Dear Ask The Doctor: I have some difficulty urinating, as sometimes my urine comes out too slow, it doesn't come out in a normal stream and it stops abruptly,it dribbles,i cant control my bladder properly as sometimes i'll feel very uncomfortable then i know i probably need to void but i wont get any sensation till about 10-15 mins later.when im in certain posture then i'll suddenly get an urge,the urge is usually very strong but sometimes if i go to pass must wait a little,i tried sitting and urinating it helps a bit but i must sit upright. No leakage of urine though. I also am always constipated passing dry and hard stools for about 3 years and have excessive gas. Noticed since problem became worst always defecate first before i pee when i need to defecate. When the constipation is for long then the urine dribbles more and the urinary symptoms are worse. I have been for numerous tests last year and this year as well. The mcug had to be repeated as the radiologist struggled to get into bladder, only during the second appointment after struggling did he get in the bladder and apparently everything was ok, but later went for an ultrasound on entire tract and thereafter drinking alot of water about 1 litre there was residual urine left and i had to go every .15-30 mins about 5 times thereafter but my kidneys were ok.normally now i go every 2-3 hrs and sometimes i cant feel the urge and become uncomfortable especially when constipated. The urinalysis and bloods were fine but before the urinalysis had 2 uti and was put on augmentin. The doctor did a rectal exam and my prostate was ok. The urologist then told me that it was all in my head and told me to see a shrink. My lower back also feels numb and my bladder area feels heavy sometimes,sometimes i also feel nauseous,perineum gets numb. I am 22 years old and very worried.could it be the constipation causing this or is it something else please help.
Dear Patient: There is a known correlation between UTI and constipation. Constipation can dilate the rectum (which is located just behind the bladder) and can cause voiding dysfunction; when this happens, urine backflows from the urethra to the bladder causing UTI. It is also alarming that your perineum is numb. However, try avoiding constipation first before concluding something is wrong. Increase fiber in your diet, eat more of fruits and vegetables and drink lots of fluids. This should make your stools softer and will relieve the constipation. If you will still be having all of these symptoms even after doing this, then you should see your doctor again. All of your tests turned out normal; it is very unlikely you have a structural abnormality on your urinary tract. Like I said, before thinking of other things, try treating or do remedies for the conditions you are certain of having, which is the constipation. I do hope I have appeased your concern and take care always.