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Why do I have problem in passing urine?

Q: I am a 22 years old boy having problem in passing urine for last one year and I got an operation done for the same, but gave no relief. The doctor said that the vein was sleek (means combined together). I consulted another doctor and he asked me to use Urimax 0.4 mg twice a day. He said I will be fine in 6 months but I still have the same problem. Please advise.

A:Problem while passing urine at a young age like yours could be due to anatomical obstruction or functional imbalance of muscles and nerves. Anatomical obstructions could be a stricture urethra (one of the diagnosis given to you, and apparently treated with surgery without relief) or bladder neck obstruction (another suspected diagnosis and treated with Urimax, an alpha blocker to relax bladder neck; though you did not mention whether it improved your flow or not). Common functional imbalances may occur with failure to relax the bladder neck while bladder contracts to pass urine as may happen with anxiety (one may pass urine in privacy, but may find it difficult to do it in public); or due to true neurologic dysfunctions as may happen with involvement of bladder nerves during previous surgery or spinal problems, apart from many other causes. You must understand that the problem is more vexing than your simplistic impressions, and needs detailed examination and work up with a specialist.

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