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Urology (Expert Forum)
Scar Tissue is the cause?
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.
Scar Tissue is the cause?
by maria c., May 16, 2003 12:00AM
Hello,
I am a 26year old female, and I have had 4 UTI's in the past 5 years. My most recent infection was this past November, but the infection was not cleared with the first round of antibiotics. Since that time I continued to have some problems. Mainly, I have microscopic amounts of blood in my urine, and I have spasms (twinges) after I urinate, as well as the mild urge to go after I have already gone. Sometime there is also burning after I go. The odd part is that this doesn't happen every time I go, I never know what I am getting when I have to go!
I have seen a urologist, and had negative results from an IVP, voiding cystourethrogram and cytology tests on my urine. I also had a cystoscopy, and the dr. told me that I have scar tissue in my bladder from my past infections and that this was causing my problems. I have never heard of this causing problems, and I wonder if this is true, then how can I help the problems I am having? Will they just subside with time, or am I stuck with them for good? Also what do I need to worry about in case I get another infetion?
I apologize for the long message, I just wanted another opinion, especially one without getting poked and prodded again!
Thank you for your help.
I am a 26year old female, and I have had 4 UTI's in the past 5 years. My most recent infection was this past November, but the infection was not cleared with the first round of antibiotics. Since that time I continued to have some problems. Mainly, I have microscopic amounts of blood in my urine, and I have spasms (twinges) after I urinate, as well as the mild urge to go after I have already gone. Sometime there is also burning after I go. The odd part is that this doesn't happen every time I go, I never know what I am getting when I have to go!
I have seen a urologist, and had negative results from an IVP, voiding cystourethrogram and cytology tests on my urine. I also had a cystoscopy, and the dr. told me that I have scar tissue in my bladder from my past infections and that this was causing my problems. I have never heard of this causing problems, and I wonder if this is true, then how can I help the problems I am having? Will they just subside with time, or am I stuck with them for good? Also what do I need to worry about in case I get another infetion?
I apologize for the long message, I just wanted another opinion, especially one without getting poked and prodded again!
Thank you for your help.
Doctor's Answer
by Kevin Pho, MD, May 16, 2003 12:00AM
, May 16, 2003 12:00AM
Hello - thanks for asking your question.
You note recurrent UTIs. You have had a very thorough urology workup include an IVP, cystourethrogram, cytology and cystoscopy. This would exclude most of the structural causes for recurrent UTIs. This would also exclude most of the causes for the blood in your urine. The only other test I would suggest would be a renal ultrasound to see if your kidneys are responsible for the blood in the urine.
Scar tissue may certainly be a possibility. Without examining you I cannot say for sure. Make sure that the bacteria is sensitive to the antibiotics you are taking. Tests for STDs (i.e. Chlamydia and gonorrhea) should be performed if not already. Some women have a genetic predisposition to receiving recurrent UTIs (i.e. more bacteria may adhere to the lining of the urethra in some women).
One consideration would be continuous antibiotic prophylaxis. Studies show a 95 percent decrease in recurrent UTIs. Most recommendations suggest a six month trial of antibiotics followed by observation. You may want to discuss this with your personal physician.
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.
You note recurrent UTIs. You have had a very thorough urology workup include an IVP, cystourethrogram, cytology and cystoscopy. This would exclude most of the structural causes for recurrent UTIs. This would also exclude most of the causes for the blood in your urine. The only other test I would suggest would be a renal ultrasound to see if your kidneys are responsible for the blood in the urine.
Scar tissue may certainly be a possibility. Without examining you I cannot say for sure. Make sure that the bacteria is sensitive to the antibiotics you are taking. Tests for STDs (i.e. Chlamydia and gonorrhea) should be performed if not already. Some women have a genetic predisposition to receiving recurrent UTIs (i.e. more bacteria may adhere to the lining of the urethra in some women).
One consideration would be continuous antibiotic prophylaxis. Studies show a 95 percent decrease in recurrent UTIs. Most recommendations suggest a six month trial of antibiotics followed by observation. You may want to discuss this with your personal physician.
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.
