Please help me. Have to force urine out. bladder doesn't feel empty after urinating. the urge to urinate is always there.

[help225]

I've had this problem for about four years now. I feel like urinatining and when I go to the bathroom, sometimes I have to force the urine out and only  a little bit comes out. It's not painful and doctor's have given me lots of UTI medication so I know it's not a UTI, but trying to force the urine out really drains me it gets me weak and frustrated.

The frequency and urgency to urinate is always there. After urinating I put on my underwear and feel like I  still want to urinate like my bladder isn't empty.   I can hold my urine for a long time but if I do I become very bloated and get this brownish  odorless discharge.

I've been to countless doctors done a cystoscopy, IVP, different ultrasounds and many other tests and medications but they can't seem to find the problem.
If I were to go to the bathroom everytime I felt like urinating I would never leave the bathroom.

even sex is difficult because while having sex i feel like I want to urinate and it doesn't feel good.

can you please help me?

[Lennox Hoyte, M.D.]

THat feeling of urinary urgency is sometimes related to bladder infection, sometimes to prolapse (i.e., dropped bladder). If these are not the case, then the possibility of pelvic muscle trigger point pain causing the symptoms should be considered as well. Other possibilities could urinary retention, and pelvic masses like an enlarged uterus or uterine fibroids. You should have your doctor check a "postvoid residual" which involved passing a catheter in your bladder after you urinate to see how much is left in your bladder after urinating. If this is normal (less than about 50 cc), then that would not be the problem. Your gynecologist could also do a bimanual exam to feel if your uterus is enlarged, or if you have any masses puching on your bladder. If this is also negative, then get an evaluation by a physical therapist who specializes in the female pelvic floor, who can help you identify painful trigger points in your pelvic floor. If these are present, then the PT can help you get rid of them, which is likely to improve your symptoms. If you do not have active trigger points, and everything else is normal (assuming your cystoscopy was also normal), then you may benefit from an anticholinergic medication like Vesicare. Ask your doctor or provider about that.

Dr. Hoyte

[alpha601]

A related discussion, Was your issue resolved help225? was started.

[alpha601]

A related discussion, What turned out to be the problem help225? was started.

[help225]

Thank u so much Dr. Hoyte for responding to my post. You gave me some very useful information. I will surely talk to my Dr. about the other tests that you suggested and try to get them done.
                                                                                                     THANK YOU!

[medicmommy]

I forgot to ask..Do you have any other symptoms? sometimes urinary urgency like you described is caused by something else...Are all you labs tests okay? Any elevations in your calcium levels?                                                      ~Melinda

[medicmommy]

Hello! Have you had a CAT scan or an MRI of your pelvic area? Crazy as this sounds, it may be something as simple as something structural like a dropped bladder (where the ligaments that hold up the bladder have become damaged or just really lax) or a cystocele...(Although those are usually found with an OB exam....) (A cystocele is when part of the bladder tries to bulge out through the vaginal opening)...If the problem is structural, sometimes just doing pelvic floor excercises (belly dancing is excellent for this!) and losing a few pounds if you have excess, will turn it around...Also doing Kegal excercises...If it is from a dropped bladder (or one that gets twisted) and pelvic excercises don't work, there is a simple "sling" surgery that suspendes the bladder back where it should be...Good luck...You sound pretty miserable having to deal with this...                                                      ~Melinda