overactive bladder or Interstitial Cystitis

[bubbles410]

I am a 43 year old married female,106 pounds.  Last week I suddenly developed what I thought was a bladder infection.  Frequency every hour or so.  I thought it was a UTI.  First on a home test the WBC was positive.  The doctor prescribed antibiotics and sent the urine for culture and perscribed phenazo.  After 2 days things were not getting better.  I went back to the doctor and after a positive nitrate test he switched the antibiotic.  Things still did not get better and I then had a burning urethra and urgency all day long, it feels like my bladder never empties.  The urine culture came back negative.  He now thinks I have a vaginal irritation from the urine and overactive bladder and percribed ditropan.  At night the burning seems worse but I am only up a couple of times.   Also the burning is worse when sitting and lessens when standing.  I also have pain in my left overy.  He has completed an internal and vaginal swab.  How can you tell the difference between overactive bladder and Interstitial Cystitis? Does an overactive bladder cause urethral burning.  Also during the last two nights I have developed pain in the right lower back.  The doctor wants me to go back on norfloxacin that I stopped taking when the urine culture came back negative.  Can you Help please?

Thanks

[David A Burks, MD]

Hi,  
The hallmark symptoms of overactive bladder are urinary frequency, urgency and possible urge incontinence.  Overactive bladder does not have a pain/burning component.  IC on the other hand has frequency, or urgency and pain in the bladder vagina or lower abdomen, usually associated with bladder filling and somewhat relieved by voiding. Urine cultures have to be negative for either diagnosis, differentiating them from a bacterial cystitis (uti) Sometimes patients have symptoms of both problems. You sound like you have IC due to the burning sensation with a negative urine culture during symptoms. You need to see a Urologist or Urogynecologist who specializes in IC to make the correct diagnosis and start the proper treatment.  If the urine cultures are truly negative antibiotics won't help.  Go to ishelp.com, the official website of the Interstitial Cystitis Association to get more info on getting a correct diagnosis.  Good Luck.

[bubbles410]

Thank you very much for your answer.  I also forgot to mention that I had a slight bladder prolapse after the birth of my second child that seems to be relapsing.  Could this also cause these problems?

Thanks for your help

[David A Burks, MD]

Hi,
It depends on what degree of prolapse you have.  If you can see your bladder coming down thru the vagina with a mirror when you strain on the toilet or you feel a mass in the vagina, the prolapse may be part of the problem.  A simple exam by your gynecologist or urologist would rule that out. More than likely the prolapse is not the major problem, just an incidental finding that a lot of women have. Good Luck.