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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Urology
Satisfied Customers: 19328
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Over 2 years ago I noticed that I had to urinate a lot more

Customer Question

Over 2 years ago I noticed that I had to urinate a lot more often than usual, probably between every 10-30 minutes regardless of what I’d drank or the amount. After I urinate, no matter how much I pass, I’ll need to go again soon after. I get a tingling feeling at the tip of my penis that just gradually builds until I feel like I really need to go. I can hold it as it’s not excruciating, but it is rather uncomfortable. Even when I go 8 odd hours without drinking I’ll still feel the need to go roughly every 10-30 minutes and I’ll pass tiny amounts of urine and the sensation will go. I get up on average 3 time a night.
At first the Urologist ran a number of tests, I had a scans on my kidneys and an x-ray undertaken along with a flexible cystoscopy, all of which revealed nothing.
The Urologist put me on medication bladder, this did not help at all.
Next I had a urodynamics study conducted. That revealed that I didn’t have an overactive bladder and that perhaps my bladder was a bit on the small side. I’d always know I had a small capacity bladder but never had to go to the bathroom as much as recently.
I was told to do bladder training that helped ever so slightly but didn’t really make a big difference. I've also tried changing my fluid intake, but just drinking water makes no difference to the symptoms either.
Next I Had a hydrodistention with rigid cystoscopy and again it was stated that my bladder looks perfectly healthy. The hydrodistention did not help my symptoms either.
When it’s really bad I feel discomfort around my perineum and the sensation to go at the tip of my penis can be really strong. It doesn’t feel like my bladder is contracting though as when I didn’t have this problem and I really needed to urinate I could feel my bladder squeezing whereas in this instance it wouldn’t feel like that.
About a month before the symptoms came on I had taken ¾ a gram of MDMA at a festival. I don’t know if this could have any connection but thought it worth mentioning.
When I was younger, between the ages of 12-19 I used to suffer from migraines quite badly; which would leave me in bed good 12 hours. I mention this as I know one of the side effects of migraines can be frequent urination.
Having the sensation of needing to urinate every 20 odd minutes two years has caused me to become depressed and socially anxious. I'm always concerned about leaving the house.
Any advice or help you could suggest would be greatly appreciated.
Thanks help.
Submitted: 3 years ago.
Category: Urology
Expert:  Shantal-Mod replied 3 years ago.
I'm Shantal and I'm a moderator topic.
I've been working hard to find a Professional to assist you with your question, but sometimes finding the right Professional can take a little longer than expected.
I was checking to see if you had already found your answer or if you still need assistance from one of the Professionals.
Please let me know if you wish to continue waiting or if you would like to close your question?
Thank you,
Expert:  Dr. D. Love replied 3 years ago.
from JustAnswer.
It will help if you could provide some further information.
What medicines have been tried to help with these symptoms including the medicine bladder and any other medicines?
Have you been placed on any medicines ?
Expert:  Dr. D. Love replied 3 years ago.
I have not heard back from my request information, and I realize that it was over a day before the moderator placed the question in the general Medical category.

I am about to leave the computer hours, so wanted to provide what information that I could in response to your question, and then can provide more information later if it would be helpful.

You have had an excellent evaluation symptoms. The primary concern at this point would be a non-infectious form of chronic prostatitis, or increasingly being called chronic pelvic pain syndrome (CPPS). It is not entirely clear what is the underlying cause of this disease. The symptoms are similar to a chronic bacterial prostatitis, so has long been also called a chronic prostatitis, but there does not appear to be any improvement with antibiotics or medicines to relieve inflammation.

One of the theories of the underlying cause of CPPS is irritation of the nerves that serve the prostate and pelvis, and there is some evidence that medicines that relieve nerve mediated pain elsewhere in the body may also help with CPPS. The most commonly used medicines are certain anticonvulsants and antidepressants, which is why I have asked about whether any antidepressants have been used. If there has not been any use of these medicines, that would be the next consideration with the symptoms that you describe.

If I can provide any further information, please let me know.
Customer: replied 3 years ago.

Thank you back to me.

I've tried vesicare, ditropan and myrbetriq. I've never been placed on any medication .

I should also add, that the only time when my symptoms did ease was when I had a throat infection and was taking penicillin and acyclovir.


Expert:  Dr. D. Love replied 3 years ago.
If there is transient easing of symptoms while taking antibiotics, that would raise the possibility of whether this is a chronic bacterial prostatitis. The evaluation that you have had would typically have detected a chronic bacterial prostatitis, but it is possible that it may be a low level infection that was missed by the evaluation.

The penicillin is not a good antibiotic prostatitis, but it may be sufficient to partially suppress the bacteria that are present without clearing the bacteria, so that the bacteria can grow again once the antibiotic course is completed.

Sometimes, if it is unclear whether there is a chronic bacterial prostatitis, the doctor will choose to provide a 30 day course of an antibiotic that is good prostate infection, such as Bactrim or Cipro. There are also some men that need a longer course of 12 weeks.

non-infectious chronic prostatitis, it would be appropriate to consider an anticonvulsant, such as gabapentin or pregabalin, or an antidepressant, such as amitriptyline. Another commonly used medicine are alpha-blockers, which can help ease secondary spasm associated with a variety of prostate conditions.