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feeling that bladder not empty fully
An_226260 posted:
Lately, i feel my bladder has some water, but i can't pass it in the washroom. I went to my doctor who did a digital rectal exam and felt my prostate gland with his finger. He asked me to give him a urine sample which i will do. He suspects it could be prostatitis. My urine stream has been dribbling instead of being steady since a week. I also have been ejaculating semen after i watch some adult movie for entertainment. Could producing of the semen cause the prostate gland to enlarge? I am a male of 28yrs. Ejaculating semen was not painful at all. I have no fever, pain of any sort. I have had a burning sensation while urinating about twice. I used to drink more water and it went away.

Also, i cannot urinate if the bathroom is cold, but if it is at warm or at room temperature i can. This issue has been since a year, but i don't know if the two are connected.

Any advice would be welcome.
counterso responded:
Apologies that no one responded sooner. The doctor who examined your prostate should have had no question whether you had an inflamed prostate (BPH), unless he was not a urologist, in which case, see the urologist for proper assessment.

Semen production has nothing whatsoever to do with prostatitis, nor does hesitancy to urinate when the temperature is cold.

Decreased urine flow (low pressure), and the feeling you are retaining water are both serious enough to warrant a trip to the urologist. It's unusual for a 28yo to have prostate issues too, so all the more concerning.
m_j_95 replied to counterso's response:
Thanks for the reply.

Apologies, since I did not see it earlier.

My doctor suspected I had UTI(Urinary Tract Infection) due to bacteria. He gave me some medicines and I am fine now.

Thank you again for the reply.
counterso replied to m_j_95's response:
It is extremely uncommon for men to get UTIs unless one of three things is happening:
1) inserting objects into the urethra
2) incontinence (from soiled underwear)
3) a physical abnormality in your urethra

All male UTIs are considered complicated and emergency situations. It would be uncommon for a doctor to think a man had a UTI unless one of these three situations were discovered. It would be far more likely that an STD caused similar symptoms, and the treatment for infection is the same.
m_j_95 replied to counterso's response:
Thanks for the reply.

1 is ruled out(since I don't indulge in such activities) and so are STD's since I am a virgin.

Regarding 2, I wash my clothes once in two weeks, should I wash more often?

How do I detect if I have 3?

My doctor(he is a primary care physician and has a M.D, but I don't know if he is a urologist) tested my urine, found bacteria in it, gave me some antibiotics and wanted to test my urine after two weeks. After two weeks testing, he found bacteria in my urine was minimal so he concluded I should be fine.
counterso replied to m_j_95's response:
By soiled underwear I mean clothes that have urine or feces in them. Underwear should only be worn once and then laundered!

The only way to determine #3 is to see a urologist for an examination. Most PCPs know about as much about penises as you do, so they're not much help in this area. And in most cases a dismissive doctor will prescribe an antibiotic if they think it might help without actually determining the cause of your reported symptoms.

In most cases the doctor believes that 80% of patients lie about the chances of having an STD, so they just assume any urination pain has to do with this, and prescribe an antibiotic.

Testing AFTER a course of antibiotics is completely useless, because as you would expect, the antibiotic did its job. Testing prior to antibiotic usage will tell you three things: 1) is there a bacterial infection, 2) what kind of bacteria, 3) what drug is most effective against this particular strain found.

If #3 is the case, you're likely to get UTIs repeatedly. I don't know your age, but this kind of infection would probably have happened a several times in your life already if this were the case.

Unfortunately it's not one of those things easy to figure out after it's gone. So, here are the rules going forward. Wear your underwear only once before laundering. And the next time, if there is one, that you get burning urination have the tests done BEFORE any kind of treatment.

Good luck!
m_j_95 replied to counterso's response:
Thanks for your reply.

My PCP did testing of urine when I first went to him, determined it had bacteria so gave an antibiotic for me to take for two weeks, then tested my urine after two weeks and predicted it was bacteria free.

I cannot directly go to a urologist. Only if my PCP recommends I can else my health insurance won't cover it.

My age is 28. Also, why do you feel PCP's know little about penis? I thought they were the first point of contact who knew enough to make a basic diagnosis of a patient, then recommend to a specialist if required.

What books would you recommend for Men's health which tell you about foods to eat, exercises to do, symptoms to watch out for?

For foods, I am reading 150 healthiest foods on earth and 101 foods that can save your life. For men's health I am trying to get Harvard's medical guide to men's health.

Thanks for your suggestions and time.
counterso replied to m_j_95's response:
No, a PCP is a generalist, and since most patients do not want to discuss their genitals, other than looking at strange rashes or hearing complaints about burning urination, most PCPs probably don't even know how to properly do a prostate exam. Urology is another couple years of school that a PCP did not have, so there is a huge gap in the knowledge of any PCP or ER doctor in this area.

Guidebooks that generalize about "men's health" are rarely useful for individual planning. They're usually decades behind in scientific knowledge, and take no consideration of individual concerns, history, level of participation, and genetics. The best thing you can do for your health is to eat a reasonably colorful diet, avoid excesses (including exercising excessively), stay reasonably active, and be sure you get sufficient rest. If your body is operating efficiently, you can tell by the ease with which you sleep and wake, your general physical appearance of vitality, and that your elimination cycle produces only mild waste.

I'm sure your urine was not "bacteria free" after the second test, but it no longer had what is considered an infection. There's a difference. And as you noted, as expected, the antibiotic did its job. The thing is, most doctors don't wait for the first urinalysis to come back before prescribing an antibiotic. Patients want immediate help. The urinalysis indicates two things. One, which bacteria, and two, which antibiotic is effective against that strain of bacteria, and that might have changed which antibiotic would be chosen (instead of prescribing an overpowered one that does other bad things to your body besides the benefit of canceling the infection).

Worrying about things that might potentially happen to you is probably more stressful than its worth. Treating your body gently and respectfully is probably the only guideline you need. It's likely you already know what "bad" food or activities do to your body, and are capable of making decisions without the help of a book.

I'm glad that your course of treatment worked for your symptoms. Perhaps pull back your faith in others (including me) a little about what you need and "should" do, and rely on your own sense of your body in knowing what you need and is good for you. Relax and be well.
m_j_95 replied to counterso's response:
Thank you for the reply.

I have to sometimes wake up once in the night to use the washroom though I don't drink anything after 7pm and go to bed at 10:30pm. This worries me as I know enlarged prostate can cause this or it could be that water is not metabolized until I fall asleep. I have not discussed this with my PCP thinking it could be common for some men of my age(28).

I get the part about worrying about things that might happen but as they say following good advice is more beneficial. I am a layman in medicine so follow the advice of practitioners. I am a vegetarian but had borderline cholesterol when I did my physical last year. I did not think it would occur to me at 28, but it did. Followed my doctor's advice, reduced foods containing fat and hope my this year's physical checkup finds less cholesterol. Till the cholesterol was determined I thought I was "healthy and fit" Hence, I have less faith in me just like a car mechanic's opinion about how to drive/maintain a car is more useful than a layman who just drives it daily and thinks his car is fine.

This forum is a useful place which is supported by kind folks like you. Thank you again for your suggestions and time.

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