Ask The Urologist Anything (Dr Michael Rotman)

Nelson Vergel said:

Hello Dr Rotman

I seem to have all the symptoms of Interstitial CystitisLower abdominal pain and referred pain down to my lower back and anus. Third occurrence. Previous two seemed to have responded to minocycline bid for 14 days.

I have retrograde ejaculation caused by a green laser procedure to remove calcium deposits from my urethra over 10 years ago. Can that be causing this issue?

I do not have urgency to urinate but I am now getting up once per night to pee. I void reasonably well. No pain while urinating or having an orgasm. No fever.

The main complaint is the abdominal (and lower back) pain that feels like my IBS has flared up (or at least what I used to think was IBS).

I am going for an urology work-up but wanted to pick your brain first. Thank you.

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JT said:

Nelson and Dr. Rotman, sorry I am a little late to this conversation about the prostate and ICS along with urinary frequency, but I am curious, is it abnormal to need to urinate once a night? From what I have read this is fairly common, but maybe that is incorrect? If your sleep is disrupted just once a night with the need to urinate is that a sign to have something checked out, or would that have to be occurring more often to be a concern?

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Paulyhotsauce said:

Hi! New member to the forum, long time reader. I have been on my trt journey since April. Had lots of ups and downs, mainly downs.
I'm at the point where I feel I am almost dialed in.
Question is: my ball sack usually is very high and tight except the first 1-2 days after my weekly injection of 200mg. After that it's right and doesn't hang.

Is it mainly due to estrogen or testosterone levels?

Thanks!

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Tom Larabee said:

Hi Dr Rotman,

I have a left testicle Variocele that I have had most of my adult life. After recent Emergency Gall Bladder removal surgery (3 weeks ago,) it now is painful during ejaculation. I have had it looked at before and all of the urologists say since it doesn't hurt leave it alone. So I guess I am wondering your thoughts on why now it hurts when it didn't before and whether you think I should get it looked at again.

Tom

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DrRotman said:

I would definitely have your scrotum examined again and see if it is related your ejaculatory dysfunction. It may not be related to the varicocele. Good luck!

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KennyT said:

My question is kind of long and drawn out but ill be brief as I can. I have low T. I was tested September ish of last year and total T was 184. I was put on Clomid to start with. Total T went up to 216 after 1 month This was October. I then was told Clomid was not the answer and was switched to testosterone cypionate 200 Mg / ML . I use 75 ML .75 ML=150 MG one time per week. I also take Anastrozole 1 MG tablets. 5 MG/ ½ tablet 3 times aweek, Mon/ Wed/ Fri My total T went up to 731 by December. ( I was feeling great). He also has me on HCG at 500IU 3 times a week to keep my buddies happy, But whey where way smaller and like mush. At witch he upped my HCG to 750IU 3 times a week. Last blood test was in February for my march appointment. Total T was 580 and feeling a bit down.
Ok. My question is. I'm having blood drawn for my 6 month checkup. If it is 580 or lower, Am I justified in asking for the T dosage to be increased? I always have more in the vial than I use each month and I'm just using it when my next batch arrives in the mail instead of opening a new vial. I have a full shot and some of the next left. I just run out of syringes and needles. I think it would pretty much add up to 1 ml per injection without having to ask for more vials per month. Side question is why would total T go down over time anyway? Nothing has changed with injections.
Long question. Thanks in advance
Kenny_T

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Nelson Vergel said:

I was given Meloxicam (an anti-inflammatory) and about to start pelvic floor therapy.

If you are getting up only one time per night to pee, you do not have an issue.

Some patients are prescribed Vesicare for overactive bladder.

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Nelson Vergel said:

In my case, increased urination (or at least feeling like you have to pee more frequently) happens when my bladder gets irritated or inflamed after eating spicy foods or alcohol. It is something I learned just recently after going to a local urologist (Dr Khera).

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