Urogynecology Expert Forum
Please help - unknown infection in urethra/vaginal area
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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Please help - unknown infection in urethra/vaginal area

Hi, I would really apperciate any help anyone could give. I am a 30 year old female and I have been battling an unknown infection in this area since March 2012. I have seen numerous doctors and gynecologists who are all baffled and don't know what is causing it. Currently on the waiting list to see a urologist but the earliest appointment I could get was April 2013.

My problems started when I became sexually active again after about seven years of not having sex. Had sex before when I was 21/22 (though never on a regular basis) without any problems. Have had problems with UTIs in the past but they were always resolved quickly with antibiotics. After having sex a few times with a new guy I was in a relationship with, I felt like I had a severe UTI. Symptoms included urinary frequency, burning in urethra, urge to go but nothing came out, etc. I went to the doctor and they prescribed Bactrim, which didn't work, tried Cipro next which didn't work, then tried Macrobid which did not work. After a week of these symptoms, I also started to have symptoms that felt like I was "swollen" all the time (similar to how I feel when I was aroused). Urine culture came back negative for bacteria so they took me off the antibiotics. Did tests for everything (chlymadia, gonnarhea, BV, yeast) which all came back negative. They also did an ultrasound which showed everything normal in my ovaries and uterus area. The symptoms suddenly disappeared overnight after about a week and a half of this with no explanation.

Relationship with the first guy ended as he didn't want to deal with the medical problems, and I was fine for six weeks while I was not having sex. I started dating someone else at this point and noticed something was wrong as every time we had sex it was excrutiatingly painful for me, when I have never had a problem with painful sex before.

(to be continued in next post)
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Sorry to read of your problem.  You description suggest you may have cyclic painful bladder syndrome and / or some degree of vulvodynia.  Cyclic UTI symptoms that are culture negative can be treated with a medication called Levsin used sublingually at the time of flares.  Vulvodynia, pain at the entrance to the vagina may be treated with steroids, avoidance of irritants, etc.  You might seek a second opinion from a urogynecologist in you area.  J. Kyle Mathews, MD
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A week after we had sex for the first time, I developed symptoms that felt like a UTI. I went to the doctor who took a urine sample, which came back negative for bacteria but extremely high for white blood cells. Doctor prescribed Macrobid which didn't seem to work. After three days, they switched me to Cipro which seemed to work as after three days my symptoms went away and white blood cell count returned to normal.

Had sex with the new boyfriend again and a week later developed what felt like a severe UTI, with the main symptom being intense burning/stinging in the urethra/vulva region. Again, urine sample was negative for bacteria, but extremely high for white blood cells. Doctor put me on a month of Cipro. Cipro seemed to work for the first day, as I felt much better the following day. A few days later, had sex with the boyfriend again and symptoms returned with a vengeance. The main symptom was again an intense burning/stinging in the urethra and vulva area. Doctor switched me to Suprax which did nothing.

Finally another doctor performed a vaginal exam on me and said that my cervix was inflamed with yellow mucous and diagnosed me with cervicitis. This doctor seemed convinced that I must have an STD because he said that was the only way to get cervicitis and prescribed me 7 days of doxycycline. Tests came back negative for STDs and doctor said he was "baffled" as the only way to get cervicitis was through STDs.

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After this, for about six weeks, I had excrutiating pain in the urethra/vulva region (did not have sex during this time). Consistently tested negative for any bacteria in the urine but high for white blood cells. Vagina area was extremely red, raw and inflamed the entire time. Was also tested again for BV/yeast and came back negative. My symptoms were:

1) Intense burning/stinging in urethra/vulva region (most common)
2) Itchiness and irritation
3) Swollen (almost like an aroused feeling)
4) A tingling feeling in the urethra, similar to a UTI which made me feel like I had to go to the bathroom all the time (would usually get this after urinating)

The symptoms would come and go randomly, switching from one to the other but never letting up. The pain would differ from day to day, sometimes being so excrutiating I could not get out of bed, other days being manageable.

I saw a gynecologist who said that it looked like I had an infection but had "no idea" what it was. She referred me to another gynecologist but my appointment with her is not until February 2013.

My symptoms went away after six weeks. Around that time the relationship with the second guy ended as he also did not want to deal with the medical problems. Since then I have not had sex. I still have a lingering soreness/irritation which pops up from time to time but not anywhere near as painful as it was during those six weeks. However, I am afraid to ever have sex again as that seems to trigger whatever this infection is.

I am afraid that I caught an STD that is unknown to doctors at this time as all the problems seemed to start with the first guy, and the constant presence of high white blood cells seems to indicate an infection. Are there any STDs that are unknown to doctors at this time? If not, what else could be causing all these symptoms?
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J. Kyle Mathews, MD, DVMBlank
Plano Urogynecology Associates
Plano, TX
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