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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Lower Abdominal Pain And Difficulty In Urinating?

I am a 67 year old male and have had recent problems with urination. My main problem is at night. The first time I get up to urinate, I need to sit for and extended period of time (sometimes 15-30 minutes) before I can start to urinate. During this time, I seem to have a lot of gas symptoms. I have lower abdominal pain and cannot start a urine stream. After numerous belches, I can slowly start to urinate. Only after several minutes of start and stop, I am able to empty my bladder with a rather long and steady stream of urine. If I get up a second time during the night, I do not seem to repeat the problem. It only seems to occur during the first time I get up. Any thoughts on what might be causing this?
Mon, 15 Apr 2019
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General Surgeon,  's  Response
Hi,

Noted your history and understood the concerns.
The delay in starting to urinate and have to wait till the bladder is cleared of urine at night when you try for the first time is due to the following reasons;
The prostate enlarges with age. Since you are 67 years old, the prostate is definitely enlarged and particularly the median lobe which may act as a valve when you strain to pass urine on full bladder.
Hence I would advise you the following:
Get per-rectal examination of prostate.
Blood tests particularly tumor marker.
Ultrasonography of abdomen particularly for genitourinary system.
Get operated for prostate so that the problem is gone.
Till then do not hold urine for long.
Do not strain while passing urine.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. T Chandrakant,
General Surgeon
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What Causes Lower Abdominal Pain And Difficulty In Urinating?

Hi, Noted your history and understood the concerns. The delay in starting to urinate and have to wait till the bladder is cleared of urine at night when you try for the first time is due to the following reasons; The prostate enlarges with age. Since you are 67 years old, the prostate is definitely enlarged and particularly the median lobe which may act as a valve when you strain to pass urine on full bladder. Hence I would advise you the following: Get per-rectal examination of prostate. Blood tests particularly tumor marker. Ultrasonography of abdomen particularly for genitourinary system. Get operated for prostate so that the problem is gone. Till then do not hold urine for long. Do not strain while passing urine. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T Chandrakant, General Surgeon