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Avatar universal

Urological Pain - makes me feel like ending my life :(

I would be grateful if someone could please help, as this is really making me feel like ending my life.

I am twenty five years male, have asthma, otherwise healthy until

I had a urethral stricture, diagnosed in April this year, and underwent an optical urethrotomy a month later on 1 May 2008. I was fitted with a supapubic catheter which was removed recently.

I have had recurring abdominal pain and countless urinary infections since, however six weeks after the operation I am still suffering from the following symptoms.

Permanent urethral pain - this gets worse after urination and after intercourse, i have urethral pain for days afterwards to the point where I cant have sex now due to post operation erectile pain and weakness. Six weeks after urethrotomy im still in permanent pain down below till its unbearable. After intercourse, I have a inflamed foreskin which turns bright red and is enflamed for up to 24 hours. Urologist dismissed these symptoms saying "Ill just have to live with it"

Abdominal pain. I have recurring constant lower abdominal pain which is worse at night, and is only controlled by tramadol. I have been referred to a gastroenterologist who done an endoscopy which came back negative. Noone can shed any light if this is a seperate issue or related to my urological problems.

My bowels arent moving without laxatives, despite having high fibre intake.

My urologist had dismissed these saying things will settle down, but six weeks after the operation im in unbearable pain, could it be prostatis?

Id be grateful if anyone could help as I am really miserable due to the above and am desperate for some help?

Thanks in advance







23 Responses
Avatar universal
anyone
Avatar universal
MEDICAL PROFESSIONAL
Hi,


It is possible that the tramadol has affected your bowel movement.
How often do you move your bowels?

Tramadol is an opioid drug and though it is great for pain relief, it has side effects, such as constipation, addiction, etc.

You will need to switch to another pain-killer for the abdominal pain, but it will have to be gradual.

It would be best to identify why you still have pain and recurrent UTIs after the surgery.

Were you advised to have sex or masturbate after the procedure, after a follow-up examination?

How much is your fluid intake per day?

Since the constipation could mostly be due to the tramadol, it would explain why only laxatives help with bowel movement.

Physical activity will also help with bowel movement under these circumstances.

Do post back with a few more details.
Regards
Avatar universal
I move my bowels every few days, but it causes great pains. Even if im not taking tramadol, I need laxatives, which in turn hurt my stomach again.

I wasnt advised anything about sex post operation. I just know that ever since the urethrotomy, Ive had painful  and poor erections. It is now 2 months since the surgery and Im when I ejaculate my foreskin goes red. Could this be prostatis?

The urologist has just dismissed this, saying I will need to "live with it". How can i be expected to live with it?  

My latest urine test has came back clear, yet I still have stinging pain in my urethra, which gets worse after urination.

Lower left quadrant abdominal pain, which wont go away, I dont know if this is urinary related?
Avatar universal
If you don't mind me asking, what were your original symptoms prior to being diagnoised with a urethal stricture?   Hope you are feeling better soon.  God bless.
Avatar universal
Hang in there.    Why dont you get yourself a heatpad and use it down there - that should help.
Avatar universal
If I were you, I would seek out a second opinion, you are well within your rights since you are not having your medical needs met.(Pain, Questions, Answers,ect) I do have questions for you. Did you have a Cystoscopy done? Any other types of diagnostic testing pre and post operatively? Please post back. We are anxious to see how you are doing. Buy the way, my name is Amy and I am a 30y/Fm with many Urology and LT Kidney Issues. I have Hydronephrosis and A Ureterocele and getting further testing done for a possible ureteropelvic junction (UPJ) obstruction. I will find out next Monday after they remove the Ureterocele and inject the Dye in my Kidney. Keep us posted
Avatar universal
Brewer,: They diagnosed a stricture due to poor urine flow, and pain on passing urine. An ultrasound revealed I had a bladder holding 1 litre of urine that it shouldnt be. Hope that helps my friend.

Does anyone have any opinion if the lower left quadrant abdominal pain and urinary system problems are linked, or any more opinions as to whether it is prostatis???

The gastro people are convinced I have IBS.

I have stopped the tramadol, due to the constipation and stopped the laxatives due to the pain in the stomach.

Too much RX - No cystocopy.

I am grateful for the help. This problem has helped contribute to a major depression.

Current Medication : Colpermin, Lanzoprazole, Inhalers, and Nytol (sleeping tablets)

Does anyone else have any ideas as to what is contributing to this unbearable pain?


489228 tn?1291535054
You might want to check into IF you could have Interstitial Cystitis.  IC is more common in women then men, however men can have it and many believe most men are misdiagnoised!  Interstitial Cystitis is a very painful disease and follows a lot of the symptoms you are talking about.,,, and is often triggered by a difficult surgery, infection etc. When you talk about the pain being soo unbearable you could end your life... that sounds like IC to me.  Sucidal thoughts are 4x higher in IC patients.  The good news is that there are many helpful treatments available that can restore your life!

YOu might want to do a search on it since there is soo  much info. out there.  I know I am not allowed to post links to other sites, sorry... however I believe there is an Interstitial Cystitis forum on this board?


Some things I use to control my IC symptoms that you might try are ice and heat... warm bath with baking soda!  AZO over the counter medication.  It is an urinary analgisc and will turn your urine orange,,, and stain everything but it helps!

I also use an MSM gel from Jacob's Lab.  Since i have a preservative allergy we compound it with lidocaine, however you can get a script for lidocaine gel that I have been told works even better for men!

Diet is another area watch and see if spicy foods etc. make it worse?  The big triggers for IC are tomatoes, cranberry, caffeine, sodas, smoking and alchol.  There are a lof of others but those are the big ones and see if going off of them helps your symptoms!

I hope that helps.  As someone with multiple chronic pain diseases that deeply effect my life... there have been times that I have felt as you.  However each time we get a coping tool to control my symptoms or recently a surgery that we believe might cure part of another problem... I think what if I had give up before finding this answers!

Hang in there.... there is help!
Shelly
Avatar universal
Hi Guys,

Update: I went back to my GP this morning and am going to see another urologist next week.

The pain in my abdominal area, she beleives are coming from the kidneys.

Does anyone have any ideas of any kidney related pain.
Avatar universal
MEDICAL PROFESSIONAL
Hi,

Most commonly, kidney pain is caused due to kidney stones or a kidney infection.

Kidney pain can be dull, persistent lower back pain radiating to the lower limbs or colicky in nature if caused by a kidney stone moving down the urethra. This can be associated with nausea and passing blood in the urine also.

Irritable bladder syndrome can present with increased frequency, pain, and or an overactive bladder.

This can be treated with centrally acting antidepressants, such as amitryptiline or gabapentine.

Left-sided abdominal pain can again be related to the kidney or the large intestine.

Regards
Avatar universal
Hi Dr Smith,

In your opinion, should I be pursusing the resolution of this pain, with a urologist or a gastroenterologist. The pain in my lower left abdomen is chronic and really taking over my life.

The erectile difficulties are secondary and can be dealt with but I really need to get the stomach pain resolved.
Avatar universal
MEDICAL PROFESSIONAL
Hi,

You may need both.

If the problem with the bladder has been present for sometime, it is possible that the stasis could have caused pressure on your kidneys and caused some damage. You would need to have kidney function tests (creatinine, urea) done to identify if your kidneys are alright. This can be dealt with by a urologist, but is primarily the domain of a nephrologist.

Your earlier posts stated that moving your bowels caused intense, excruciating pain. This would need to be addressed by a surgeon or a gastroenterologist.

A general blood exam (RBC, WBC, Hemoglobin, ESR, differential count), and the aforementioned kidney function tests, along with a liver function test would most probably give an idea of which system is affected and referral to the concerned department can be taken over from there.

The blood for the above tests can be drawn just once and you could have results within a day or two.

Regards
Avatar universal
Update:

I had an abdominal CT scan of my urinary system, which showed everything was in working order with my urological system, slight distension in right kidney but he beleives this is not causing the pain as it is in my lower left/middle abdomen. Went to see a second urologist who cannot offer any urinary reason for my abdominal pain.

My mian symptoms are now intense heartburn and intense burning on my left lower abdominal pain which spreads between my lower left abdomen and belly.

Urologist now says I should see a gastroentologist.

Does anyone have any ideas? :(
Avatar universal
Sorry constant pain in belly, abdominal area, with heartburn.
Avatar universal
have you consulted with a physical therapist who specializes in treatment for pelvic pain, prostatitis, and/or visceral fascial dysfunction? Depending on where you live you might be able to find a PT who specializes in treating these issues and might be able to obtain some pain relief by having fascial release work performed on your thorax/abdominal regions. If the imaging shows normal kidney function, the pain could be caused by fascial restrictions or immobility in response to the surgical procedures you've had and the positioning/posturing of pain postures after surgery (forward bent into flexion because it hurts to stand up). You can search the APTA's website (Am Phys Ther Assoc) and use the find a provider feature to search for someone in your area. You might look for a women's health specialist and then call them to ask if they know of a provider who creates male pelvic pain syndromes. Good luck!
Avatar universal
big oops!
I meant call the women's health specialist to ask if they know of a provider who "treats" (not creates) male pelvic pain syndromes.....
Avatar universal
I would say do what you think is necessary--see a gastro doc, for belly pain, but it could be just from the stress of what you are going through, I had a bunch of urology problems a while back, and started having really bad stomach pains that eventually went away, could also be a type of food you are having trouble digesting, get it checked out and figured out.  good luck.
Avatar universal
I just wondered whether there is any other urogolgical tests I can have done.

Ive had an abdominal CT scan and kidney ultrasound.

I asked about prostatis, but my urine is clear so does that rule it out?

Can I order my urologist to do any more tests?
Avatar universal
MEDICAL PROFESSIONAL
Hi,

You could be having gastritis, hyperacidity, or the beginnings of an ulcer.

The heartburn could be occuring in response to either irregular bowel movement or the stress and medications you have been under.

Please do the following measures and get back to me regarding your body's response.

Start taking Rantac (ranitidine) 150 mg 30 min after meals 3 times daily.
Take pantocid 40 mg on empty stomach (first thing in the morning). Do not take tea, coffee, or any other beverages or food for 30 min after this tablet. Just take it with a glass of plain water.

Dilatation of the renal pelvis, however slight, can be a sign of an obstruction and would require further imaging studies. A simple Xray of the pelvis can usually pick up a stone which has been missed on other investigations, but this can also be done with the aid of a radiolucent dye.

No, a clear stream of urine or a negative urinalysis does not rule out a prostate infection.

A prostate massage test would enable collection of fluid specifically from the prostate and help diagnose infection, if any.

It would not be a good idea to order any doctor to perform tests. :-)
You can request him/ her to investigate the cause of the renal distension further.

Regards
Avatar universal
I am in the UK.

I have been trying lansoprazole with no success, should I still try ranitidine and pantocid?

Could the constant bruising feeling pain in my penis/urethra have been caused by masturbation too soon after the urethrotomy? I did it 10 days after the urethrotomy. Maybe I could have damaged something permanently?

Could this have caused permanent damage to my penis/urinary tract by doing this?

At the moment the 2nd urologist, just advised to refrain from intercourse and dilate once a week? Can I stop dilating after a second time?

He thinks things will heal naturally. Is this possible?
Avatar universal
MEDICAL PROFESSIONAL
Hi,

Have you been taking the lansoprazole on empty stomach with a 1-hour interval before food consumption, once daily?

If you have been taking the medicine as I described, it should have worked. If it has not, then, it may not be solving your problem.

Yes, Ranitidine would help as it has a different mechanism of action from that of lansoprazole. Pantoprazole (pantocid) is from the same group of drugs as lansoprazole, but some individuals respond better to it.

You can try the ranitidine and the pantoprazole while stopping the lansoprazole. Note that pantoprazole should be taken on empty stomach and there should be a time interval of 1 hour between the pantoprazole and any food or beverage.

Ranitidine is to be taken 30 min after food.

Structures in the penis and even the urethra take longer to heal. Masturbation within 10 days need not have caused any permanent damage.

You will need to have the dilatation done depending on need -  that is, based on how the stricture is improving.
This will prevent any scar tissue from blocking the urethra.

Given time, things will settle down and heal by themselves. You will need to stop paying too much attention to this problem even though it is such an ever-present part of life right now. Health issues have a way of taking over your life and the worry they cause does impair quality of life.

Just improve your nutrition to include micronutrients that help restore the normal mucosa.
These include natural foods such as vitamin C, fish and milk for vitamin A, and shellfish (if you are not allergic) and wheatgerm for zinc.

Regards
Avatar universal
You've been getting lots of very good advice.  Just wanted to share-- my 21 y.o. son going through a lot of similar stuff.  In his case the "cause" stems from reactive arthritis which he's had since a small child (an autoimmune syndrome initially triggered-- if you're genetically susceptible-- by common food poisoning germs like salmonella--  inflammation affects 3 systems: lower joints & sometimes heels/toes, eyes, & urethra -- not all at once.)  Syndrome was joint-related for first 10 yrs, but has been mainly urethral since mid-teens. It came & went & was bearable at one time w/OTC pyridine , but in recent yrs a couple of severe bouts of unrelated illness seem to have kicked it into high gear.  

Not suggesting you have reactive arthritis, shattereddreams--  & by the way that diagnosis & a subway token will buy you a ride if you know what I mean.  I just want to note that in high gear, his urethritis has ballooned out into every symptom you've mentioned--  except that he's only gotten lower left quadrant pain a couple of times.  He already was having plenty of gastric issues (which a gastro told us often accompanies reactive arthritis, oh goody), but had found some ease from that by switching to lactaid milk (even tho he does not have lactose intolerance) for a few days, & always chewing a lactaid pill before eating ice cream. We figured it must be that just eliminating lactic acid gave his poor tummy one less thing to deal with & that helped it settle down.  When the urethritis is severe & persistent, it quickly radiates to prostate & bladder--  this level of extreme pain causes you to involuntarily hold your urine, which irritates the bladder & the prostate-- next thing you know you're constipated from any pain meds you're taking which exacerbates the whole prostate thing-- stomach starts spasming, belching, can't digest-- it's all related, in his case.

Best of luck.  Don't give up.  
Avatar universal
I think vivbarker is on the right track.I wonder if you have a chronic fungal infection.Try avoiding all sugars and prosessed grains including breads, pastry, cakes and even fruits and dairy. Try and find a low sugar source of antioxidents ie vitamin C and E or if you can find some mangosteen pericarp (not the whole juice as it is high in sugars) I used this successfully to treat my chronic candida infection.  You can be tested  for systemic fungal infections by getting a live blood analysis from a Naturopath
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