Please help urethral discomfort but testing negative for UTI.

As a child I had had problems with UTI's. I was a bed wetter at that time and had probably had at least 2 UTI's before the age of 9. Since then I have had no issues. About 2.5 years ago I had to have a catheter put temporarily. As soon as it was removed I felt like I had a UTI and have since then been getting chronic UTI's on average 2 to 3 times a year. The last time I got one was the first time my urine dip came back negative and my doctor gave me the antibiotics anyway as I tend to get them chronically and he said if the symptoms feel like that for you I will give you the meds as a precaution. I took the meds and they went away. That was probably at least 6-8 months ago. I once again feel Ilke I have a UTI and I have noticed that the last few had one thing in common and that was having sex with my partner. He is someone I have been with  for the last four years before I had the catheter put in but the last 3 times I felt UTI symptoms always started like the next day after we've had more vigorous sex than usual and I feel as if my urethra becomes irritated and then I start to have issues voiding and even not being able to hold my urine and would have a accident while running to the washroom to void as I cannot hold the urine. My doctor sent my urine out for culture last week as the normal urine dip came back negative. I have an appointment to see her in 3 days and I am still experiencing irritation of my urethra and a urgency to void and not voiding as much as I usually do and I am someone who voids quite often as I drink a lot of water. This is so frustrating and at this time feels like it's a constant problem. Any suggestions as to what may be causing this. Is it the vigorous sex, is it a low grade UTI that is just not registering a positive test or do I have an entirely different issue. I am also highly susceptible to yeast infections that tent to be chronic in nature as well and don't always go away. Could this be a cause. Being on antibiotics as much as I have been on them as I also had a problem with tonsillitis (until they were removed in 2006) and every time I am put on an antibiotic I develop a yeast infection and they get so bad my family doctor has teated it with the oral diflucan but she has had me take 3 pills on 3 consecutive days to get rid of this. Will all this information do you have any ideas as to what is the cause of this urethral discomfort. Is it due to sex or is it a UTI that keeps getting misdiagnosed, yeast infection or something more serious. Please help, it is getting to be more than just an nuisance and more like torture. Oh and I am not a diabetic nor do I have issues with my blood sugar so I am at a loss. :(

[UKlady1001]

Hi there and welcome to the Urogynecolgy forum.  

You have several questions rolled into one here and I am not sure they are necessarily a Urogynecology problem but lets look at them seperately.

Firstly you dont say how old you are or if you have had children.  I too had many years of antibiotics due to tonsil infections that were finally identified as mainly actinomyces which you cant get rid of without taking out the tonsils.  What ever was wrong with your tonsils it is good you had them out but with years of antibiotics with this and also urine infections you may well have a more resistant situation going on with yeast infections than has been identified as yet.  This is common so dont worry.  Do you take probiotics?  You may do better long term to use probiotics regularly and upping the dose around any times you have to take antibiotics.  I know I have to do this and also follow a low yeast diet as well.  It has helped me.

I too have had life long problems with urine infections and painful wee even without infections.  This can be due to Interstitial Cystitis ( IC ).  See the forum for this on this site and also the Urogynecologist on the Ask the Dr side of this forum explains the foods and drinks to avoid if you have this problem.

Sex and painful urinating...Yes this is something again that I have some experience on.  I have for years followed the advise that it is best to wee within 10 minutes before sex and 10 mins after sex to flush out any bugs that can get encouraged to travel a bit too far up your urethera with the activity of sex and then gain a foot hold in the bladder and urinary tract.  This helped me a lot.
Also during sex there is the natural friction and stress on the skin which can lead to a more sore and open skin area vulvally and urethrally that can be both frictionally sore as well open up the skin to the possiblity of infection.  To void this, consider lubricant and the most comfortable position possible.
In addition to this, make sure you drink at least 300mls of water before sex and try to do this in a bit of a run up to sex if you are aware it is likely to happen, so you can flush out any bacteria that have travelled about the urethra area etc during sex.  This is normal.  My GP explained to me years ago that sex has a pumping action that is very affective in terms of conception but also pumps away at external skin at the same time pushing at tissues making them a bit sore at times and pushing bacteria about that can cause problems if succeptable to infections.

I would encourage you to consider asking your Dr to send you to a Urologist for your bladder problems and if you feel you have any prolapse problems ( feel any bulge in your vagina ) ask your Dr to send you to a Urogecologyst as well.

Finally.  It is possible that you have an issue with your urethra which may need investigation.  This is part of the picture, and therefore not necessarily the case but if you try everything else and still have pain in this area it may be a good idea to have this looked at.  I still feel a Urologist may be you best bet here for an investigation with regard to bladder issues if all else fails.  

You can come back from this and be Ok. You are asking questions and are on the right track.  Keep going.

I hope this helps.  Let us know how you get on, and good luck.

[UKlady1001]

Sorry correct spelling is Urogynecologist for any prolapse problems.