irritated/burning urethra & frequency/urgency & urgency feeling during sex

[Stephanie29]

I have no prior health issues & 4 months ago I started feeling severe urgency&frequency. I've seen 2uro and 2gyn.They've done ua's, urine cultures,vag cultures, STD tests,all neg.I also had an MRI,Cystoscopy and ultrasound,all normal.My bladder capacity was 550ml on the cysto.Good days,my capacity is 12-16oz & I can hold it for a few hours. Bad days its a few ounces &I void every hour.My gyn also did the PST for IC.Also neg. Now the severity of frequency/urgency is less than it was 4months ago &is tolerable.I'm not currently taking meds.I took enablex but it didnt help the irritation/burning in the urethra,which feels like its the main issue because the more irritated, the more it triggers frequency.I still have burning in the urethra all the time.I have mild shooting pains in the suprapubic area,like someone is snapping a rubberband. When I finish voiding,I get that UTI feeling like i have to go more, but when i do its only a few drops.
Sex has become impossible.I have a severe feeling of voiding w/sex. Any pressure in the vagina against the urethra causes urgency.Sex seems to irritate the urethra more.Could there be something irritating the inside of the urethra that the Cysto didnt see causing frequency? It also feels like the urethra or neck of bladder is opening up, urine feels like its going exit & then the urethra closes up.I never have incontinence but it always feels like I will.Any ideas on what this could be?

[Kevin Pho, MD]

You have had a comprehensive evaluation including several referrals to consultants.  Infection would be the most common cause, but has been ruled out.  An MRI, cystoscopy and ultrasound has already been done.

The potassium sensitivity test is not 100% sensitive for IC - but the cystoscopy has already been done, ruling out structural lower GU abnormalities.  

Sometimes, vaginal dryness can lead to some of the symptoms, and an estrogen cream can be tried.  

At this time, I cannot think of any tests that would lead to more useful information.  A referral to pain management, or a neurologist can be considered if the discomfort continues.  Metabolic diseases like diabetes or B12 deficiency can be considered.

These options can be discussed with your personal physician.

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.
kevinmd_

[Stephanie29]

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