Urine and Ejaculation Problems

[iceman46]

Hi,
Well I'm 46 yrs old in otherwise good health. I have had trouble and on off again bladder and prostate problems since I was a young guy about 19 yrs old. When I was in my early to mid 20's I saw drs and they diagnosed me having NSU and gave me antibiotics. Didn't help...

Finally got checked by a good Urologist and did a iodine test where they inject it and take x-rays to see how your kidneys and I think bladder are? Well everything appeared normal.

One urologist figured out I had a ureathral stricture and did an outpationt ureathral dialation, and afterward still no real improvement. Next he performed a ureathodomy cause I had some scar tissue.

That seemed to help for a little while and noticed that I was urinating better stronger stream and stronger ejaculation as it would actually squirt and felt good.

Over the last I guess 8 yrs I have been having some light trouble again not getting good strong streams when taking a pee, plus sometimes getting up middle of the night to urinate several times plus the old ejaculation troubles again.

Now over the course of the last several yrs I have been having a rather strange and embarrassing problem that has seemed to develop. Again when urinating I'm not getting a good strong stream and getting the start stop routine for one. Also either during intercourse or masterbation right up to when I'm about to ejaculate it all feels good then during ejaculation I feel like it is not able to really squirt out and then just dribles out never getting my strong contractions.

Basically feels like something blocking it from squirting out normally

Ok now here is the other problem dealing with my urinating and not going properly. I didn't realize at first I was wetting myself during sleep as it was tiny, but it' finally got to where I realize what is going on

I don't have insurance and can't begin to afford a battery of tests on this at this point and don't know what to do.
Could a prostate infection be causing this? or a combo of bladder and prostate infection be causing this?

[Dr Smitha Mathews]

Hi,

When did you have your last prostate exam?

A stricture could cause some of the symptoms you described, but not all of them.

Yes, a prostate enlargement can cause urge incontinence.

You will need to go in for a DRE of the prostate and also have your PSA levels checked.

Menawhile, do avoid prostate irritants such as citrus juices, caffeine, soda, and alcohol.

Regards

[iceman46]

Thank you for replying.
The problem also is everytime I ever had a regular prostate exam always turned up ok. So I am wondering if it could be the return of a stricture? Also would an enlarged prostate cause the accidental bed wetting in the middle of the night?

Thanks
Chris

[Dr Smitha Mathews]

Hi,

It appears that you have a prostate enlargement which is causing both the ejaculation and urinary problem.

Benign prostatic hypertrophy can appear in men around the age of 40, sometimes earlier, and manifests with poor stream during urination, starting and stopping, dribbling, spraying, and even incontinence in varying degrees.

A doctor can do a digital rectal examination to identify if the prostate is enlarged and will direct you regarding further tests.

However, management of BPH can be done with medications depending on the extent of the hypertrophy.

"adrenergic receptor antagonists) provide symptomatic relief of BPH symptoms. Available drugs include doxazosin, terazosin, alfuzosin and tamsulosin. Older drugs, phenoxybenzamine and prazosin are not recommended for treatment of BPH.[5] Alpha-blockers relax smooth muscle in the prostate and the bladder neck, and decrease the degree of blockage of urine flow. Alpha-blockers may cause ejaculation back into the bladder (retrograde ejaculation).

The 5α-reductase inhibitors (finasteride and dutasteride) are another treatment option. This medication inhibits 5a-reductase, which in turn inhibits production of DHT, a hormone responsible for enlarging the prostate. When used together with alpha blockers a reduction of BPH progression to acute urinary retention and surgery has been noted in patients with larger prostates"
en.wikipedia.org/wiki/Benign_prostatic_hyperplasia+BPH&hl

Do keep us posted on your doubts and progress
Regards