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Urology  (Expert Forum)
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Chronic Urinary, Bladder probelms in DEAPERATE need of answers
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Chronic Urinary, Bladder probelms in DEAPERATE need of answers

by Jenn202, Jan 12, 2005 12:00AM
I am a 33 year old female. I have a history of chronic illness ( Lyme Disease and Autonomic Dysfunction).

For the last 3 years I have been having constant and intermittent Pelvic Cramping....goes around to lower back, Burning in my urinary tract and vaginal area, and a need to always urinate , as if my bladder never feel empty. I also have cloudy urine on and off and brownish particles that look like pieces of skin. I also can feel very weak with chills when I get this way. I also suffer from Bartholin cysts that cause me to feel ill.....I get weak and chills, feverish along with it, which no Dr can explain and they keep telling me I shouldnt feel that way. They were able to culture my last cyst, and found e coli bacteria.

My symptoms COMPLETELY go away when I take Bactrim. I have been on Bactrim as part of my treatment for Lyme Disease for the last 3 months.....Every symptom dissapeared. I then went off Bactrim for a few days due to med changes, and ALL symptoms came back again.

I have seen My Gyno several times. I always have a negative urine cultue b/c I have been on ,long term antibiotics to treat Lyme. My vaginal cultures were neg...
He suspected Cystitis or endometriosis, but I really do not fit this profile completely.... No one who has it can relate to need for abx to clear it up and the weakness and physical problems as well. I saw a uroloisgist who was nto quite sure what the porblem was either.

My question is: is there something I am missing? I spoke to a woman with similar problems who ended up having Klebsiella...SHe needed IV antibiotics to clear the infection up.
Would Klebsiella be a possibility and how do I go about testing?
I am hoping to have children one day and am scared this could effect my fertility if I have a chronic infection all these years not properly treated.

Thank you for reading. ANy advise would be appreciated since I feel I have hit a brick wall with trying to figure this out.

by Kevin Pho, MD, Jan 12, 2005 12:00AM
Difficult case.  If Klebsiella is a possibility, then it likely would have shown up in the urine culture.  I cannot come up with a good explanation why the symptoms always resolves with the Bactrim.

Certainly you can consider another urological opinion (preferably at a major academic medical center).  You can consider a cystoscopy to evaluate the lower GI anatomy.  Another option would be to evaluate for interstitial cystitis - which can be done via a potassium sensitivity test.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b
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