September 22, 2018

Ask The Doctor > Questions & Answers > Ok I have been going to a urologist for a

Ok I have been going to a urologist for a

Patient: Ok I have been going to a urologist for a while now. I’m in my 30’s and this NEVER had ever happened before 27ish when I bought a fleshlight, that I stopped using due to lower ab pain, testical pain, also seemed to “pull me out”, and the hole for urine/ejaculation started just being open like someone who dropped their jaw. I’ve had an ultra sound of my testies and I have some vericose veins but nothing else checked as abnormal. During masterbation as orgasm comes my testicals both slide to the side and above my penis. I have a few questions I would like to ask as my next apt is forever away. I have incontinence issues for both urinary and fecal for at least 1 week after masterbating sometimes up to a month. Constant “dripple” “seepage” and sometimes intense urges to go. A few things I have noticed is my penis seen to be larger both erect and flacid (Im all for that) but it also never seems to contract all the way like it once did any more. And there seems to be irritation to the both the penis skin and anal sphincter everytime I please myself. The I guess duct for ejaculation can become insanely large bulging from the testies to the shaft a 1/4 inch off my body. And my right testicles seems to have become permanently 5x the sizes it once was. I’m not joking you can ask any girl who was with me previous to my desperation of loneliness from 22-27. Everyone made a remark on the small size of my testies, my left is still small. Sometimes very rarely noticed I have semen come at the end of the urination. Sometimes orgasms are painful in penis, abs, testies, and whatever is between testies and anus. Sometimes urination is painful in penis, abs, and testies. At 1 time the perenium felt so large that it seemed like that was what I was sitting on. My testies no longer hold tight to my body but hang as low or lower than the tip of my penis. Is it possible that I have damaged the deep fascia? It could explain the increase in size, the rips in the skin both front and back, along with swollen perenium, don’t know but seems reasonable that testies may pulled together here? I know if I could only communicate to correctly to my dr he could help but I fail everytime. I can’t even feel clean after a shower. Can’t work a job that isn’t from home, can’t hang out with friends, I even spent my sisters entire wedding in hiding. When I ask everyone says I don’t smell, but when I drop my pants the smell I thought was there is oh so present, or when I wipe there are clearly colors and foul odors. I dont even “pass gas”. In hindsight I would have been better off catching std’s (short of aids… maybe? I’m sorta already dead anyway) than getting a fleshlight. I goto a pelvic therapist and they had to “up” me someone who works with pressure points because I was too tense…. cuz having something up my butt is comforting or somethhing? It took 18 months of “down trainging” before I got my first exercises. I simply cannot wait another 18 months to be sort of in control, and another 18 to be mainly in control, and another 18 to be in control. Till that point, there is zero chance I will leave my home, and I’m not getting any younger, more attractive, or stable money wise. I need this rooted out, most days when I wake up I would prefer to go back to nightmares than live my life. If it can be called that. Does anyone have insight or perhaps suggestions of how to word things in a way that can help my dr help me? I would greatly like to see my friends again, well the ones who haven’t completely left behind thinking I don’t like them. Even know what it’s like to embraced by a women again. There must be something I’m missing, something I haven’t noticed, or words I haven’t used. Oh I’ve also noticed a “spray” not a stream alot during urination.



Symptoms: Incontinence, pain in abs, testicals, penis, frequently, sometimes during urination, numb penis, trouble having strong erection, general depression, and a non existent person to those I want to be around, and family.



Doctor: Hello,Thanks for the query to ATD for an opinion.It is evident from the history that you have been experiencing urinary incontinence and also experiencing night falls at night post night mares. There is a concern about your small testicles and also there is painful orgasm during masturbation with evidence of varicosities or dilated veins over your scrotum evident during erection.Firstly, urinary male incontinence can be very embarrassing at your age, it is generally seen in cases of recurrent urinary tract infection or detrusor instability. this can be confirmed with the help of URODYNAMIC studies which can easily differentiate between stress incontinence, over active bladder ( neurogenic) or genuine incontinence due to urethral sphincter instability. If sphincter is the cause then sphincteroplasty is the sole treatment post which you can be relieved completely else first UTI has to be treated and then you may have to be placed on bladder relaxants to allow decrease in symptoms, followed with behavioural exercises and Kegel’s exercises to tone the pelvic muscles.Secondly the concern regarding night falls is usually seen in men with low BMI and poor eating habits. it is important to take nutritious balance diet regularly and vitamin B complex caps twice a day for a month and then once a day for next 2 months, plenty of water during to day to maintain circulation and avoid stress in life both psychological, emotional and physical. Adoption of yoga and meditation can help in this regard.Thirdly presence of dilated veins or varicocele evident on scrotum may have to be operated to surgically remove them as they may land up being a cause of male infertility later.You may now discuss your options with your physician and take an informed decision.I hope I have answered your query in detail,Wishing you good health,Regards

Comments / Follow Ups

Patient: I think its possible I’ve someform of urodymanic studies, they stuck prob of some sort up my rectum and measure the strength of sphincter, they said I was spasming and strength was excellent but no endurance and no “relaxed” mode,and after a few visits they tried electro stimulation but it didn’t take but a few minutes for them to say it was making them worse and have me go to a women whoworks by feeling muscles and releaving pressure and tension. Giving stretches and meditation advise. It took me 18 months between the 2 before they started giving kegals (up training) as it was all “down training” to relax before then. From a quick google search there looks to be much more to it than just a probe to the rectum. Is this correct? I do have urine tests each visit to urologist but never has a uti come up in conversation. There is pain in the urethra during some esp frequent ejaculation and urine but not always. I was eating a more healthy diet but was put on adderall which has made me more aware of my body and can relax on command and went from 116 to 108 116-125 is what I have bounced between since 13, short of a 6000 cal diet in high school in attempt to play football where I reached 138. So now I start my day with a bcaa with a cla matrix, citraline malate, arginine and ornithine, 30 mins later almond milk with a 180 cals protein powder, and cla, a carb powder, frozen or fresh fruits, and heaping table spoon of coconut oil and sometimes a heaping spoon of natural almond butter. With slow release b vitamin and choline. Before bed same thing but ensure plus instead of almond milk, fruits, no carb powder, sometimes almond butter, sometimes coconut oil, sometimes benecalorie. I avoid vitamin c in the morning as it interferes with adderall digestion/absorbtion. Roughly 4000 cals a day with meals include. I have added steak to my diet since I’ve always preferred fish, chicken, and even more than those veggies and fruits. Fish oils with every meal and the bcaa’s roughly 2 hrs after each meal with arginine and ornithine. 1-2 snacks of almonds and fruit most days, but I’ve never enjoyed eating. No candies, as never have enjoyed candies. I am currently back up to 122.5 as 2 days ago, even at 5’7 that’s still skinny and lein. While I have put on weight I’m pretty sure my bodyfat has dropped from 12% to prob 6-8. I was 2.7 in highschool when I was 138lbs. It’s a very protein and fat heavy diet but I try to stay away from trans, and keep polysat to min. My water intake has improved but no fluids make me fearful that I’m just going to dripple it all out. No working out though, hand/wrist pain that no one has been able to find a cause short minor carpel tunnel and aggrivated tendon on the outside ball of ankle that was surgically repaired 15+ years ago… football… plus I’m not trying to burn any cals as it’s hard enough to intake enough even with my sedentary life and IT job. Both before and after going on adderal. But I do do yoga, but as an ex dancer I know that doing it in my house is not safe, the exact muscles and body alignment need to observed by a true professional but I can’t bring myself to punish someone else with my odor. I have cut caffeine short of occasional soda or green tea. My uro is not keen on the idea of removing the vericoles he said something about very delicate and easy procedure to mess up could leave impotent or sterile. Sadly but also good he is the #1 uro in my area with his med degree from baylor and opperates out of research hospital. Had 2 uros previous but after oxybutinin they were all out of ideas, but it’s usually 2-3 months wait for an apt.
In terms of fecal seepage it’s most noted after bowl movements, I may have nothing to wipe right after, but for the rest of the day I can go back and check and 9 of 10times there is something there. Much like urine, fully empty bladder has dribbles after and never stops. I have improved but am still always “moist” and the odor is always present to some degree, just don’t have streaks down my pants that I impart moisture and odor to chairs after sitting (as often). I will have to buy all new furniture provided I ever get over this. It is very embarrassing, and the faces people make…. disgust and disdain. Even in a yoga class the teacher was fine till I arrived then she was sort of “sniffing” taking large quick breaths via nose she suddenly had a “headached” and canceled class. Nothing was said of odor or me, but I’m 90% positive it was my odor. It almost hurts worse that no one will tell me, because it makes me feel like it’s all in my head but I know it’s not, they think they are sparing my feelings but they aren’t. I’m not depressed but i do feel helpless, sad, and a burden to anyone in my presence. Sometimes I lay in the fetal and cry a little because I do feel alone and almost helpless in many ways. I worry I can never have sex, be a intimate, or finish my computer science degree, which I am only 1 1/2 semester credits from but would have to be on campus to finish. Like I said it was several years before worked up the courage to goto dr and now it’s been 18 months with very minimal results. At this rate I’ll be sterile and have ed before I can so much go into public. I have schedule another apt with my pelvic therapist, and have a euro coming up and I will discuss your opinions.

Doctor: hello, please let me know what your therapist has to say.


Dr. Jimmy Obaji M.D.

Dr. Jimmy Obaji completed his residency in Family Medicine at the University of Manitoba. He currently operates a walk-in-clinic in downtown Toronto.

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