Prostate problems ???

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For over a few years now i have had difficulty starting to pee, stream/flow very week, only pass urine in small quantity, sometimes stop peeing after just 4-5 seconds. Late last year things were getting worse, i finally plucked up the courage to ring my drs, sadly i couldnt get a face-to face appointment, i asked if it could be due to enlarged prostate and asked if they could arrange for me to have a blood test for prostate cancer. Done the blood test which came back clear, the gp who wasnt my regular gp, said she would follow up after she received the result, she never did.

I just left things again, in November last year i was rushed in to hospital, it was decided i needed a operation, a bullectomy. Whilst i was in the hospital waiting for the op i found i could no longer pee at all, my bladder was said to have been like a 6mth pregnant woman because of the retention.

I came home in the december, i was tried a couple of times without the catheter they fitted, both times i still couldnt pee and i was sent home with the catheter in situ.

So after 9mths with a catheter, and severe pain in my penis for at least 2mths, i finally had a urology appointment this week for a trial without catheter.

When my bladder was scanned they said it was empty, which i was fairly suprised about as during the 6hrs without the catheter i was struggling to pass urine, i was passing only a little each time i had the urge to go. I was sent home without the catheter, which in a way i was glad about, the nurse said to me that the continuous pain i was having was probably due to bladder spasms.

Im still like i previously was before i went in to hospital. Hard to start to pee, peeing for around 4-5 seconds each time and then it is only trickling out very slowly, sometimes leaking a bit before i get to the toilet, i can stand at the toilet for a good minute or more before i pass anything, its also a bit painful before i pass anything.

I did have my prostate examined in urology, must have been ok because the consultant didnt have any comment to make.

Think im going to have to contact my gp again, but i feel it will be a waste of time,and i dont really get on too well with him and you dont get the option to see any other gp unless your own just happens to be away that particular day.

Im 62 years old at the end of the year, any idea what you think could be going on?

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    how was your prostate examined? if it was a digital rectal exam, that can give clues but isn't 100% a guarantee the doctor can get it right. one doc from stanford told me it was 30cc and normal and MRI and TRUS confirmed I had a 75cc large prostate. he/she would be checking for nodules and pliability, and size, but ultimately they cannot know how obstructed you may be on the inside walls (urethral) without a cystoscopy. have you had that done?

    regardless, i did have some obstruction but much of what you describe could also be chronic pelvic pain syndrome (or prostatitis type III - non bacterial based unlike type I or type II where UTI's and cultures identify a microbe). while this is generally seen in younger males vs mid to older males, it's not impossible. CPPS is essentially pelvic floor dysfunction and a pelvic floor physical therapist can do an internal check through the rectum to see if you have trigger points in the muscle bed down there. i was like you not having normal sized voids for 3-4 years and frequency slowly getting worse. really didn't feel uncomfortable but I had coincident slow bowel motility / constipation and that could make things uncomfortable. I stopped drinking much water unconsciously to stay comfortable. I didn't see a PT during that time until I got a constant urge to pee and flare-up that took things to the next level. I was almost in retention during this flareup. the PT I believe helped relax muscles that from sitting, stress and anxiety had likely been tight for many years and worsened during the flareup. The PT took my pee volumes up higher (not to fully optimal but better). frequency was still an issue and of course the urologists decided operating on my enlarged prostate would possibly help with that. it hasn't solved the entire problem so I likely have some pelvic floor dysfunction still there. Or it's OAB (overactive bladder) but now with no obstruction.

    You could have OAB with obstruction. to treat the OAB, they'd need to treat the obstruction first. but hopefully you don't have obstruction from an enlarged prostate. I'd recommend a cystoscopy, a TRUS to get a better measurement of your prostate, a PSA that measures general inflammation, and perhaps a urocuff (less invasive) urodynamics test. I wouldn't go so far as the invasive urodynamics test where they pump water into your bladder.

    either way, for both of those scenarios (young people or older), uros start with flomax and possibly 5mg of cialis to see if it helps you. given your age you should get a full workup on your prostate.

    Lastly, I know I didn't get an STI bug over the years but I recommend you do a NAAT test for ureaplasma (which includes mycoplasma). many people live with these bacteria with no cell walls for years like HPV without issue until something in their immune system changes and it colonizes (the ureaplasma mostly). many younger people on reddit present symptoms like you do as well with lingering frequency due to ureaplasma. there doesn't have to be discharge or burning. Quest and Lab Corp have good tests for those and you would give a urine sample first thing in the morning. Because of your age and likely stability in life, most doctors would not pursue this path much and default to your prostate size and pelvic floor condition first but I'd pursue all avenues.

    Best of luck in getting your urinary tract cleaned up and improved. The pelvic floor will help undo years of issues/damage.

    the bullectomy probably caused systemic inflammation and further obstructed you to cause the retention by the way. that would be my hypothesis. you might want to try a week of tapered predisnone too to see if things improve with that.

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