A possible stricture in parts of the anterior urethra?

[jazzman19us]

Hello, I'm a 27 year old male that was diagnosed with prostatitis a couple of weeks ago. Three weeks ago I had a cystoscopy done and ever since then it has went down hill. My symptoms are delayed urination at the tip of the penis, spraying of urine at the very end of urination everytime, urinary leakage, weak urine stream, urinary frequency with no urgency, sometimes stopping and starting of urination with occasional splitting, no pain at all during urination only afterwards and it feels like at the base of the penis it is narrowed because when I go to void it has that feeling of tightness and pressure all the way through the stream. My doctor put a referral in for another urologist because the one that I had doesn't know what is wrong with me and I prefer a second opinion because I am pretty sure I know what is wrong. Is it possible to have all of this happen after a cystoscopy scarring of the urethra? I'm afraid that these strictures will grow and completely block the flow of urine.  I'm currently taking Septra DS for prostatitis even though my prostate is fine they gave it to me for a precaution because they couldn’t figure out what is wrong with me and uroxatral oral to relax my bladder muscles and prostate. Ultracet for the pain because I do get pain in the penis. They did a pelvic and abdominal CT scan 2 days ago to rule out any possible kidney or bladder stones. That is the only thing I can predict to be causing my symptoms is a urethral stricture because I am to young to have BPH and prostatitis wouldn't have my urine spraying everywhere towards the end of voiding and narrowing at the base of the penis. Any information or knowledge on this will be greatly appreciated.
On the mean time if this is what I have what home treatments can I do so it won't get worse until I get an appt with the urologist?

Thank you and god bless,

[Dr Smitha Mathews]

Hi,

Yes, the culture report can be prepared after 72 hours as the organism is given time to grow in the media.

Prostatitis is an inflammation of the prostate gland. This can be in response to infection or may be abacterial inflammation.

It is possible that the cystoscopy damaged a part of your urethra which has resulted in a stricture. This stricture could be the factor causing the blockage and the spraying.
This needs to be evaluated to decide whether you need any intervention, such as dilatation of the stricture.

You need to follow up on the culture sensitivity if there were bacteria present in your urine at the first urinalysis. If there were no bacteria present, you may need to have the urinalysis repeated as, sometimes, the bacteria from the prostate are not detected in the urine in just 1 or 2 urine exams.

Following the advice given for management of prostatitis (in previous post) will help relieve some of the pain and will ease the other symptoms.

Regards

[jazzman19us]

Thank you Dr. for the response, I started having the spraying of urination in the glans penile a couple of days after the cystoscopy, so I put two and two together because I know sometimes that  procedure could cause scarring in the urethra. All they did was a  24 HR urinalysis report prior to giving me anti-botics, doesn't the culture report have to sit for at least a couple of days before bacteria can form to reach a diagnose for prostatitis or any bacterial infection? I honestly think from the way I void that when I start to go there is a slight delay at the tip of the penis as the pressure is initiated and at the final part of the urine stream it then starts to spray. Could that be possible to have a slight blockage of tissure inside the tip of the penis, either from the Urologist taking out or putting in of the scope.

Thank you and god bless

[Dr Smitha Mathews]

Hi,
Did you have the spraying prior to having the cystoscopy done?
It is possible that you had a stricture prior to the cystoscopy and it is also a possibility that the cystoscopy could have caused some trauma to the urethra resulting in a urethral stricture and the associated symptoms.

The Septra that you have been prescribed -  Was it following a urinalysis and culture sensitivity report?

If you have a urinary tract infection, it will be necessary for the organism to be isolated and a culture sensitivity test to be done prior to being started on antibiotics for the same.

Urethral stricture will need to be managed with urethral dilatation. You can discuss this procedure further with your urologist.

In the meantime, you can do the following:
   Drink at least 2000 ml of fluids per day (8 glasses).
   Drink cranberry juice and other citrus juices.
  Avoid the use of any chemicals or irritating substance at the urethral opening and the affected area
Maintain hygiene.
Avoid intake of caffeine and alcohol

Do keep us posted on your doubts and progress.
Regards