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cystitis, chlamydia, urinary TB? abdominal pain won't go away.
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cystitis, chlamydia, urinary TB? abdominal pain won't go away.

I have a vague abdominal pain (concentrated around the navy) all day long.  I wake up at night with the urge to urinate (usually around 6 hours after I go to bed), and after urinating I have a lot of pain for the next half hour and can't go back to sleep.  Urinating doens't burn and I can empty my bladder with no difficulty.   I had chlamydia six months ago, and since then I've been having these symptoms.

Here is the complete story:
On sept 2002, I had something that looked like a yeast infection, 7 days after having sex for the first time with a new boyfriend.   I stopped sex and used regular yeast infection treatment.  The yeast didn't go away.  
After 2 weeks I went to the gynecologist, who gave me stronger treatment and said I my cervix was very swollen.  Yeast didn't go away.  I started having abdominal pain and waking up at night with an urgency to urinate and the symptoms described above.
After 4 weeks I went to another gynecologist who suggested chlamydia and gave me azytrocine together with lomexin, ibuprofen, micronidazol and albothyl.  Performed HIV and diabetes tests, and both came out negative.  My partner tested negative on chlamydia and I didn
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Hello - thanks for your question.

You may be describing a presentation of Chlamydia, namely dysuria-pyuria syndrome.  Women with urethral infection complain of typical symptoms of a urinary tract infection (UTI) such as frequency and dysuria (painful urination), and occasionally of lower abdominal pain. Urinalysis reveals pyuria (white cells in the urine), but no organisms are seen on Gram stain or in traditional culture.

There are several causes for this.  First, it may be possible that the Chlamydia is resistant.  You have already taken azythromycin and doxycycline.  Other antibiotics that are used  include ofloxacin or levofloxacin - you may want to discuss these options with your physician.

In terms of diagnosis, you may want to inquire about other tests for Chlamydia to ensure accuracy.  You mentioned the immunoenzymatic cervix test.  Other tests include a Chalmydial culture and direct nucleic acid amplification.  These two tests are more accurate and may be considered to ensure that you indeed have active Chlamydia.

Other diseases that can cause your symptoms include a low colony count UTI, gonorrhea, or herpes - ask your physician to test for these.

Regarding urinary TB, imaging of the kidneys suggest the diagnosis.  A specific urinary test (known as acid-fast bacteria smears) is needed for a definitive diagnosis.  Again, if this is a concern, you should be tested.  

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.

Thanks,
Kevin, M.D.
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