bladder infections?

[debcon]

Last year I had a bladder infection every month.  Severe pain with urination, throbbing in my urethra,  pressure in my stomach, frequency, urgency, cloudy urine, and blood (visible, sometimes clots).  Took antibiotics and seemed better until the next month.  Saw a urologist, he did a cystoscopy and saw nothing unusual.  He did a urethral dialation because I had scarring.  He did a cat scan and still saw nothing unusual.  He told me I had a slight cystocele and I had that corrected in December 2008.  I have only had a couple cultures which showed nothing or slight growth.  Since the surgery I have had 4 more infections, one of which my gynecologist did a culture for and it was positive.  I took and antibiotic and felt better, but I constantly have a slight burning.  I have been diagnosed with fibromyalgia.  Could that be the issue?  I have an appointment to see another urologist in May.  I just dont know whats going on.

[David A Burks, MD]

HI,  the first question is---- are these culture positive urinary tract infections (UTI) that you were/are getting every month?  If so, then the organism needs to be identified and the correct antibiotic to clear your infection needs to be prescribed.   The second question is------ are these frequent recurrent infections (infection that resolves on antibiotics then you get reinfected again frequently), or a persistent infection (one that  never went away but gets suppressed on antibiotics, then returns off treatment)?  Persistent infections are usually the same bacteria everytime, and means that there is a structural problem like a stone, blockage or other problem causing the infection to persist.  Hopefully your new Urologist will sort this out.  You may needs X-rays or an ultrasound of your kidneys and a cystoscopy (look into your bladderand urethra) to sort this out.  Some people have very frequent UTIs or a chronically infected bladder wall or kidney that needs daily suppressive antibiotics for months to resolve.  Your UTI problem is separate from fibromyalgia.  If this is not a simple UTI problem your Urologist will know how to work up other causes of your symptoms.   Good Luck  

[debcon]

Out of all the uti's I had, only 3 cultures were done.  One was negative, one was not able to be cultured?, and one was positive.  I had a cystoscopy done and nothing showed on it.  The last culture I had done, I was given Levoquin 500 mg for 10 days.  2 weeks later I had UTI symptoms again.  I took 5 days worth of Cipro that I already had.  Yesterday I felt like I had another UTI, but today I dont feel too bad.  Thanks for answering my questions.

[David A Burks, MD]

If your culture is positive for infection when you have symptoms, and your work up (ultrasound of kidneys) is normal you may need to be on a daily dose of antibiotic at night to prevent an infection for a few months to break up this bad cycle. Talk to your new Urologist about this option.  Good Luck.