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Urology (Expert Forum)
Ureteral Stone or ?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Ureteral Stone or ?
by MarieJ, Mar 14, 2003 12:00AM
I am a 26 year old female in overall good health. I have been with the same sexual partner for 10 years and we are married and monogamus. I started having pain & pressure in my pelvis area a week ago. Along with this I was having occassional discomfort urinating. It would burn sometimes after I urinated. I didn't have in an increase in frequency though. I went to my primary care physician who tested my urine with a stick test. It came back negative for bacteria or blood. Since, I was not having any vaginal symptoms I decided to go to a urologist who I saw on Tuesday. Again they tested my urine and found nothing (no blood / bacteria). The urologist also gave me a pelvic exam which he said was normal and scheduled me for a CT scan. He thinks I have a stone. I went back to him yesterday (Thursday) because I started having constant pain & burning in my urethra. He had the nurse insert a catheter to give me some kind of medication to numb my bladder. This helped very little. About 3 hours after they gave me this medication I had trouble urinating. Then about 7 hours after they gave me the medication I could urinate okay again, but started have more pain than ever when I urinated. It felt and still feels like I am peeing needles. And when I am done urinating, I am having constant buring and pain in my urethra and the area surrounding it. I asked them if the catheter caused this since I was already having problems there. They said I should not be in this much pain. They said they could do nothing else for me until I get the CT scan. I had the CT scan today, which is Friday. The doctor has the day off today and they said he would call with the results on Monday. I just wanted another opinion on this matter. Could this be a stone, considering there is no trace of blood in my urine? Also, does it sound like they are giving me the standard care a patient receives when presenting with these symptoms? Should I also consult a gynecologist? Thank you.
Doctor's Answer
by Kevin Pho, MD, Mar 15, 2003 12:00AM
, Mar 15, 2003 12:00AM
Hello - thanks for asking your question.
Please understand my limitations over the internet as I have neither met nor examined you. This information is for patient education only. Please see your personal physician for further evaluation.
The symptom of painful urination (dysuria) is a troubling but not uncommon condition. 25% of all women experience this symptom at least once per year.
I have to assume that every test for a UTI has been done and was negative. You mentioned that there was no blood/bacteria in the urine. Was there a comment about white blood cells? (pyuria). There are several conditions that would be negative for bacteria but positive for pyuria. I will discuss some conditions for dysuria where there is no bacteria in the urine.
Urethritis - Both chlamydia and gonococcal infection can cause dysuria. The urine will typically have no bacteria but evidence of pyuria.
Trichomonas vaginalis, Candida albicans, and Herpes simplex virus all can cause urethritis. Other associated symptoms and signs (eg, cervicitis or vaginitis, vesicular eruptions) suggest the diagnosis. Trichomonal urethritis typically produces pyuria while candidal urethritis usually does not.
Vaginitis is a common, often neglected cause of dysuria and "negative" urine cultures. The organisms most commonly involved are Candida albicans, Trichomonas vaginalis, and Gardnerella vaginalis.
A kidney stone can also cause dysuria. A CT scan would be a appropriate test for evaluate this. If this is negative, I would suggest tests for the infections I mentioned above.
A gynocological referral would be helpful if all the test above were negative to further evaluate your cause of pelvic pain.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Please understand my limitations over the internet as I have neither met nor examined you. This information is for patient education only. Please see your personal physician for further evaluation.
The symptom of painful urination (dysuria) is a troubling but not uncommon condition. 25% of all women experience this symptom at least once per year.
I have to assume that every test for a UTI has been done and was negative. You mentioned that there was no blood/bacteria in the urine. Was there a comment about white blood cells? (pyuria). There are several conditions that would be negative for bacteria but positive for pyuria. I will discuss some conditions for dysuria where there is no bacteria in the urine.
Urethritis - Both chlamydia and gonococcal infection can cause dysuria. The urine will typically have no bacteria but evidence of pyuria.
Trichomonas vaginalis, Candida albicans, and Herpes simplex virus all can cause urethritis. Other associated symptoms and signs (eg, cervicitis or vaginitis, vesicular eruptions) suggest the diagnosis. Trichomonal urethritis typically produces pyuria while candidal urethritis usually does not.
Vaginitis is a common, often neglected cause of dysuria and "negative" urine cultures. The organisms most commonly involved are Candida albicans, Trichomonas vaginalis, and Gardnerella vaginalis.
A kidney stone can also cause dysuria. A CT scan would be a appropriate test for evaluate this. If this is negative, I would suggest tests for the infections I mentioned above.
A gynocological referral would be helpful if all the test above were negative to further evaluate your cause of pelvic pain.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments
by MarieJ, Mar 17, 2003 12:00AM
To: Urology - General
0
by CRAZY DOCS, Jul 08, 2003 12:00AM
To: Urology - General
0
