urinary problems

[codastorm]

I am a 33 year old male and I have recently been experiencing the problem of having frequent strong urges to urinate. At night the most I can sleep is around 2-3 hours then I am woken by the sensation of having to urinate, though when I go there isn't even that much that flows out. The problem occurs throughout the day as well but seems to be a lot worse when I am lying down for some reason. I have had the problem for a little while now but basically ignored it until lately it has worsened and my urinary stream has become noticeably much weaker and I have also noticed my ejaculations have become much weaker as well.
This problem seems to really be becoming worse. At first I linked it to the symptoms I read of having an enlarged prostate but I recently found in readings that lower back problems can cause these same symptoms as well. I did have surgery for a lower back injury on disk L-5 about 4 1/2 years ago. I still do feel soreness in my back frequently. So I am not sure what it could be. It is really starting to become unbearable.
Any advice given based on this information will be greatly appreciated.

[Vanessa Lacuesta]

Hi.

I do think it is necessary to seek consult with your urologist and it is important to mention to him your previous history of spine surgery.

At this point, your symptoms clearly point towards a urologic problem. Since you have not been completely assessed by a urologist yet, I suggest that you promptly see one. An underlying prostatic involvement needs to be ruled out. An enlarged prostate may cause weak urine stream and some problems with sexual response. A chronic infection of the prostate may not necessarily present with pain or swelling in the perineal ( area between anus and scrotum ) area as in the acute cases, however they may present with urinary symptoms and discomfort in the groin.

At this point, a prostate condition is my primary differential. Discuss this with your urologist. This requires further evaluation.

[codastorm]

Hi,
thanks for your response. I did have all the recommended follow ups that my surgeon suggested. On my last visit witch was only about  6 months to a year post surgery, he said that I didn't need any more follow ups. At the time my symptoms were mild and for whatever reason I made the mistake of not mentioning anything to him.

I don't have diabetes or thyroid problems. I do however drink a lot of water throughout the day but not really prior to bedtime. I have noticed that even if I don't have anything to drink, I still have this problem. It seems like lying down effects it even more so.

One thing that I forgot to mention in my initial post is that when I do urinate, upon finishing, I often get dripping or dribbling that is almost impossible to stop.

I haven't  had a consultation from anyone yet. I wasn't sure if I should make an appt. with my surgeon, Family Dr. or urologist.

[Vanessa Lacuesta]

Hi,

When was the last time you had a follow up for your spine disorder? I suggest that you seek consult with  a neurologist to have this evaluated. This may be contributing to your symptoms however, the affected portions of the spine L4-L5 may not readily explain the urinary urgency. However, this may need to be looked into in case a new onset problem has occurred.

Also, I suggest that you have a urologic consult done so that a baseline urinalysis and urine culture may be taken. Infections may cause urinary frequency and urgency.

Do you have any diabetes or thyroid problems?

Do you drink a lot of water prior to sleeping at night?

An evaluation of your prostate as well as an abdominal scan may be able to help rule out any underlying structural problems.

Have you had an initial consult done along this line?