considerations. One would be an anatomical abnormality, including a urethral stricture or polyp which can be evaluated with a cystoscopy. Other considerations would be problems with bladder neck or urethral spasm. This can be treated with appropriate medications.
Regarding the problems with orgasms, this can be further evaluated by a urologist or neurologist - I cannot think of an obvious cause from your description.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Without examining you it will be impossible to say what is going on. You state that the prostate exam, STDs, colonoscopy, hormones are all normal.
One consideration would be a more thorough exam for prostatitis. This would include prostatic massage for fluid and cultures. If positive, treatment for chronic prostatitis may last as long as 12 weeks. I would also consider a transrectal ultrasound to evaluate if there are any abscesses associated with the prostate.
As for the problems urinating, there are several considerations. One would be an anatomical abnormality, including a urethral stricture or polyp which can be evaluated with a cystoscopy. Other considerations would be problems with bladder neck or urethral spasm. This can be treated with appropriate medications.
Regarding the problems with orgasms, this can be further evaluated by a urologist or neurologist - I cannot think of an obvious cause from your description.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
