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Forum Name: Urology Topics

Question: Frequent + Difficult Nocturnal Urination with Abdominal Pain


 sugarbear - Thu Jan 25, 2007 5:47 pm

Hi,

I have had a desperate condition for the last 4 years and urologist is baffled. I am 40, male. My history is below. Here are my symptoms:
- I need to urinate approximately every 2 hours during the night. Daytime urination is somewhat normal.
- Whenever I urinate at night it is extremely difficult and I produce very little urine.
- I have a mild abdominal pain half way between my belly button and my penis (not sure of the organ)
- I often awake up with an erection (multiple times each night)
- After ejaculation, the symptoms seem to be ‘aggravated’ for about 4 days (especially the pain)

Some of my history as follows:
- I am very healthy, don’t smoke or drink, exercise regularly
- I have had a Cystoscopy that was normal excepting my bladder wall had “a lot of veins”
- My PSA is normal but have a larger than normal prostrate (but not large enough to explain these symptoms)
- I had various internal muscles “Botoxed” (i.e. take them out of commission) to see if they were responsible but no luck
- I have been encouraged to try various drugs to see their effect (Ditropan XL, Vesicare, Enabelex, Flowmax and the bed wetting drug kids use) with little effect
- I have tried not drinking before bed with little change


Needless to say, I am desperate and my quality of life is suffering significantly. Please help!

Humbly,

rob
 Dr. Safaa Mahmoud - Wed Jan 31, 2007 4:58 pm

User avatar Hello,

Can you please explain what did you mean by normal cystoscopy examination except for blood vessels (veins)?

For the urine analysis, was it clean or there was a microscopic hematuria? Did they repeat any of the investigations including the cystoscopy?

I need also to know if you have been checked by a neurologist. Some neurological problems present with similar conditions.

Keep us updated.
Best regards.
 sugarbear - Mon Feb 05, 2007 11:17 am

Hi Dr. Mahmound,

Thanks for your reply. Here are some answers to your questions:

1. Regards the cystoscopy, I do not have any more information other than a comment made by the urologist during the examination that it seemed to have "more blood vessles than usual".

2. Regards the urine analysis, it was clear.

3. Regards repeating the tests, the cystoscopy was not repeated but I have had a comprehensive flow analysis (fill my bladder and take photos with an xray machine) This did reveal a very weak flow. This was how they decided to botox certain muscles to see the effects to no avail.

4. I have been checked by a neurologist and have even had a full MRI/MRA of my spine, neck and head. All was clear.

It seems to me that this could be cone of the following 4 things. If you could help me think through which is the most likley and how to know for sure, I would greatly appreciate it. Here they are:

1. Flammatory CPPS - Chronic Pelvic Pain Syndrome (was called non-bacterial prostatodynia and Non-bacterial Prostatitis )

2. Chronic Bacterial Prostatitis

3. Interstitial cystitis (Painful bladder syndrome)

4. Benign prostatic hyperplasia


Thanks,

rob

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