Urination Problems - Male

Is this your symptom?

  • Male
  • Pain or burning when passing urine
  • Problems include urgency (can't wait), frequency (passing small amounts), hesitancy (waiting for urine flow to start), nocturia (waking at night to pass urine) or straining (hard to pass urine)
  • Cloudy or smelly urine
  • Not cause by a genital injury

Causes of Urinary Symptoms

  • Urinary Tract Infections(bladder or kidney) are possible at any age, but are more common in men older than 50 years. They can be diagnosed by checking a urine sample. Symptoms are pain in the lower part of the abdomen (tummy), pain or burning feeling when you pass urine, needing to pass urine more often than usual, or a feeling you need to pass urine urgently. Incontinence may result. The urine can look cloudy or have blood in it. Certain health problems can make infection more likely. These are enlarged prostate, kidney or bladder stones, having a urinary catheter, or a weakened immune system (from cancer treatment or diabetes).
  • Enlarged Prostate. The prostate is a gland that sits just under the bladder and is wrapped around the urethra (the tube that takes the urine from the bladder through the penis to the outside of the body). The prostate slowly gets larger with age. This narrows the urethra, causing less flow of urine out of the bladder. The prostate can also be enlarged from infection, inflammation (prostatitis) or cancer. Common symptoms are poor urine flow, slow start of urine flow (hesitancy), dribbling towards the end of passing urine and feeling as though have not emptied your bladder fully. You might also need to pass urine often or during the night. It can cause overflow incontinence. Symptoms may be mild at first and get worse over a number of years.
  • Acute Prostatitis is an infection of the prostate gland by bacteria, often that come from contact with stools. Symptoms include pain at the base of the penis and around the rectum. The pain may spread to the lower back, testicles and penis. A bladder infection often occurs at the same time. Fever and a small amount of discharge from the penis may occur. You can get acute prostatitis after prostate surgery or catheter use. It is not an STI (sexually transmitted infection). Antibiotics are used to treat it.
  • Chronic Prostatitis is long-term inflammation of the prostate gland. It may or may not be caused by infection. Symptoms may come and go. They are similar, but less severe, than those from acute prostatitis. You may feel ill and have aches and pains. Urinary infection may also be present. Treatment is with antibiotics. There may be mild ongoing symptoms such as frequent or urgent need to pass urine and problems getting an erection. Ejaculation may be painful. Your doctor may refer you to a urologist for tests to find the cause and decide on treatment options.
  • Overactive Bladder is when the muscles in the wall of the bladder suddenly squeeze the bladder and you have to pass urine right away. You may get this urge day or night and it can happen often. It can also cause painful urination. Your doctor can run tests to see if you have this.
  • Genital Infections such as genital herpes cause blisters and sores on the genital area. These raw areas are painful; even more so when urine comes into contact with them.
  • Interstitial Cystitis / Painful Bladder Syndrome. There is recurrent or constant pain in the bladder area which gets worse as the bladder fills. There is also frequency of passing urine and a need to get up to urinate during the night. The cause is unknown. Infection needs to be ruled out first, before the diagnosis can be made.
  • Sexually Transmitted Infections.
  • Bladder Outlet Obstruction Syndrome is when the exit route from the bladder is blocked and the bladder has to work hard to push the urine out. This can cause pain when trying to pass urine. The blockage could be from inside the bladder (stones) or from an enlarged prostate. Tests are needed to tell if this is the cause of your pain.
  • Urethritis. The urethra is the tube which carries the urine from the bladder, through the penis, to be passed from the body. Inflammation can be from a sexually transmitted infection. Symptoms may include a discharge from the end of the penis, pain or burning when passing urine, soreness or irritation inside the penis, or a feeling of wanting to pass urine often. Some men do not have any symptoms. If bacteria is present, the infection can be spread to a partner unless treated. Chlamydia infection only causes symptoms in about 50% of men, but can cause serious problems for their female partners. It is important to get tested and treated. If you think you have urethritis, do not have sex (vaginal, oral or anal sex) until you have been treated. Tell your sexual partner(s) to get a test as well.
  • Urethral Stricture is narrowing of the urethra, usually due to scarring. It can result from damage from injury or infection. Sometimes the stricture can be congenital or due to cancer. Symptoms often get worse with time, such as reduced urine flow and straining to pass urine, painful urination, urine sprays or a double stream, or dribbling at the end of passing urine. There may be a urinary infection. There may be a reduced force of ejaculation. See your doctor, who will check for infection and refer you for more tests, if needed.
  • Diabetes. If diabetes is not well controlled, high sugar levels in the blood may make you pass urine more often. It is important to see your doctor to get your blood and urine tested. Urinary infection is also more common with diabetes.
  • Bladder Stones or Kidney Stones can cause blood in the urine and severe pain when passing urine. This may feel like passing gravel. The stones can also block the bladder outlet, so you can’t pass, or have to strain to pass urine.
  • Bladder Cancer. Symptoms include blood in the urine, but it is not usually painful to pass urine. In most cases, the cancer only affects the lining of the bladder and can be removed. If treated early, this may cure the cancer completely. Do not ignore bladder symptoms. Seek care from your doctor.
  • Prostate Cancer is one of the most common causes of cancer in men older than 65 years of age. It is a slow growing cancer. It may or may not cause symptoms or need treatment. It does not always reduce life expectancy. Risk increases with age and with a family history of prostate cancer before age 60. Symptoms, if present, are similar to those of an enlarged prostate. Other symptoms may occur, such as pain at the base of the penis or passing blood. Prostate cancer can spread to the bones (spine, hips and pelvis) and cause bones to be painful. Your doctor will do a prostate exam and blood tests. Scans and biopsies may be done. Treatment options depend on symptoms and the stage the cancer has reached.
  • Neurological Conditions are problems with the nerves that affect how the bladder works. Multiple sclerosis (MS), congenital spinal conditions or injury to the spine can damage the nerves to the bladder. They can make it hard to pass urine or cause incontinence.
  • Medication. Some meds can cause urinary symptoms. Antidepressants (such as amitriptyline) can make it difficult to pass urine. Diuretics and lithium can make you pass urine more frequently or make you feel you need to.

When to Call for Urination Problems - Male

When to Call for Urination Problems - Male

Call 911 Now

  • Not moving or too weak to stand
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Severe pain when passing urine
  • Fever or chills are present
  • Stomach, side or back pain
  • Pain or swelling in the scrotum
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Blood in urine
  • You have a weak immune system. Examples are diabetes, sickle cell disease, HIV, cancer, organ transplant, taking oral steroids, kidney problems.
  • Blisters or sores in the genital area
  • Discharge from your penis that is not normal
  • You think you might have an STI (sexually transmitted infection)
  • Urinary symptoms, but none of the symptoms above
  • You have recurrent or ongoing symptoms
  • You think you need to be seen, but the problem is not urgent

Call 911 Now

  • Not moving or too weak to stand
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Severe pain when passing urine
  • Fever or chills are present
  • Stomach, side or back pain
  • Pain or swelling in the scrotum
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Blood in urine
  • You have a weak immune system. Examples are diabetes, sickle cell disease, HIV, cancer, organ transplant, taking oral steroids, kidney problems.
  • Blisters or sores in the genital area
  • Discharge from your penis that is not normal
  • You think you might have an STI (sexually transmitted infection)
  • Urinary symptoms, but none of the symptoms above
  • You have recurrent or ongoing symptoms
  • You think you need to be seen, but the problem is not urgent

Care Advice for Urinary Problems

  1. What You Should Know:
    • Urinary symptoms are common in men after the age of 65. The most common causes are
      • Enlarged prostate
      • Overactive bladder
      • Bladder infection
    • Bladder infection can occur at any age, but is more common in men 50 years or older. A urine test will help rule this out.
    • Here is some care advice that should help, until you talk with your doctor.
  2. Fluids:
    • Drink extra fluids if urination is painful. This will dilute the urine so it does not sting.
    • Avoid or reduce how much alcohol, caffeine and soda you drink. They can make symptoms worse.
  3. Quit Smoking:
    • Nicotine irritates the bladder. Stopping smoking may lessen your symptoms.
  4. Hesitancy:
    • Try to relax when standing to pass urine.
  5. Pain Medicine.
    • To help with the pain, take an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil). Ibuprofen workswell for this type of pain.
    • Use as needed, but do not take more than the maximum recommended dosage as stated on the package.
    • If you are not sure what to take, ask a pharmacist.
  6. Return to Work and Other Activities:
    • Bladder infections can't be spread to others.
    • You do not need to miss any work or avoid activities, unless you are feeling ill. Or unless your workplace limits how often you use the restroom.
    • Horseback riding and cycling can be a cause of painful urination due to trauma to the genital area. If this is the case, you may want to take a break from those activities until symptoms have cleared.
  7. Call Your Doctor If:
    • Pain becomes severe
    • Fever occurs
    • You think you need to be seen
    • Your symptoms get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023 Schmitt Decision Logic LLC.

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