Aa
Aa
A
A
A
Close
Avatar universal

painful urination, trauma? Prostatitis?

40Yr old male with a long history of off and on prostatitis. Two and a half weeks ago I suffered a punch to the testes and penis during a "friendly" football game.  I immediately iced the area and carefully went to the toilet and urinated.  Felt a little sore but all seemed well. I am now concerned that perhaps some damage was sustained but i wanted other opinions on that.  My symptoms did not begin until 2-3 days after the incident.  I began to feel quick sharp pains from the urethra towards the tip of the penis during urination.  I also began suffering burning like sensations for a while after each urination.  Ejaculation causes a similar burn.  My urine stream is normal.  There is no blood.  I dropped of urine for bacterial analysis today.  Assuming that comes back negative...

Could this be a normal reaction to the trauma, and I can expect it to resolve soon?
Is it likely that the trauma has caused urethral inflammation or stirred up another episode of prostatitis?
Or am I likely looking at something for long term like a possible stricture.

I was born with a narrow urethra and I am deathly afraid of a catheter or cystoscope.

If this continues, what are my other options for evaluation?  Xray? Ultrasound?

Any other suggestions?  I have read that a bath with diluted tea tree oil might be a good idea.

Thanks,
JJ
5 Responses
Sort by: Helpful Oldest Newest
Avatar universal
well...for anyone following this, I am happy to report that my symptoms have resolved almost completely.  All in all it took about a month.
Helpful - 0
Avatar universal
It seems my urologists are booking out several weeks.  In the meantime, my urine flow has returned to normal, with no more splitting. The pain remains.  It is not acute, but more of a persistent and recurrent burning, stinging.  There seems to be periods where the pain is almost non existent only to resurface after a urination.  I

I am quite apprehensive to have the cystoscopy, and will avoid this in the short term for fear of aggravation and complications.  I am open to other tests, but am quite interested to see what else might be in my differential diagnosis for painful post trauma urination.  Again, I have no blood, and a fairly normal urine stream.

I am also hoping you will expand on the notion of a nerve compression.

Appreciated,
JJ
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hello,
If the urine is splitting in two streams, it can be due to congenital defects, scarring of the urethra due to STDs or other trauma, Obstruction, structural changes in lower urinary tract and prostatis. Passing of recurrent kidney stones can also cause scarring of the urethra and hence two streams of urine.

For evaluation of the same, I would suggest you to get it examined from a urologist and get an ultrasound and cystic urethrogram done to confirm the diagnosis. Even cystoscopy can be done which is one of the best tests.

I hope it helps. Take care and regards.
Helpful - 0
Avatar universal
Dr. Singh:  I just read your reply and will take your advice.  My urine results did come back as negative for WBC and Bacteria.  I would like to add a little more information and ask a couple of follow up questions. I noticed today that twice my urine started in a split stream, resolved almost immediately and during midstream, but then ended with a spray and a dribble.  The burning and pain continue but much less severe and more intermittent.  My most recent trip to urinate was more normal.  Any further thoughts on this?  Is stricture a possibility, even with episodes of normal urine stream? How does one treat a potential nerve compression?  How can I get my Dr. to order an ultrasound as he is only offering cystoscopy?

many thanks for your anticipated reply,

JJ
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hello,
It looks like trauma to the penis causing a nerve compression and hence such symptoms. Application of mild corticosteroid cream and oral antiinflammatories like ibuprofen/acetaminophen are also helpful.If the symptoms are severe then it will be best to consult a urologist as you may need ultrasound uterus to confirm the diagnosis.

Hope it helps. Take care and please do keep me posted on how you are doing. Kind regards.


Helpful - 0
Have an Answer?

You are reading content posted in the Urology Community

Top Urology Answerers
Avatar universal
Southwest , MI
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Discharge often isn't normal, and could mean an infection or an STD.
Dr. Jose Gonzalez-Garcia provides insight to the most commonly asked question about the transfer of HIV between partners.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.