Pelvic Pain after urination

[jazzman19us]

Hello doctor,  I'm a 27 year old male who has posted on here a couple of times before and I was just curious as to why at the very end of urination my urinary stream seems to thin out dramatically when the stream starts to diminish; like the urine comes out on half of the urethral meatus upon observation. Here is a brief history of my urinary problems:

-Cystoscopy done for an unexplained penile and urination pain in early May, everything came back normal
-Been through tons of antibiotics for a long period of time (a month)with no resolution, probably not a bacterial infection
-Several urine test and prostate exams performed, everything normal
-Retrograde urethrogram performed in June, no obstruction in my urinary tract
My current symptoms:
-Occasional dysuria
-Pelvic pain most around the base of penis after micturition majority of the time that is my main symptom
-Weaker urinary stream
-No urinary frequency, I go every 3 to 4 hours
-little or no urge to go to the restroom, routine 3 to 4 hours to empty bladder even with a lot of fluid intake throughout the day.
-constipation
Here is the diagnosis I came up with
-CPPS/Prostadynia
-Pelvic Floor dysfunction
-Stress or Anxiety related, psychological issue?
I have another appt with my doctor in a couple of weeks, just takes awhile to get in and my mind is going around in circles to figure out what is wrong with me, maybe I'm going crazy or looking to deep into this I just miss being normal.
Any information would be greatly appreciated and god bless you for what you do for people day in and day out.
Thank you

[Dr Smitha Mathews]

Hi,

How old are you?
Have you noticed any mitigating factors over the course of your illness?

Do you consume any tea, coffee, or alcohol?

It is possible that the weak urine stream and dysuria could be attributable to a prostate condition. Have you had a prostate ultrasound done?

Pudendal neuralgia can also cause pain in the area supplied by the pudendal nerve.

There are a few common prostate irritants that may aggravate a prostate condition.
These include coffee, tea, alcohol, spicy foods, citrus fruits, etc.

Increasing or keeping fluid intake in excess of 2000 ml will help prevent any UTI.
Increasing fiber content in diet can also help with the constipation.

Do keep us posted on your doubts and progress.
Regards

[jazzman19us]

Thank you for the reply doctor,I'm a 27 year old male and I noticed through out the progression of my illness, that I have chronic pain in the pelvic area more and more as the time goes on. I comsume tea every once in awhile but mainly I intake water. I had a prostate ultrasound done and everything is normal. Could the prostate cause a very thin/spraying of the urine stream at the very end of the urination with no force to it or could there be a stricture in the head of the penis or narrowed meatus because of insturmentation trauma??
I have another question with regards to my bladder function. During the day I consume a lot of water through out the day and I go to the restroom like i normally should, but later in the evening when I consume a lot of water, I wont have the urge to urinate until I wake up in the morning 10 to 12 hours later?? I don't even go to the bathroom before bedtime because I dont have the urge to go. What do you think that could be??

Thank you again

[Dr Smitha Mathews]

Hi,

Spraying can occur due to an enlarged prostate altering sphincter action or due to a stricture or scar in the urethra.
If you noticed the appearance of the spraying after the instrumentation for diagnostics, it is possible that the problem arose secondary to trauma during instrumentation.

If a stricture is detected, you will need to undergo urethral dilatation at the least or more extensive intervention.

Tea is a diuretic. If you consume it on a regular basis, it will induce increased urination as long as the theophylline effect lasts.

If you have been excreting larger amounts of urine in the day and cease drinking tea in the evening, your body will absorb most of the water consumed to restore cellular levels of fluid.

Many individuals do not awaken at night to pass urine. There is no cause for worry in this regard. However, it would be good to void the bladder before bedtime.

It is possible that you do not feel the urge to pass urine at night because you are not drinking as much water or as frequently as in the day.

Regards

[jazzman19us]

Hello doctor,
                        
                   Maybe I have a strong bladder because I usually drink 1 to 2 12 oz glasses of water during the evening and I dont have to the urge to urinate. Usually the next time I go to the restroom or have an urge is when I wake up in the morning. Can a normal bladder hold urine for that long before contracting?  Also, occasionally maybe 1 or 2 times a day I get a burning sensation when I urinate and only go small amounts, usually when I dont consume water but with no frequency so it wont be a UTI right?. Bascially if I drink water throughout the day, I dont get a burning sensation but when I havent had anything to drink in 2 to 3 hours, that is when I get the dysuria? I try to drink 4 to 6 glasses or bottles of water during the day at work and 2 bottles of water during the evening. No nocturia Ma'am

One more question: Would a stricture cause spraying throughout urination and frequency because I only have spraying of urine at the very end of my urination with no frequency like something it plugged in the head of the penis or meatus.

Thank you and God bless:)