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Confused and helpless about recurrent UTI/ irritation
I am a 24-yr-old female. I've not had sex since last Sept'04 when I got a nasty UTI after having intercourse (used a condom). I thought I had a yeast infection because my genitals were swollen and itchy but I also noticed a feeling like I needed to urinate despite an empty bladder. My Dr. swabbed my vagina and found nothing unusual but I DID have a UTI. I took antibiotics and it cleared up but I occasionally felt little "twinges" of it and it came back in Jan. (no swelling and itching). I went to see another Dr. and she prescribed more antibiotics. I showed her the bottle from my last course, she said that I was given three days of an antibiotic that I should have had for seven. It seemed to go away but in April I noticed that I was having to use the restroom a lot, and it always seemed urgent and sudden, especially after having caffeinated beverages. I went to the health center for anxiety problems and I tested postive for UTI during routine thyroid and diabetes testing. After antibiotics, my stream was faster like it used to be before the infections but it slowed down again a month later, and I noticed that I never felt like I was finished urinating. If I continued to sit on the toilet I could let more urine either trickle or shoot out about every ten seconds. I would think I was done but there was always more. I could sit there all day! It seemed like every fluid went right through me, even water. I would drink it and 15 minutes later have to go. Went back to the Dr., tested positive for UTI and she did a urine culture, more antibiotics, improvement, then it came back again a few weeks later. Went back, UTI, antibiotics...this time, they did an ultrasound on my kidneys and bladder (AFTER the antibiotics kicked in and my flow was back to normal)and the results were normal. My problems came back again after feeling better for two days. I went to a urologist and they said my urine was clear after all the antibiotics. Also, the sample LOOKED like water because I drank some water about 30 min before my appointment and had to stop on the way to urinate. I drank more when I got to the Dr's and I had to pee again 15min later. My urologist feels that these aren't infections but irritation and put me on a low-acid diet (on it for 3 days now, no caffeine for past 2 wks.) I don't have urgency anymore but almost always feel like I need to urinate. I never wait until my bladder is full to go because emptying those few ounces provides SOME relief.
Questions: 1)If it's only irritated, why all the positive UTI results, and why do the antibiotics always seem to relieve all symptoms (temporarily)? 2)Could there be permanent damage to my bladder from the coffee & tea I used to drink and because I had a bad habit of "holding it?" Does the bladder/ urinary tract "heal" like other body parts? 3)Can irritation LEAD to infection? 4)Is it bad to go whenever I feel the urge even if my bladder isn't full? 5)AZO tests show +WBC -Nitrites. Why? 6)Ideas?
Questions: 1)If it's only irritated, why all the positive UTI results, and why do the antibiotics always seem to relieve all symptoms (temporarily)? 2)Could there be permanent damage to my bladder from the coffee & tea I used to drink and because I had a bad habit of "holding it?" Does the bladder/ urinary tract "heal" like other body parts? 3)Can irritation LEAD to infection? 4)Is it bad to go whenever I feel the urge even if my bladder isn't full? 5)AZO tests show +WBC -Nitrites. Why? 6)Ideas?
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MEDICAL PROFESSIONAL
To answer your questions:
1) Recurrent UTIs are certainly a frustrating problem. There could be an anatomical variation with the lower urinary tract that could predispose you to recurrent UTIs.
2) Constant UTIs as well as "holding" urination can lead to damage to the lower urinary tract.
3) Normally it is the other way around. If there is a foreign object in the lower urinary tract (i.e. a foley catheter), that can lead to irritation as well as infection.
4) Increased urinary frequency can lead to infection. Other causes, such as diabetes, should be ruled out.
5) Increased WBC suggests an infectious etiology. If there is constant infection, you can consider chronic antibiotic suppression to preven future infections.
These options can be discussed with your personal physician or in conjunction with a urology referral.
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
1) Recurrent UTIs are certainly a frustrating problem. There could be an anatomical variation with the lower urinary tract that could predispose you to recurrent UTIs.
2) Constant UTIs as well as "holding" urination can lead to damage to the lower urinary tract.
3) Normally it is the other way around. If there is a foreign object in the lower urinary tract (i.e. a foley catheter), that can lead to irritation as well as infection.
4) Increased urinary frequency can lead to infection. Other causes, such as diabetes, should be ruled out.
5) Increased WBC suggests an infectious etiology. If there is constant infection, you can consider chronic antibiotic suppression to preven future infections.
These options can be discussed with your personal physician or in conjunction with a urology referral.
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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