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Constant Urge to Urinate
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Constant Urge to Urinate

21 year old otherwise healthy male. I never had any UTIs or any problems with frequent urination in my life prior to my symptoms. I've had a constant urge to urinate that popped up out of nowhere last September and hasn't gone away since, to varying degrees of intensity but always present. Certain days I can hold it for 2 1/2 to 3 hours, others I'm going every half hour/hour. On a "good day" I go about 8 times. Other days I can go as many as 15-20 times (I've had a lot more bad days than good lately) There's occasional tightness in the bladder but mostly the sensation is in my penis/urethra
.
Most of the time very little urine comes out and I almost have to force it to get a stream going (which is usually weak). Which leads me to believe my body isn't actually producing more urine, just something causing the urge). I've experienced no pain. but the urge seems worse when sitting forward/on hard surfaces (ex. driving), after bowel movements and ejaculations,  and lying down on my side. Also haven't really noticed if any foods/liquids make it any worse, except for alcohol sometimes. I pretty much eliminated soda from my diet for roughly 3/4 months and that didn't really do anything. Also haven't noticed any blood or discharge in the urine. No incontinence but a lot of dribbling after I urinate.

As far as treatment goes, I originally went to a clinic for a urinalysis thinking I had a UTI. The urine came back clean with no bacteria but I took doxycycline twice daily for a week and the symptoms persisted. Went to a GP roughly 3 weeks later who checked my prostate, took another urine sample, and tested my blood for diabetes/kidney disease. All came back normal for the most part. Took ciprofloxacin twice daily for a week. Again, symptoms persist. Shortly after had a bladder ultrasound pre and post void where I had to drink 32 fl. oz an hour before the test. Bladder was apparently emptying with no abnormalities.

Because of a lack of insurance that had to be corrected, didn't see a urologist until February. Again, urinalysis came back clean, prostate normal. He prescribed vesicare once daily, which hasn't really done much and seems to be decreasing in effectiveness lately. I went for a CT scan (no contrast) in March of my pelvis/abdomen to see if maybe there was a stone or something of that sort. That also came back normal. I have an in office cystoscopy scheduled in about a month (which I am kind of nervous about).

So I think it's safe to say this isn't an infection that's been lingering for 9 months. At this point the only 2 things I can think of are overactive bladder and interstitial cystitis. Sincerely hoping it's neither but I really just don't know what to do anymore. Any ideas?
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1711789_tn?1361311607
Hi there!

Well, without a clinical evaluation it would be difficult to determine the cause of your symptoms. Possibilities that may need to be considered include infections, inflammations, hormonal/ endocrine abnormalities, neuro-muscular causes, medication/ drug side effect etc. With infections and diabetes ruled out, one may consider looking at inflammatory and neuro-muscular issues (precisely similar to the lines you have been thinking). It would be best to consult a urologist for a detailed evaluation. After a cause is identified, it can be managed accordingly.
Hope this is helpful.

Take care!
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Avatar_m_tn
Well I had an in office cystoscopy last week and the doctor didn't find a stricture or anything abnormal in my bladder. The next step is to see if it's a prostate issue such as inflammation or elusive bacteria or something of that nature. Prescribed me 10 days of Mobic (an anti-inflammatory medication) and a 6 week course of Bactrim DS, which I have been taking for 6 days without much relief yet. I imagine if this is something the bactrim can fix it might take a little longer to work hence the 6 weeks, so I'll give it time.

I have an appointment for urodynamics on Oct. 29th so we'll see how that goes. If all is normal with that then I will be at a loss since it seems like it's the last test I haven't had. My urologist said in that case he may need to refer me to another doctor for a second opinion. At that point I think all that it is left would be the dreaded interstitial cystitis diagnosis. Not sure how since I have no pain and have zero history of bladder problems before this all started abruptly. Zero UTIs in my life and I generally only had the urge to go 4-5 times a day despite a heavy caffeine intake (that I have since basically removed).
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Avatar_n_tn
fairly new post, (i posted in another one with a later date) but I been dealing with your EXACT problem since i was around 18 (now am 25) it is a WORLD OF HELL AND ONLY GETS WORST :( I cannot support myself any longer due to not going out AT ALL, I really hope you find what is wrong because EVERY doctor I went to just says (it's all in your head) My prostate went through the SAME excruciating pain making me go in a feedle position crying silently for it to go away thinking my left testicle will explode, years down the line i give up now and just hoping someone found a solution or a way to get money to survive :(
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Avatar_m_tn
It sounds like you are on the right track as far as getting a doctor’s evaluation. You could have chronic prostatitis, which unlike BPH is not unusual in younger men. I would also suggest trying a prostate supplement (health professionals recommend Prostate Ph) made from all-natural botanical extracts such as sang huang mushroom and white button mushroom. Medical studies have shown that these have a positive effect on the health of prostate tissue in white lab mice.

Best,
Alex, PhD
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