Blood in urine

The other night I got up from bed to urninate. While standing in front of the toilet squeezing my penis waiting for pressure to build-up to help facilitate a forceful urination I enexpectedly coughed while continuing to hold my penis tightly between my thumb and forefinger. During the cough I felt a stab of pain in my penis behind my fingers. When I urinated I experienced moderate pain and noticed a small amount of blood in my urine. I surmised that I had ruptured or torn my urethra from the extra urine pressure induced by coughing while pinching my penis shut with my fingers. I went back to bed and hoped the dull pain I was experiencing would subside by morning. In the morning the pain had subsided, but when I urinated there was still some blood in my urine and mild pain. In subsequent days the pain went away and the blood in my urine disappeared which I took to indicated that my urethra was healing. Was my diagnosis correct and should I be doing anything to facilitate healing? How long does it take for a torn urethra to heal and will it be weakened in the area of the tear? Will having an erection or ejaculating reinjure the area where the tear occurred?

Thanks!

[Kevin Pho, MD]

It is possible that a tear in the urethra can cause the bleeding.  Other causes of blood in the urine include infection, a prostate infection or enlargement, or kidney or bladder disease.

I would suggest obtaining a urinalysis to evaluate for continuing blood or infection.  A digital rectal exam should be done to examine the prostate.  

Depending on your age, a cystoscopy or IVP can be considered to evaluate the bladder.  Blood tests for kidney function or a kidney ultrasound can be considered to evaluate for intrinsic kidney disease.

If a urethral tear is present, there is no set time for healing - it would vary from patient to patient.  If there is proper healing, there should be no adverse effects from an erection or ejaculation.

I would suggest a referral to a urologist.

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.

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