Hi Dr. --
I'm a generally healthy 30 YO male -- and I just lost my health insurance. I have an unresolved issue I'd like to get your opinion on. Over the last year or so, I've been noticing that I have to urinate very frequently -- often (relatively) small amounts. Lately, the stream has been weaker, too. There has also been occasional discomfort/slight burning feeling AFTER urinating (but not during). And I've been dribbling a lot after urinating -- I'll shake "it" before zipping my fly, but my boxer shorts will still get a little wet.
I've seen a urologist a few times and had several tests. At first, he put me on medication for a slightly enlarged prostate. The medication reduced the prostate's size, but the symptoms didn't stop. He also performed several tests -- a bladder ultrasound, urine cytology, and a CT scan. They all came back OK and bacterial infection/UTI was also ruled out. He then put me on medicine for OAB, beacuse he couldn't think of anything else, but it did nothing. That's when my insurance ran out.
I've been baffled what it could be. Then I remembered that a few years ago, a different urologist told me I had a sports hernia. I didn't feel any pain and it was news to me. He told me not to worry if there were no symptoms. But now I wonder: could the hernia be pressing on my bladder and causing my urinary issues? One thing I;ve noticed is that running and walking make me feel like I have to pee...
You have certainly had a good work-up. The only further studies that might be considered are a cystoscopy (looking into your bladder with a small telescope) and a cystometrogram (a way of examining your bladder's function by filling it at a controlled rate and measuring its' pressures, sensation and capacity) and a uroflow (speed/bladder pressure while urinating). These would best be done when you have insurance coverage. The poor urine flow that you have been noting may well be due to small urine volumes from frequent urination.
If not a problem within the urinary system, then there may be a need to study your intestines as an Inflammation in your colon or your appendix could cause these symptoms, also.
Your sports hernia is not the cause of your symptoms. I obviously do not know your whole story, but it all your tests come up normal, then anxiety may have to be figured into the situation.
Thanks you for the reply. I do plan to get back to the urologist when I get the insurance situation settled.
Just one follow-up: I'm wondering why you're confident a hernia/hernias wouldn't be causing my urinary issues. I've seen this written about in several places, and it was about the only thing that seemed to make sense for me. (One example: http://www.buzzle.com/articles/hernia-symptoms-in-men.html)
If not a hernia, I'm getting very nervous about the possibility of bladder cancer.
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