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Trouble in urinating, pain in lower back, hip, perineum area, prostatitis

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Practicing since : 1998
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Several symptoms for many years...
I'm 40, 5'11", 170lbs, and healthy for the most part. In 1995 at the age of 24 I began having trouble completely emptying while urinating and my urine stream seemed to become a bit weaker. The issue has remained for the last 16 years. It doesn't seem to have gotten worse but it hasn't gotten better either. There are times when I don't have any issues but for the most part I've been dealing with them for the past 16 years. In order to completely empty when I feel like I haven't, I put pressure along my perineum and force the remaining bit of urine out, otherwise I'll have some leakage. Rarely I experience slight pain in the perineum area and just above the groin, along with some lower back and hip pain. I have also had some erectile issues over this period of time. I saw a doctor in 1997 and was told I had prostatitis even though I was never given a prostate exam because the doctor told me I was too young to worry about prostate cancer. I then saw a doctor again in 2006 who gave me a digital prostate exam and a psa test. I was told my prostate was swollen a tiny bit and the PSA test came back fine. This doctor also told me I had prostatitis. Do my symptoms equate to having prostatitis? Since I'm still experiencing all of these symptoms, should I go back and get another prostate exam? Thanks for your help.
Posted Sat, 21 Apr 2012 in Urinary and Bladder Problems
Answered by Dr. Rajiv goel 1 hour later
Thanks for the query.

Your symptoms and the age at which it has appeared suggest that you have dysfunctional voiding rather than prostatitis.

It may be caused by inappropriate muscular activity in the muscles of the bladder wall, the muscles that control the starting or stoppage of the flow of urine out of the body (sphincters), or the muscles of the pelvic floor. Neurological impairment and certain medications can also contribute to bladder dysfunction.

The symptoms can include sudden, strong urges to urinate during the day or night,the need to urinate often,Incontinence,difficulty during urination,Decreased force of urine stream,Incomplete bladder emptying,Recurrent take a trial of alpha blockers and see whether you improve.

If your symptoms don't improve then you should undergo examination by urologist and also examination of expressed prostatic secretions to rule out prostatitis.

Hope i have answered your query.I will be available for follow up.

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