I EXPERIENCE OFF AND ON THE CONSTANT NEED TO URINATE. I ALSO EXPERIENCE A BURNING, PRICKLY SENSATION AT THE TIP OF MY PENIS. I HAVE NO DISCHARGE OR SWOLLEN TENDER LYMPH NODES. THE PAIN GOES AWAY WHEN I URINATE. SOMETIMES IT LAST A COUPLE OF MINUTES OR A COUPLE OF DAYS. I WOULD APPRECIATE ANY ADVICE YOU MIGHT HAVE. THANK YOU.
Dear Chris,
It would be very important to know your age and if your symptoms have been acute or chronic. These symptoms do not usually indicate penile cancer, but irritative voiding symptoms could be a symptom of a bladder lesion. However, my initial thought is to make sure you don’t have a bladder infection or a urinary stone. These diagnoses are common and could account for your symptoms.
Another thought is that you may have a condition known as interstitial cystitis(IC). This is a chronic inflammation of the bladder wall and unfortunately there is not a known cure. It is less common in males but can account for your frequent urination and pain. It differs from common cystitis(UTI) in that the later is caused by a bacterial infection which can be treated by bacterial antibiotic therapy. It is also important to note that IC is not a psychosomatic disorder nor is it caused by stress.
IC can affect people of any age, race or sex. It is, however, most commonly found in women. A 1987 epidemiological study estimated that 450,000 people may be affected by the disease. The symptoms include:
-Frequency-Day and/or night urination(up to 60 times a day in severe cases.) In early or very mild cases, frequency is sometimes the only symptom.
-Urgency-The sensation of having to urinate immediately may also be accompanied by pain, pressure or spasms.
-Pain-Can be in the abdominal, urethral,or vaginal area. Pain is also frequently associated with sexual intercourse.
-Other Disorders-Sometimes patients also report experiencing symptoms such as muscle and joint pain, migraines, allergic reactions, colon and stomach problems as well as the more common symptoms of IC described above.
Diagnosis is very difficult and must follow several steps:
1)Urine cultures must be negative
2)Rule out other associated disease, bladder cancer, stone disease, anatomic abnormalities
3)cystoscopy-routine cystoscopy in the clinic may not be sufficient to make a diagnosis of IC. It is usually necessary to distend the bladder under general anesthesia in order to see pinpoint hemorrhages on the bladder wall a hallmark of this disease. It may even be necessary for a biopsy to be taken at that time as well.
4)Diagnostic radiology-IVP,KUB
5)Urodynamics
Treatments
1)Bladder distention
2)Oral medication-anti-inflammatory drugs, antispasmotics, antihistamines and muscle relaxants.
3)Self Help- biofeedback
4)Elmiron-(Sodium Pentosanpolysulfate)
5)Anti-depressants
6)Diet
7)Tens Unit
8)Silver Nitrate
9)Clorpactin WCS-90
10)Self Help- biofeedback
11)Surgery
It is always difficult to make suggestions without examining the patient, thus I would suggest that you see a urologist if your symptoms persist. He or she can perform a physical and get your full history. If you do have significant symptoms, all or a portion of the above work-up for IC could be performed.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword: Dysfunctional Voiding
