cause of frequent urination

[lesz9604]

I'm a 25 year old male.I have a couple things going on that I would like your advice on.  First of all i went to go see a urologist about 4 months ago.  I have always had a problem with frequent urination and over the last year i have been experiencing weak erections.  I told the urologist about all this and he tested my urine and said there was no infections. He did an ultrasound and found that my bladder didn't empty completly so he scheduled me for a very fun test where he stuck a camera up my penis to look at my bladder.  He said nothing was wrong with my bladder, but the muscles of my bladder looked very week he said.  The second time they did the ultrasound they said my bladder was completly empty the second time.  He wants me to come back and see him 6 months from my last appointment.  I still **** like crazy.   I try to avoid diuretics completly, because it just makes it worse.  I feel like i spend half of my day going to the bathroom.  Another problem i talked with him about was my weak erections and premature ejaculation.  Since i've started having the weak erections i'll admit that i've been over analyzing that area a little.  I can still get an erection, but they are weak and go away very fast without stimulation. I also rarely wake up with erections anymore.  there is also a slight pain in the left shaft of my penis.  it also seems smaller and shriveled up, it doesnt' have the same weight to it anymore if that makes sense.  I also ejaculate very fast.  I do masturbate about once a day.  Is it possible i'm just overstimulating myself.    I told the urologist all of this and he just told me it was probably stress and he didn't run any tests or anything.  Is it possible that i slightly injured it during vigurous masturbation or sex, and now it just doesn't have great blood flow anymore.  Would exercise help circulation?  So if you could help me understand these problems a little better i would appreciate it.

Jeff

[Stephen Liroff, MD]

Let me address one item at a time. The weak stream and frequent urination  may well be a single issue. If you are urinating frequently, there may not be much volume in your bladder and then, when you do void there is decreased speed of urinating because of the small volume. The issue then may really be the frequency. If this is a daytime frequency and you are not arising during your sleep period to void, then anxiety issues are high on the list of causes. If it is a day and night issue, then problems with the nerves that control your bladder or something pressing on your bladder or even a stone in the ureter need the be considered (though usually there is blood in the urine to go along with a stone.
Why would you take diuretics??
As regards the erectile dysfunction, this too can be an emotional issue. Certainly, I recommend that you cease masturbating daily to see if this changes  your erections. The rapid ejaculation that you are experiencing, is this with a partner ?  How much foreplay are you engaging in? A lot of foreplay may be too exciting and result in a rapid ejaculation. Is this issue dependant upon  your partner? (i.e., is there an issue with one partner and not another? Again, I am thinking emotional issues.
The aching does have me concerned and I would suggest that you try an anti-inflammatory such as ibuprofen (if you can tolerate the medication)  and that you stop sexual activity (with and without a partner) for a week at least and see if the pain improves. If getting better, stop penile manipulation until the pain is all  gone.
Exercise is always good (up to  a point) and is overall a healthy activity. People who exercise regularly do maintain their libido and potency longer . I am not aware of any literature that demonstrates improvement in potency after exercising, however
My “gut” in your case is that your symptoms have a strong emotional component. You might consider discussing an anxiety relieving drug with your physician  and considering what you can do to  relieve stress.
I do not see where these problems will resolve on their own and I think that your should  get some help to deal with the emotional side, if that is what is the problem, or  get a firm diagnosis and treatment  for a physical issue.
Hope that this  helps and good luck!
S.A. Liroff, M.D.