Re: Bladder question.....Should I be concerned?

[Trisha__0__0]

Posted By Trisha on June 14, 1999 at 12:16:48
I have read several posts here and see that there is alot about intersitial cystitis. But I believe that I might have something else going on I have this problem after urination there is blood and this severe pain. I have had UA's done by my primary doc my GYN and also urologist all are negative for infection but there is blood and protein and I have gross hematuria..... My ? what are the tests they use besides cystoscopy and IVP which I have had done already IVP(not remarkable) and cystoscopy showed an inflamed bladder but the urologist said he may have to do something else but they put you out for it~!!!! I have no clue what it is...

I am very concerned because I have all this back pain(Flank) and it goes around
to my groin ...I have to have a CT this week but the pain is pretty bad and I have been given pain killers and told to wait for more tests... Is there something else these docs should be doing or is it ok to wait?
Thanks very much for any info you can provide
This is a great service you all provide here....

[hfhs M.D.-AK]

Posted By HFHS M.D.-AK on June 17, 1999 at 17:22:16
Dear Trisha,
I think a CT scan is a logical next step.  The CT should have narrow cuts to increase the chance of detecting a stone if present.  You may also want to have a bladder urine cytology performed to rule out bladder cancer as a cause.  Make sure that the ureters are clearly visualized in their entirety on IVP or a retrograde pyelogram could be performed.  If both the CT and cytology are negative, then Interstitial Cystitis is a diagnosis that should be evaluated.  Bladder hydrodistention and medications would be considered for therapy.
Personally, you pain is very suspicious for a stone or ureteral abnormality.  Sometimes the only identification of these problems occurs when an IVP is repeated during times of pain.  I would not give-up hope in finding the reason for your pain.  The only other studies that might be of use would be a nuclear scan of the kidneys to determine differential function and look for obstruction, or ultrasound to look for hydronephrosis or shadowing from a renal calculus.
Good luck!  I think your urologist should continue the work-up until an answer is found.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword: Renal Calculus

[Trisha__0__0]

Posted By Trisha on June 20, 1999 at 15:04:38
Thank You so much for your response.... I had my CT and it showed I have cysts on my ovaries which I am tols are not large eonugh to cause my pain and also free flowing fluid in my pelvic area I am wondering what could this fluid be... I am in alot of pain and it is in my back around my side and in my groin and pelvic area I have been in alot of pain and the only thing I was told is that I would have to have exploritory surgery to see what else in my abdomen could be causing this pain.....My ?  Is this appropriate? Or is this something like a stone make of uric acid if I am correct they are hard to find with these test.... My urologist basically told me it's not from a urilogical problem... I am confused I thought blood and protein was a problem now he is blowing it off saying that alot of people have this and the inflammed bladder what about this? I am not asking you to answer all of this only to ask is this the appropriate way to diagnose or should I get a second oppinion?
Thank you so much for any info you can provide!!
Trisha

[hfhs M.D.-AK]

Posted By HFHS M.D.-AK on June 22, 1999 at 14:13:53
Dear Trisha,
It is difficult for me to comment on your situation because I dont have access to your films.  I tend to agree with your urologist, this doesnt sound like a urologic problem but I dont have all of your information.  Your CT scan would have shown a stone, hydronephrosis or a mass if there was a serious urologic problem.  It is also possible to have a fibrotic process that encases the ureter called retroperitoneal fibrosis.  However again, there would be findings on the CT scan.  Other thoughts would include, endometriosis or uterine fibroids.
I do think a second opinion is a good idea before exploratory surgery.  An IVP at the time of pain could also help diagnosis your problem if it is urologic.  This is different that your other IVP that was normal, in that we know your pain is occurring at the time of the x-rays.  You also mentioned in your first question that your had gross hematuria.  A cystoscopy with bilateral retrogrades may be helpful to localize the bleeding to one side.  It is also possible depending on your race that bleeding can occur secondary to sickle cell trait or disease.
Whatever the cause of your pain and bleeding, more tests need to be considered before surgery as a last resort.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Abdominal pain

[SLW-MD]

Posted By SLW-MD on July 07, 1999 at 23:20:57
Your symptoms may be allergic.  Have you tried an anti histamine when they are active.  Benedryl over the counter may help.  Also have you tried a course of a urinary antibacterial like nitrofurantoin?  not all infections grow out in cultures.    Do you take bubble baths or scrub wioth a lot of soap around the vagina?  both of these can cause symptoms.










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