IC or not?

I'm a 26yo female. I've had recurring UTI's since I was 15, only getting more frequent when I was about 22. Saw numerous doctors which all diagnosed me with a UTI, and was put on an Antibiotic (been on every one in the book), which in turn would "clear it up" for a couple months, then I was back at the doctors again. This has been going on for a little over four years, and has just been getting progressively worse, and A LOT more frequent. I finally saw a Urologist last year, and peed in a cup, and waited to see if anything grew. It did, and again I was put on Antibiotics which only helped for a month or two. Then he ordered a Renal Ultrasound, and that dye thing, and the thing where they stick that little camera/thing up your UT, everything supposedly came out "normal", and his diagnosis... possible IC. I didnt like the fact that he wasnt LISTENING to me, and acted like hes heard it all before, and diagnosed me before he even knew the facts, so I never went back to him. Anyway. So, this last week I havent really had any symptoms until I went out and had a few drinks, and the very next morning I had a REALLY STRONG AMMONIA smell in my urine. Urine was cloudy, but VERY light in color. No real burning WHEN I urinate, but right after I have horrible pain in my UT. I dont really know how to describe the pain. I guess it just feels like Im having that camera thing shoved up my urethra over and over and over again. I have many questions, but right now my main question is: is an overpowering ammonia smell a common symptom of IC? Because I havent seen anyone else with IC saying anything about an overpowering ammonia smell as a symptom. Thank you SO much for any info.!

[David A Burks, MD]

Hi,  You have the common problem of having a history of frequent recurrent urinary tract infections.  They usually start when you become sexually active. 50% of women will get al least 1 UTI and 25% will get recurrent UTIs.  You had a structural work-up so this is not a stone, obstruction, tumor or other problem.  This is a biochemical susceptability to infections.  We do treat patients with a daily dose of an antibiotic at night to block the infections from occuring to break the cycle.  When you have symptoms, but the urine is not infected it could be another disorder called interstitial cystitis. The symptoms of IC are pain/pressure/burning/discomfort/, urinary urgency and frequency, with a clear urine.  Plenty of patients have both disorders so it can sometimes be tricky to diagnose.  A urine with a strong amonia (ammonia) smell may be simply a concentrated dark looking urine that is not infected, but you simply haven't had a lot to drink or lost water thru sweating.  You need to drink more water to clear it up, and a urine analysis would help rule out infection and check the concentration. The strong smelling urine is not a symptom of IC, but could make patients with IC worse.  You need to work with a Urologist experienced in IC to sort these issues and get a correct diagnosis.  Good Luck,