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Forum Name: Urology Topics

Question: Pain at entrance to urethra!


 irishmrman - Mon Jun 21, 2010 7:04 pm

A few months ago I was treated for a UTI. I awoke up one morning & went to the toilet while urinating I sneezed while in full flow, straight after this i received a sharp pain on the tip of my penis and then started to bleed ,not much just a few drops each time & when i finished urinating for approx 4 times after this. I went & seen my doctor, he treated me for a UTI it cleared up after approx 1 week. Just the other night while I was out socialising I was in the toilet urinating I coughed & again I received a pain on the tip of my penis then started to bleed. I went to my doctors the next day with a urine sample he dipped/tested the sample it was clear no blood or protein. What was confusing as only a few hours before i went to see him I had visual blood in my urine not much but a drop after I urinated. This is making me think that it may not be a UTI. I find when I drink a lot of water I have no pain while urinating but when my urine is a dark yellow colour I have pain. The pain is on the entrance to my urethra (top of penis) What do you think this could be?
 Dr.M.Aroon kamath - Wed Jun 23, 2010 12:42 pm

User avatar Hi,
Pain at the tip of the penis(at the external urethral meatus) can be due to
- a local pathology (ex; urethral caruncle), or
- referred pain (esp from a pathology of the seminal vesicles).

Some of the possibilities are
- neoplasms of the urinary tract
- A-V malformations of the urinary tract,
- pelvic A-V malformations,
- urethral caruncles( only few reported cases in males),
- fibro-epithelial urethral polyps (mostly in males during the first decade of life) etc.

A-V malformations of the urinary tract can be aquired(more common) & congenital(rare). Congenital renal AVMs can result in significant bleeding.Congenital renal AVMs usually present in the 3rd or 4th decade of life.Women are affected more often as men(3:1).

Pelvic A-V malformations involving seminal vesicles have been reported.These also can present with severe urethral bleeding.

Urethral caruncles can present with pain in the distal urethra, prolapse of mucosa or occasionally bleeding.Very few cases have been reported in males.

In your case, it is better to exclude these possibilities - especially, the A-V malformations.
Best wishes!
 irishmrman - Wed Jun 23, 2010 3:35 pm

Thanks very much for your reply doctor!

As i said i was in with my doctor he did not seem to bothered as ther was no infection or blood in my urine at the time he dipped it what i found strange due to a few hours before having vissable blood dropes after urinating . He did say that if this happens again then i would need to be refeered to an urology doctor! it has been a week from this incident & i am 99.9%. I have very little pain now when passing urine. Can you recomend any home treatments or tips to stop this from happening again?

Thanks for your valuble time!

irishmrman
 Dr.M.Aroon kamath - Fri Jun 25, 2010 12:22 pm

User avatar Hi,
I am glad to learn that you are feeling better.However, i still urge you to consult a urologist. Using home-made remedies is not a safe option. Good luck!

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