Hello, been having an issue related to the topic for a while now; I'm hoping there is a urologist or knowledgeable person lurking this board here to help me out.
Before I begin, let me give background incase it may help anyone who reads this that cares, I'm an 18 year old non-sexually active white male with an average sized, straight (as in physical orientation) circumcised penis who is 5'10 and right around 185 pounds with no family history of the issue.
Anyway, let me hop in: it started roughly 5 years ago when I went to urinate the stream would do odd things such as bifurcating with one stream going the right way and a lesser stream going off to an angle or that lesser stream sometimes turning into dribbles that would occasionally drip back onto my pants, and it seems to have gotten marginally worse since then as my penis has grown. Suffice to say, I have peed sitting down for well into 2 years now, which as I'm sure you can guess, I would prefer not to have to do in public places. Moving on, about 9 months ago, while on vacation in Arizona I became very sick and eventually went to the hospital with magenta colored urine where I found out I had a UTI. When I told the doctor that I was not sexually active he didn't know how I contracted the illness, but when I told him of my difficulties with urination he suggested it was possible that I had a ureteral stricture and it could have blocked something that became infected. While I was in the hospital a Urologist did come by my hospital room to give me his diagnosis; after inspecting my penis and not seeing any noticeable physical abnormalities he came to the same conclusion as the hospitalist who had suggested that it was a stricture. I then went home several days later after I was well and immediately got an appointment with my primary for a referral to a Urologist (my insurance requires it). It took them a few months because of several issues, but eventually the referral did go out and I was able to visit a Urologist who suggested after inspecting my penis and as well finding no abnormalities that I should come back in a few weeks to get scoped to look for obstructions. A month or so later after the scoping I went back in for another visit and he told me that he did not see any obstructions and that he wanted to schedule me for a pressure test as that may be why the stream was not right. So I went back in for the pressure test (not fun!), and after I was called back in a week or two later he told me everything looked normal, though I was not able to fully empty my bladder, and proscribed flomax and told me I should take this and see if it works as he would not suggest surgery for someone so young. I didn't take it for awhile because I lost the pill bottle, but I found it yesterday and started taking it again, only to find no change in my urination, but a change in my ejaculation yesterday (almost nothing escaped the penis). I hoped maybe it was a fluke, but again the same thing happened today (this possible side effect was never even explained to me), and there was still absolutely no change to the urination.
So the real question is if there allegedly isn't an obstruction, my pressure's fine, and there are no physical abnormalities what could be causing the issues I'm having?
Look forward to responses if anyone has any ideas!
I can think of one possibility. The urethra itself may be bifurcated, with a small second opening like in hypospadius, but inside the main urethra. In other words, the urethra may branch into 2 openings inside the main urethra. The second opening may be too tiny to see on scope, but open up under pressure. If they could give you a urinary dye that is radioopaque, have you urinate while an xray is taken, the xray may show 2 tracts of dye coming out. It probably is only an academic point unless you continue to get urinary tract infections.
Would the second opening be visible while I'm urinating? I ask because I have taken the time to look closely, and it appears to be coming out of just one opening. Do you think it's possible that an obstruction or stricture in my case was just missed by the doctor?
Last edited by JackSchitt; 05-08-2013 at 04:17 AM.
The second opening could be inside the urethra, and too tiny to be seen even on scope. That's why the urinary dye trick could work to identify it. Consider though whether this is a problem worth considering surgery to fix or merely curiosity on your part. If you get another UTI, I would say it's worth exploring further.
Hmm, well thank you; you've given me a bit more to talk to my Urologist about the next time I see him. As for whether I would consider surgery to fix it, if it was the reason my stream was so irregular and I could actually urinate while standing up without drenching the entire bathroom, I would jump all over that ****!
Well I know the problem has gotten progressively worse since I noticed it, it could have existed since birth but just became aggravated going into puberty where my penis grew, but I don't know. Like I said, I will definitely mention what you said to my doctor, it sounds plausible, though it sounds like the surgery won't be fun.
Hey man, thanks for responding to my post. I don't know if I can help you, but I have had my share of urinary tract problems. There were a couple of years when I was 15-16 where I got occasional UTIs--blood in the urine kind of let me know there was a problem. (You're right--that's an awful feeling. Just seeing that magenta color was the worst part for me.)
Anyway, my problem ended up being a bladder diverticulum--basically, a pouch extending from the bladder that caused urine retention. I don't know if that could affect the stream at all, though. But I do know diverticuli can also occur in the urethra. I'm guessing your tests probably would've shown something if that were the issue, but I thought I'd just throw in my two cents anyway. Best of luck, and I hope you find a resolution to your problem soon.
Thanks mate, I imagine they would've mentioned the diverticulum if it had been present in the x-rays, but I appreciate the information and the well wishes; I hope this issue is a distant memory soon too!
Hey Jack, just to ease your mind, the problem with no *** from ejaculating when taking Flomax is normal. If at some time you quit the Flomax you will start to *** again. If you want a similar drug that doesn't cause this problem ask your doctor for a prescription for Uroxotral (the generic name is Alfuzosin). Does the same thing as Flomax but you can still ***. Best wishes in finding a solution to your problem.
If I can give any possible advice, it is to make sure you are going to the right urologist. I had a urethral stricture with symptoms appearing when I was in 7th grade, with my main symptom being blood in my urine. I didn't have your issue of a split stream. As time went on my stream started getting weaker and weaker until I required a surgery. Ten years and two surgeries later I was told I would require a more invasive surgery to the ones I had already received. The Urologist I went to referred me to a urologist in the area that performed this surgery. The important part here is that he could perform the surgery, but was not experienced in the field, and was not an expert. But I went to him, and had some imaging of my urethra done to determine the length of the stricture. Afterwards, I was told my stricture was 4-5 centimeters, and would require a graft of skin from my mouth to fix. But during the discussion of the surgery I started to feel a little uncomfortable with the doctor, and some of the answers he was giving me. So I went out and searched for a urologist that was an expert on fixing urethral strictures, and went to see him. Biggest problem was that he was 2000 miles away from me, but... I am 24 years old and freshly married. This isn't a surgery I was willing to take any chances on. So went to see the new doctor, and when he took imaging of my urethra we found out that the stricture wasn't 4-5 centimeters. It was a little under 1. The other doctor was off base by about 500%. I was able to have a surgery performed that didn't require a graft from my mouth, and was significantly less terrible, and it was performed by a doctor I was comfortable with, and I knew he knew exactly what he was doing. I am a few weeks into my recovery, and it has gone perfectly up to now.
I know this is a really long post, and it isn't exactly the same problem as you are describing, but I hope my story at least helps. If you are having these issues with your urinary function it is not normal, and I understand how much it sucks to have to sit down when you pee (My stream went in one direction, but at times it was too weak to comfortably make it into a toilet or urinal without it dribbling into the seat or the floor). If you are having these issues, there is probably an issue with your urethra, and if your urologists can't seem to find the issue, it might be time to find another urologist. Research them, and find one that you feel comfortable with their experience on strictures. (As a stricture was the original diagnosis, I am assuming that is the real issue.) Sorry if this post beats around the bush, but I hope it helps you, and you find a solution to your problem.