Q. Local doctors don’t seem to take my problem seriously, and I don’t know who else to ask. For the last year or so I’ve had erection problems. I seldom wake up with an erection. This affects my social life because I’m afraid I won’t be able to perform. I also have no force behind my stream when I urinate. If I pee outside, I barely miss my shoes! And when I am done urinating, I have to shake and dance a great deal to get it all out, and it still leaves a spot in my pants! Sometimes I even smell like urine. This scares me. I’m only 33, 165 pounds at five feet seven inches. I never miss work due to illness, and I see a doctor only for emergencies. I smoke, drink and drink coffee. I need help and I don’t have a lot of money. Is there any inexpensive treatment or over-the-counter medication I can use?

A. I would recommend seeing a urologist to evaluate your condition. You may well have diabetes or another condition that affects either the nerve supply or blood supply to the penis. Swelling of the prostate gland can impede the flow of urine, lessening the force of the stream. Until a diagnosis is made, there is no treatment that can be recommended. As untreated diabetes can have serious life-threatening complications, you would do best to see a physician and undergo evaluation.

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