Possible Intersticial Cystitis/other and/or PFD Case
I have had multiple UTI's starting from the age of 14 before any sexual activity. My first infection was located in my ureter I had a negative UA but a positive culture. I am now 22 years old and in Sept 2012 I felt similar symptoms of having another ureter infection, my UA was negative again but I was not able to run a culture due to insurance and financial complications. My DR prescribed me a regular course of Bactrim with 3 refills. The pain subsided but I had what I thought were yeast infection symptoms follow the Bactrim. I also had my menstral cycle at this time so it made sense that I would develop a yeast infection, I have had them before in the past as well. A month later I experience severe UTI symptoms with exptreme pain, macrohematuria, frequency and what felt like a swollen bladder. I informed my Dr of my symptoms and refilled my Bactrim prescription. After taking this dose I felt an unbareable itching around my vagial area. I developed a bleeding ulcer on one side of my vulva and could not sleep for 2 nights. After 2 weeks my symptoms subsided. 2 weeks later I had the same UTI symptoms. With out consulting with my Dr I refilled another prescription of Bactrim. After taking one pill I immediately experienced the same extreme itching and developed the same ulcer on my vuvla. I got about 3-4 hives, my face a lips swelled and my throat and chest became very tight. I took 2 Benedryl to counter act the allergic reaction, which worked and I did not need to go to the hospital. My urinary symptoms continued for about 1-2 weeks. After my allergic reaction I regularly experienced these urinary symptoms either weekly or every 2 weeks and this has persisted until present (end of March 2013). It hurts my urethra to urinate, it hurts after I urinate and I feel like I have to go even after I've enptied my bladder. Sometimes I experience incontinence along with my urgency and frequency to urinate. My bladder also feels very swollen and I get throbbing pain in the ureter I have had an infection in. With bad flare ups I also see blood on my toilet paper after wiping and a trail of blood in the toilet. I have cut out coffee, bananas, acidic foods, and wine (for the most part) as these all seem to exaserbate my sysmptoms. I am prone to allergies, I have asthma and eosinophilic esophogitis. I saw a Urologist in January and he described my condition as PFD and gave me a list of physical therapists to see. While I do think physical therapy may have some benefits, I can't help but think that this had more of a physiological trigger rather than of muscular dysfunction. Something like a combination between the frequent UTI's and Bactrim reaction. This physician completely ignored this suggestion and insisted I had PFD. Should I continue seeing this Urologist and see a physical therapist or should I insist on further screening for something like Interstitial Cystitis? I want to make sure I get the right treatment plan so I can manage these symptoms in my life as soon as possible. Any advice is appreciated! Thank you!
Well, without a detailed clinical valuation it would be difficult to determine the cause of your symptoms. Possibilities that may need to be considered include GU infections, inflammations, trauma/ injuries, ulcers/ erosions, calculi, growths/ masses, neuro-muscular causes such as pelvic floor dysfunction etc. I would suggest following the doctor’s advice for a few weeks and if the symptoms do not seem to resolve on 6-12 weeks, you may seek a second opinion with another urologist.
Hope this is helpful.
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