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Urology (Expert Forum)
cystitis, chlamydia, urinary TB? abdominal pain won't go away.
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.
cystitis, chlamydia, urinary TB? abdominal pain won't go away.
by martha0303, Mar 28, 2003 12:00AM
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’t have the test since I had a lot of yeast and fluids, and I have been applying ovules for a couple of weeks. With antiobitics yeast went away but I started having an abdominal pain and burning sensation around the navy again. I took a 7 days doxycicline treatment on my own, pain continued all of November. And in December it went away and I could sleep fine. I had sex with a different partner at the end of December with no pain. At the end of January, I had sex with a different partner again, and 6 days after, I had another yeast infection. This is the last time I have had sex since then. Before taking anything, I had a vaginal culture, and chlaymidia test. Chlamydia test came positive, and the culture came all negative except for Candida. I took azytromicin 1g, single dose, cefaloxporine 1g, single dose, doxycicline 3 times a day for 7 days. After I ended treatment, the abdominal pain came back and I took another 10 days of doxycicline 3 times a day. I had a small yeast infection in the meantime and I took lomexyn and albothyl ovules and the infection went away. At day 10 of the second treatment I started waking up in the mornings again with the urge to urinate. Gynecologist suggested it might be intestine inflammation because of so many antibiotics. She told me to stop the treatment. For all this time my abdomen has been pretty swollen. My gynecologist suggested me to have urinary test and culture, which came out with white cells (5 per field), bacteria (1+) but no growth. Chlamydia came out positive again (inmunoenzimatic cervix test) Urologist suggest cystitis or urinary TB. They say chlamydia positive result only means I had chlamydia but not that I have it now. How do I know if I really got rid of Chlamydia, and if not, what's the treatment to be followed?
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’t have the test since I had a lot of yeast and fluids, and I have been applying ovules for a couple of weeks. With antiobitics yeast went away but I started having an abdominal pain and burning sensation around the navy again. I took a 7 days doxycicline treatment on my own, pain continued all of November. And in December it went away and I could sleep fine. I had sex with a different partner at the end of December with no pain. At the end of January, I had sex with a different partner again, and 6 days after, I had another yeast infection. This is the last time I have had sex since then. Before taking anything, I had a vaginal culture, and chlaymidia test. Chlamydia test came positive, and the culture came all negative except for Candida. I took azytromicin 1g, single dose, cefaloxporine 1g, single dose, doxycicline 3 times a day for 7 days. After I ended treatment, the abdominal pain came back and I took another 10 days of doxycicline 3 times a day. I had a small yeast infection in the meantime and I took lomexyn and albothyl ovules and the infection went away. At day 10 of the second treatment I started waking up in the mornings again with the urge to urinate. Gynecologist suggested it might be intestine inflammation because of so many antibiotics. She told me to stop the treatment. For all this time my abdomen has been pretty swollen. My gynecologist suggested me to have urinary test and culture, which came out with white cells (5 per field), bacteria (1+) but no growth. Chlamydia came out positive again (inmunoenzimatic cervix test) Urologist suggest cystitis or urinary TB. They say chlamydia positive result only means I had chlamydia but not that I have it now. How do I know if I really got rid of Chlamydia, and if not, what's the treatment to be followed?
Doctor's Answer
by Kevin Pho, MD, Mar 28, 2003 12:00AM
, Mar 28, 2003 12:00AM
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.
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.
Member Comments
by martha0303, Mar 29, 2003 12:00AM
To: Cystisis
0
by Peas47, Jun 27, 2003 12:00AM
To: Cystisis
0
