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Urology (Expert Forum)
Frequent Urination, Dribbling after urination (Narrow bladder neck)
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Frequent Urination, Dribbling after urination (Narrow bladder neck)
by K3PIO, Dec 10, 2003 12:00AM
I am 34 years old. I started getting pain in the groin while running and doing almost any physical, sexual activity about 2 years ago. To make the long story short, after going thru 5 Urologists I finally decided to settle on a uro that I was comfortable with in July 2003. Semen culture indicated enteroccocus bacteria in July 2003. The uro did prostate massages for 3 weeks ( twice a week, August 2003) since my prostate was mildly boggy and put me on Cipro while doing the massage. Pain the the groin subsided a lot after the massage. The last 2 prostate massages did not bring out any fluid so we stopped and finished with Cipro about 10 days later (in early September 2003) after the final prostate massage.
I started getting frequent urination and dribbling after I went finishing the prostate massages. I did not have dribbling before the prostate massage. I started getting a lot of itching sensation in the urinary tract after completing the Cipro and prostate massage treatment in mid September 2003.
I went to another Uro in November 2003. I went thru another semen culture about a month ago. I was prescribed Geocillin for 50 days for enteroccocus bacteria found in my semen culture. I am on Geocillin now. It seems like although the prior prostate drainages helped a lot, Cipro was not able to penetrate into the blood stream to get rid of the bacteria completely. While on geocillin I went for prostate massages again for about 2 weeks. I also went thru UroDynamics, Cystoscopy, Prostate Ultrasound and was told yesterday that I had a narrow bladder neck. He also mentioned that I had a small prostate. My only options according to the uro was to either take Uroxatral for the rest of my life or invasive surgical procedure (which he advised against cuz of me being young).
I went back to the Uro who had done prostate massages in August 2003. He said, he would have to do cystoscopy again with a hard scope and that he could dilate the bladder neck during the cystoscopy that could relieve my frequent urination and dribbling symptoms. I have researched dilation on the net and people who have their bladder neck dilated seem to be happy with it.
My groin pain has significantly subsided to almost zero and I can run and have sex again without pain but I will be on geocillin for another 20 days.
Do you think that the prostate massages could have caused the narrow bladder neck (due to trauma from the the massages)? What do you think about dilation of the bladder neck?
Can you please help and provide any suggestion?
Thanks
I started getting frequent urination and dribbling after I went finishing the prostate massages. I did not have dribbling before the prostate massage. I started getting a lot of itching sensation in the urinary tract after completing the Cipro and prostate massage treatment in mid September 2003.
I went to another Uro in November 2003. I went thru another semen culture about a month ago. I was prescribed Geocillin for 50 days for enteroccocus bacteria found in my semen culture. I am on Geocillin now. It seems like although the prior prostate drainages helped a lot, Cipro was not able to penetrate into the blood stream to get rid of the bacteria completely. While on geocillin I went for prostate massages again for about 2 weeks. I also went thru UroDynamics, Cystoscopy, Prostate Ultrasound and was told yesterday that I had a narrow bladder neck. He also mentioned that I had a small prostate. My only options according to the uro was to either take Uroxatral for the rest of my life or invasive surgical procedure (which he advised against cuz of me being young).
I went back to the Uro who had done prostate massages in August 2003. He said, he would have to do cystoscopy again with a hard scope and that he could dilate the bladder neck during the cystoscopy that could relieve my frequent urination and dribbling symptoms. I have researched dilation on the net and people who have their bladder neck dilated seem to be happy with it.
My groin pain has significantly subsided to almost zero and I can run and have sex again without pain but I will be on geocillin for another 20 days.
Do you think that the prostate massages could have caused the narrow bladder neck (due to trauma from the the massages)? What do you think about dilation of the bladder neck?
Can you please help and provide any suggestion?
Thanks
Doctor's Answer
by Kevin Pho, MD, Dec 14, 2003 12:00AM
, Dec 14, 2003 12:00AM
Prostate massages do not necessarily cause a narrow bladder neck. Occasionally, the bladder neck can be prone to spasm - where alpha blockers are used to improve urine flow.
If bladder neck obstuction is causing your symptoms, studies have shown that dilation or an incision of the bladder neck do improve the symptoms in the majority of cases.
Another consideration would be an MRI of the prostate. There may be some cases of an abscess that may not be seen on the ultrasound.
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.
If bladder neck obstuction is causing your symptoms, studies have shown that dilation or an incision of the bladder neck do improve the symptoms in the majority of cases.
Another consideration would be an MRI of the prostate. There may be some cases of an abscess that may not be seen on the ultrasound.
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.
