Posted here before but have a few diff questions. OK so i had a urologist appointment recently. I do have a tight foreskin and havent been able to retract ever so its not acquired. Anyhow, ive had betamethasone cream before and it didnt seem to work by "thinning" my skin out. Recently ive been having a issue with my bladder/prostate (i think) not too sure. From what ive gathered its not a STD and my urine came out with no infection (Except for it being cloudy on 3 urinalysis). In my opinion i thought it has been prostatitis however i dont know how i would get such a ailment. Currently ive been on doxycycline for 7 days and as of right now my urine flow has been frequent but hasnt been as blocked as before i started the antibiotics. I got the antibiotics from my GP and got referred to a urologist for a consultation (2nd urologist ive seen). Fast forward to the other day and my appointment. I went in and told the urologist what i was feeling as far as delayed start of urine and frequent urge to urinate. He said it was not normal for a young man (im 22) to have such issues and that he wanted to do a cystoscopy and set me up for an appointment. And as far as the phimosis he didnt seem as concerned he said since its not ballooning or he didnt see any scars that my urine problem was much more important. I dont really want to do a cystoscopy because i just dont like that idea of it especially with my phimosis condition (even though the urologist assures me that it doesnt make much difference and didnt seem concerned ). He believes i may have a stricture and wants to double check. Are my worries a bit over exaggerated? I would hate to have this procedure done and everything be normal and it cause a infection from the procedure itself.
Your tight foreskin and the urination problem are unrelated, and the doctor isn't concerned about the foreskin. Just be sure he understands your desire not to be circumcised.
Sterile procedures are used to do such exams, so it's unlikely you'll catch anything. If you do, you can be treated. It's really critical that the cause of your problem is discovered and treated. If it isn't treated, you could experience some life threatening problems.
If the urologist is not concerned about phimosis, that is clearly a good sign - it is quite incidental to your current symptoms and something to be dealt with by patient and careful stretching. You don't expect to see "skin thinning" from use of the steroid (preferably, ointment), you just expect it to make the stretching somewhat more effective. Point is, the stretching is the critical aspect, either you do the stretching and get somewhere, or else steroid application alone will do absolutely nothing.
There are a few possibilities that come to mind regarding poor voiding including a stricture and some form of "urethral valves". Cystoscopy - nowadays flexible cystoscopy just as often performed in the doctor's rooms using a local anaesthetic (combined with lubricant) squirted back into the urethra in advance - is appropriate to check it out.
Mind you, simple flow studies (measuring how fast and how much you pee) and assessment of your bladder volume before and after voiding using an ultrasound device that the urologist would already have in the office, would be the earlier step in assessing this problem - I would be surprised if he had not done this already and given you an assessment based on this.
There is some small risk of infection from a procedure - even inserting a catheter carries some risk although minimal if it is simply "in and out"; many people (including both sexes) have to do this for themselves a number of times a day and manage quite well. And urine infections in the absence of significant structural problems, are simply treated with antibiotic, part of the doctor's management and follow-up.
Actual prostatitis - if it were that - is a nasty condition which responds rather slowly to treatment over a period of weeks.
Anonymous (no login)
Outlook not so good
February 1 2012, 10:54 PM
dont really know how i would acquire a stricture, accept from maybe prostatitis that only would be caused by stress or anxiety since i dont have an STD. Unless yeast or smegma that got inside my urethra could have been the cause. Basically its not very helpful that im having the urination issues in combination with the phimosis. If he does discover something then the chance of me keeping my FS doesnt seem very likely doesnt really leave much room to correct a stricture. After reading what they do to correct it it just seems so horrid. I dont really know why or how i got a stricture but its basically the worst thing i could be dealing with. I pray its not anything though because i just ended a 7 day antibiotic course and from what ive read that might be long enough. But who really knows.
Anything he does will be done through the urethra. If you are peeing, he has room for whatever he uses.
Anonymous (no login)
in addition to my other response
February 1 2012, 11:39 PM
I researched and found that prostatitis can be caused by yeast and or stress as well. I had cloudy urine several times and for the past couple days havent. I think it may be due to the antibiotic. But now that im out im not too sure what i should do. Im not sure even if i get more if it will go away for good.
The suggestion of prostatitis being "caused" by stress or anxiety is quite absurd.
Yeast is somewhat plausible. Generally speaking, the prostate is reasonably isolated from the outside by a good eight to ten inches; bacteria (or in fact, viruses) would have to travel that distance against the urine stream - the same as they would have to do to cause a bladder/ urinary tract infection. The STDs do this stepwise, that is to say, they infect the urethra itself (and more correctly, all the glands which line the urethra and are responsible for the production of pre-ejaculate or "pre-come") and simply infect progressively further and further inward until they reach and include the prostate. It is possible that other, non-sexually-transmitted agents do this, but just what these are and from where they come is very poorly understood and they are proving difficult to identify, which is why things are blamed on such implausible things as "stress". On the other hand, having any genital or urinary infection certainly results in stress!
As Jim explains, your foreskin has nothing to do with this or anything that the doctor might need to do. Your doctor seems almost unusually competent in advising you of this, but it is still wise to beware of any possible suggestion otherwise; the fact that you find any such suggestions on websites merely indicates that they are not authoritative, and as I had to suggest to a lady today who had been reading all the horror blogs about the Implanon implant which she has, that she really should not look on the Internet because the majority of such "information" is total nonsense written by people with cognitive and psychological disturbances.
The summary is - urine comes out and no problems at that point (that is, the foreskin), so there is no problem with passing an instrument back the same way. If there is a stricture, then it will need to be dilated (or much less likely, incised) and it will be. To a certain extend this might also dilate the phimosis but in fact, any stricture within the urethra will be much tighter than the foreskin (you already pointed out there is no ballooning and such, no restriction at the foreskin) so this will be a trivial effect on the foreskin. Mind you, the instruments used to dilate a stricture, or actually, much larger gauges of the same, would be particularly useful in stretching the foreskin.
Anonymous (no login)
February 5 2012, 1:00 AM
Thanks I know it's improbable but felt it would be ironic for something to happen because of the procedure. As far as the prostatitis, the only other thing I can recall is a bit of smegma getting inside my pee hole while I was attempting to clean around it. This was about a week or 2 prior to the onset of symptoms. I never had a fever or pain in the perineum and the urinalysis showed no infection just cloudy and remember seeing the ph was 7
You mentioned "clouding" of the urine. Urine is frequently "supersaturated" with the various salts it contains, all the more likely if you are not drinking enough (water) to keep it dilute and especially in the hot weather. In your bladder it is of course, at body temperature, which is actually quite warm as you will notice if you pee on your hand in the shower - quite similar in temperature or even warmer than the water in which you shower.
If you pee into a container, it begins to cool fairly rapidly, and is no longer hot enough to keep all the dissolved material in solution. Some material may already have started to precipitate and make it cloudy, and as it cools, this rapidly progresses and it becomes more and more cloudy.
This is a normal phenomenon. It does however mean that normal function depends on the urine continuing to pass promptly from the kidneys to the bladder because if it is held up at any point for a significant time, the precipitating material can fail to pass through and become caught, forming a seed for further precipitation and the development of a stone. In the bladder, this is usually not so much of a problem, as voiding is generally sufficiently vigorous to eject any small particles.
Smegma will not get (anywhere near) far enough into your urethra to cause any problems.
Anonymous (no login)
Re: Oh yes,
February 7 2012, 1:27 AM
i just am trying to prevent such a thing as a stone forming. Ive read that some of it has to do with hydration. But as you mention on your last post you say that if it stays for a long amount of time it may crystalize. Is there any way to know if its doing that, or is it from constant super saturation. I feel as if my urine is potentially stone forming at times. But have no way of telling. Any bit of info on what you were referring to on your previous post "prompt moving from kidneys to bladder" i would be interested in reading.
Textbook stuff. There are generally three aspects to this. One is that it is dependent on the concentration of solutes; it is always the case that the excretion of these is relatively constant, dependent on the amount that is excreted which is fairly well defined by their production in the body plus intake, so the more water in which these are dissolved, the less likely they are to precipitate. Drink two litres of water a day is a good rule of thumb. But not much more than three except in hot weather.
The second factor is the presence of particles on which the stones can form. Bacteria are such particles, so infection and stones are inter-related. Women, having a much shorter urethra, are more at risk of infection.
The third factor, is a structural anomaly which slows the passage of urine through the kidneys and ureters (or indeed, blocks the bladder). This can be congenital (present at birth) such as kinking, narrowing or blind passages (diverticulae) or due to injury (even surgical), pregnancy or a tumour.
That's basically it. You cannot readily predict the third (or feel a "potential" for a stone), there are aspects of avoiding infection, but you can drink a generous amount of water and avoid too much spinach and rhubarb (oxalic acid).
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