Hello and thank you for asking HCM. I have read your symptoms and understand your concerns. It s normal for a patients with catheter to have these symptoms,so don t worry,there is nothing wrong here. When having a catheter,there are two main reasons why a patients feel pain while passing urine. -When a patients has a catheter, all the urine produced by the kidneys it s supposed to get out through the catheter. BUT in certain patients,especially the ones that have a middle-lobe prostate growth in which cells grow into the urethra and the bladder outlet area, a small part of urine may pass between the catheter and the urethra, and give pain/burning sensation. This happens especially when you contract your abdominal muscles when you are in the bathroom to pass stool. b-infection of the urinary tract Since you are already on antibiotics, i would rule out the infection. Here are some advice to help you with your symptoms. -healthy diet,fresh vegetables and fruits especially these kind of fruit/vegetable that help increases the bulk of your stool so it can move along on its merry way (prunes,kiwis,popcorn,oranges,rice ect) -plenty of water. it will help your constipation problem,also it will help your bladder get clean -Support your feet with a small step stool [about 6 in. (15 cm)] when you sit on the toilet. This will help flex your hips and place your pelvis in a more normal squatting position for having a bowel movement If you have any other question,feel free to ask me. Dr.Endri Katro