Painful urination with blood

Patient

Q: I am a 23 year old male. About a year ago I started to have painful urination. It progressed to me having blood in my urine. I went to my urologist and he said I had a UTI and gave me meds to take for the infection and pills that made my urine orange so it wouldn't hurt when I pee. The pain went away and everything was great. About a month later I was straining hard to urinate fast as I was late for a meeting and the pain came back and then the blood came back. Me being a stubborn human being I didn't see my doctor again and just dealt with the pain til it went away. This was on and off until recently i started having trouble emptying my entire blader, then the skin around the hole started to get dry and now harden, then skin inside the opening harden. I now have what I can only describe as what feels like a wire running unattached to my penis but parallel to it and into my groin. This "wire" is painful to the touch. I can literally grab it and lift it away from my penis, still under the skin of course, but it is tight and hard... thoughts please doc. I'm seeing my doctor ASAP but until I can get in I wanted some info : (

Symptoms:  Extremely painful urination, blood in the urine, dry skin around tip of penis.
Doctor

A:   Hello,
This seems to be urethritis and cystitis together where a primary bladder infection has spread to the urethra now causing severe burning and painful urination.
You need to visit physician sooner for a urine routine microscopy and culture again along with a urethral swab culture to identify the causative organism. Earlier you were possibly given nitrofurantoin which caused the orange color but this time a longer course may be warranted . Increase your water intake in the meantime and if there is still blood in urine at the end of urination , then a Cystoscopy examination may be warranted after ruling out and treating infection to look for any local causes inside the bladder as cause of bleeding..( possible bladder ulcerations).
I hope i have answered your query in detail,
wishing you good health,
regards

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