DR FLO: Why doesn’t my bladder empty completely?

Dr Flo, of late I have observed that I have a high frequency of urination and I am not able to hold the urine once I get the urge to empty my bladder Sometimes I urinate and some urine remains and I have to force it out. What’s the problem? Jus

Dear Jus,

Men have a small organ called the prostate that is situated just beneath the urinary bladder.

It surrounds the urethra as it comes out of the bladder. With age, the prostate enlarges in most men, and in some people, it causes problems with urinating because it squeezes the urethra. This is more common in men over 45.

There is no known cause of the enlargement, though it is more common in men who have testicular abnormalities or have close male relatives with prostate problems.

Symptoms of enlarged prostate include:

• Incomplete emptying of bladder
• Frequent urination even at night
• Weak stream and dribbling after urinating
• Leaking urine
• Needing to urinate urgently
• Having to force urine out
• Pain when passing urine
• Blood in urine

It is easier to get urinary tract infections when the flow is blocked. When the blockage is severe, urine accumulates in the bladder then flows back to the kidneys and can even lead to kidney failure.

It would be advisable to visit a urologist for examination and tests like urine test, prostate specific antigen (PSA), ultrasounds, x-ray and/or CT scan, prostate biopsy and cystoscopy.

Some medications like anti-depressants, sedatives and antihistamines may affect your urinary system, and the doctor will adjust them. Treatment includes medication or surgery, depending on severity.

At home, urinate as soon as you feel the urge. You can have timed bathroom breaks, even if you don’t feel like emptying your bladder at the time.

Avoid alcohol and caffeine, keep warm, relax, and exercise, and do Kegel exercises.

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Dr Flo, when I have intercourse with my girlfriend, there is a lot of a cloudy milky fluid on my penis that smells really bad. It disgusts me so much, that nowadays I am not interested in intercourse. The worst thing is that when I tried to initiate a discussion with my girlfriend about it, she didn’t care. Please advise me on what to do. Concerned

Dear Concerned,

Men produce two to five mililitres of semen or seminal fluid which is usually white or grey in colour.

It contains spermatozoa (one per cent) and other components (99 per cent) that help with the nutrition and function of the sperms. Most of these are alkaline, making semen smell like bleach, ammonia or chlorine. The smell changes when semen interacts with vaginal fluid, which is acidic. The smell can also change depending on the kinds of foods or drinks you eat e.g. meat, garlic, asparagus, caffeine or alcohol.

If you have an infection, you will have a lot of foul-smelling discharge. See a doctor who will examine you and take a urine sample for analysis and culture. If an infection is found, you will be given antibiotics to treat it.

Abstain from sexual intercourse until you have completed treatment, and you have been retested and found to be cured. Any partners you have had in the past three to six months also need to be treated, for their own health’s sake, and to prevent re-infecting you.

***

Dr Flo, I had a pimple on my chest and I pressed it to remove pus, but it reappeared later. Several years later, the spot where the pimple was doesn’t have pus, but it gets itchy especially when it is hot. The swelling also itches at night and has grown bigger. My late dad had a similar but bigger thing across his chest, but he never talked about it. I also have several small swellings on my back which sometimes itch. What could this be? Rashid

Dear Rashid,

You may have keloids, which are an overgrowth of scar tissue.

When there is an injury or infection on the skin, scar tissue forms to protect the area and help with healing. A keloid may be reddish or brown in colour, it may be itchy, and it may grow over time. You can have keloids forming where there is a rash, cut, burn or even an injection site. You are more likely to develop keloids if one or both of your parents have it.

Keloids are usually not dangerous. If the growth continues or if you want it removed, visit a skin specialist (dermatologist). After examination, a test may be done to check for other diseases. Treatment may involve steroids, cryotherapy, and laser or radiation treatments.

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