3 uti's this month help!!!

[tempest21]

I'm a 31 female and have had 20 uti's in the past 2yr. Recently I had 3 uti's in one month. Each uti becomes more painful than the last (dysuria, pain in lower abd). I have cultures done on all UA's and all result in lacotbacilli growth only. I have tried a daily dose of macrobid, urination after sex, increase in fluid intake, cranberry tabs, and every thing else that my doctor has told me to do. This last uti my doctor changed my antibx three times before it cleared(1st bactrim DS, 2nd levaquin,3rd keflex). I can't take it anymore what can i do to stop this. recently i have noticed some swelling in my legs with muscle cramps and some lower back pain. I'm not sure if it has anything to do with this uti problem, but i'm miserable. Instead of waiting for my month period I'm waiting for my month uti help!!!!

[David A Burks, MD]

Hi, the question is --- what is the diagnosis?  If you are truly having infections this frequently the cultures should grow a true bladder bacteria like E Coli. Lactobacillis is a normal organism found the healthy vagina, and is not a bladder infection. As you void, the urine can pick up vaginal bacteria that grown in the culture.  If these episodes are not a bacterial infection, and don't respond to antobiotics, then what are they?  You need a structural study of your kidneys (CT scan or Ultrasound) and a cystoscopy (a look into your bladder and urethra) to see if there is anything causing the UTI like symptoms.  A urethral diverticulum, bladder or ureteral stone, or a bladder tumor can cause your symptoms. A chronic cystitis is a deep infection of the bladder wall, often the urine culture is negative, and it can take a month or two of antibiotics to clear it.
  If there is no structural/infection problem, there are two diseases that can cause your symptoms with monthly flare ups: endometriosis and interstitial cystitis.  These would need to be sorted out with a urologist and gynecologist working as a team.  Good Luck.