Why is my urine abnormal?

Dr Flo, whenever I urinate the last drops of my urine are thick like semen. Sometimes a very white and thick substance comes out, sometimes in form of small colourless pellets. At times I feel discomfort along my urethral duct forcing me to visit the toilet for short calls frequently. I have been to hospitals, samples of my urine have been taken and analysed by several laboratories, but to my dismay none of them found the underlying problem.  What am I suffering from? Leonard

Dear Leonard,
Your symptoms suggest you have an ongoing infection. It may be chlamydia, trichomonas infection, or another type of bacterial infection.

It may also be due to gonorrhoea infection. Most likely, you acquired the infection through sex from any partner you have had in the past three to six months.

If not treated, the symptoms may actually reduce with time, though the infection is still present. The danger with this is that the infection can spread to the testicles and the rest of the reproductive tract and in the long run, can lead to infertility.

The infection can also spread to the rest of the body, causing serious illness. Any time you have unprotected intercourse, you can spread the infection to your partner. In women, this can lead to infection in the reproductive tract and pelvic organs, and fertility problems.

Less common causes of these symptoms include kidney stones, bladder stones, prostatitis (inflammation of the prostrate), and very rarely, bladder cancer.

Since you have been tested several times without getting a diagnosis, it would be advisable to see a urologist. You need to have a sample of the urine and the discharge taken for analysis and culture in a good laboratory.

You also need a chlamydia test, since many times it is not easily diagnosed using the regular urine tests. It is also advisable for you to have a HIV test.

You will be given antibiotics to treat the infection, depending on the results. 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 tested and treated, for their own health’s sake, and to prevent re-infecting you.

If there is no infection found, you may benefit from a kidney/ureter/bladder scan and a prostrate examination. The treatment will depend on the diagnosis made.

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Dr Flo, I was diagnosed and treated for a urinary tract infection last year. After treatment the doctor told me the infection had cleared. However, I was left with some pain on the left side of my lower abdomen. What might be the problem? Andrew

Dear Andrew,
Urinary tract infection (UTI) refers to an infection in any part of the urinary system, either in the kidneys, ureters, bladder or urethra.

Pain on the left side abdomen could be due to inflammation in the kidneys, the ureters or the bladder. This pain should have resolved once the infection was treated.

Left lower abdominal pain can also be caused by other conditions affecting the organs that are in or close to that region like kidney stones; any problem with the testicles, like injury, torsion or inflammation; inguinal hernia; having a lot of gas; indigestion; constipation; any problems in the large intestines like inflammation or obstruction; diverticulitis or even a painful viral rash (herpes zoster).

You need to see a doctor. Tests will be done depending on the symptoms, for example urine tests, stool tests, abdominopelvic ultrasound, testicular ultrasound, etc. Once a diagnosis is made, you will be treated.

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Dr Flo, I have been trying to conceive after losing my first pregnancy but six months later I haven’t gotten pregnant. Could it be a problem caused by the previous pregnancy or is it that the doctors didn’t do the cleaning well in the theatre after my miscarriage? My husband wants a child. I am worried. Please help. Hilda

Dear Hilda,
Getting pregnant again is usually possible from six weeks after pregnancy loss. Just like anyone else, conceiving is not automatic, and may happen when you want it or it may take some time.

Medical professionals only get concerned when you have been unable to conceive for a year. If your periods have resumed normally, and there is no abnormal bleeding, abdominal pain or abnormal discharge, then most likely the cleaning that was done after the miscarriage was done properly.

To be sure that nothing remained after evacuation and there are no complications, you can visit a gynaecologist for review and have a pelvic ultrasound done.

You can also be examined for any identifiable and treatable conditions that may have caused the loss of the pregnancy. In many cases, however, a cause may not be identified, and losing one pregnancy should not prevent you from getting pregnant again.

If you are ready for another pregnancy, you should keep trying, without putting any pressure on yourself. In the meantime, you need to be aware of any psychological issues that you may have like fear, guilt or trying to replace the baby you have lost.

You may need to talk to a psychologist or counsellor to help you deal with these issues even as you look forward to another pregnancy. Severe emotional stress may actually contribute to a delay in getting pregnant.

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