Re: HELP

Posted By hfhs M.D.-MS on April 10, 1998 at 15:41:34:

In Reply to: HELP posted by Kristie on April 04, 1998 at 21:08:59:






I'm a 21 yr. old female who has always had perfect health until the past 2 yrs.  I had never had painful sex or any kind of infection before and 3 yrs. ago I was diagnosed with a UTI.  I was given Macrobid and ended up in the hospital because I needed Cipro IV.  3 weeks later I was diagnosed with a bacterial infection.  Symtoms (symptoms) included vaginal discharge with a terrrible odor, pelvic pain,and lower back pain.  I took the antibiotics prescribed to me. I have probably been diagnosed with 7 bacterial infections since and had been having painful intercourse off and on during this time. Then I was diagnosed with HPV and had a LEEP procedure done(Oct. '97) for severe dysplasia.  After the LEEP the painful intercourse was gone until recently.  2 weeks ago I began having pain while urinating and alot of pain in the middle of my pelvic area(bladder).  The pain was very specific and different from my last UTI.  I was given Septra for 3 days and continued to have burning and now I was also having painful sex.  They gave me another 3 day regiment of Septra.  I'm still having SEVERE pain during intercourse and the pain dosen't subside for at least 2 days.  I'm sick of fighting all the different doctors I've tried.  I feel ignored when I'm just given an antibiotic every time something is wrong.  I feel in my heart that there is an underlying problem.  Perhaps PID which I was also once diagnosed with and it was completely looked over by my new doctor and when I asked her about it she said she doubted that diagnosis.  Is there a difference between a UTI and a bladder infection?  I need much help, and advise would be greatly appreciated.  




Dear Kristie
I am sorry  you have had so many health problems.
Urinary tract infections is a general term and can apply to an infection of the kidneys call pyelonephritis or the bladder which is called cystitis.    Usually a UTI does not cause painful intercourse.  Pyelonephritis does cause back pain and cystitis causes burning and pelvic pain.  For frequent urinary tract infections especially ones causing hospitalizations should be worked up with and IVP ( intravenous pyelogam) an Xray that looks at dye as it goes through the kidneys and a cystoscopy,( a telescope which looks into your bladder. these test can rule out reasons for you to have frequent urinary tract infections.  Here are a few examples which can be diagnosed by cystoscopy;  infected kidney or bladder/  stone , fistula ( a connection between the bladder and the bowel), interstitial cystitis (a bladder / pelvic pain syndrome whos etiology has yet to be determined). Once a structural cause has been ruled out your doctor may prescribe long-term (6m) antibiotic to keep you from getting a UTI and give your bladder a chance to heal and  protect itself.
Many doctors prescribe antibiotic just before intercourse because this is when the bacteria are introduced into the bladder.    
A gynecologic work up should also be done( a pelvic exam ).   A full panel of sexually transmitted disease test should also be performed.  Remember if these are positive, your partner needs treatment also.   A pelvic ultrasound can also diagnose any problem or complications from PID ( pelvic inflammatory disease) which might cause you pain during intercourse.  If your pain comes during your period, endometriosis as a diagnosis might be entertained.  You should be follow very closely for your severe dysplasia diagnosis because this lesion ( severe dysplasia ) is a precursor to cancer of the cervix.
There are reasons for your symptoms whether  biological or mental , they should be treated.  I would recommend finding a doctor you trust and can talk to about which test are needed to rule out / in  some of the above diagnoses.  Once all the appropriate test are done you should get a straight diagnosis from your doctor or a referral to a specialist in this field.
More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians notes and lab test results that you may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Good Luck
Sincerely Yours;
HFHS-M.D.MS
* keyword; UTI, Urinary tract infection , pelvic pain