Acute onset urinary frequency and bladder pressure

Acute onset urinary frequency
by RHR, 2 minutes ago
I am a 50 yr. old post-menopausal (5+ yrs.) woman having feelings of pressure on my bladder and the need to urinate which never goes away and becomes more acute after urinating. There is no pain or itching.  This began suddenly about 10 days ago after week at beach. I was in water, sitting in wet bathing suit and in heat.

Have had urinalysis, urine culture, pelvic ultrasound of ovaries and bladder - all normal. No blood, no sugar, no protein, etc.  Examinations for yeast and bacerial infections were negative. Was treated for possible urethritis with 3 day dose of Levaquin of 250 mg, then 3 days of 500 mg  Levquin, then switched to doxycline 200 mg a day.  Just started 2nd day of doxycycline and feeling no better - not sure when I would notice anything.  No recent sexual activity.

Gyn thinks it's estrogen deficiency and wants me to start vagifem, but I am questioning the acute onset of this??  Cannot detect any bladder spasms, but am extremely uncomfortable feeling like I always need to urinate.  Notice it is particularly bad when lying down and on either side.  Can only sleep on back.  Some nights it wakes me up every 3 hours, some nights I can make it through the night.  Yesterday, had short period of time in morning and early afternoon where I thought symptoms were better, but then got worse in afternoon and have stayed worse since.

Does anyone have any idea what this could be?  Was given prescription for pyridium, but that sounds like it's more for pain and don't want to mask anything as I have urology appt. on Wed.

[sherrieP]

Do you have any pressure sensation in your vagina or rectum or is it just high up by the bladder? If it is lower, it could be POP issues; some women experience pressure sensations, some experience pain, it varies so much from woman to woman. Please read the following post to see if anything else fits.

http://www.medhelp.org/posts/Urogynecology/Taking-Pelvic-Organ-Prolapse-Out-of-the-Closet/show/1271553

Sometimes something as simple as lifting a heavy object can change your pelvic floor scenario from POP "contained" to POP "with issues".

Whether it seems to fit or not though, I'd still recommend you see a urogynecologist, they are the specialists for pelvic floor disorders and are familiar with all organs and structural tissues within the pelvic region. I'm sure you'd be able to get an accurate diagnosis of what is going on from a urogyn.

Good luck, I hope you find the answers you need!
Sher

[cathytn]

I've just read your post and I'm shocked at the details. Finally someone who is living with the same thing I am. I'm 50 and have all the same symptoms except I am not fully post menepausal. I've been treating this as a uti but knowing there more to it. Have not been to the Dr. because i don't have insurance.This is driving me nuts!!! Can you tell me how everything turned out in your case so I'll know if I should go to the Dr. or not.
Thanks so much,
Cathytn

[RHR]

Wish I could tell you my situation was resolved.  It's better, but not resolved.

Since I last posted, I have been to a myriad of doctors.

First stop - gyn who thought it was urethritis and treated with antibiotics.

Next stop - vaginitis specialist who diagnosed me with vaginal atrophy and said vaginal estrogen was the answer.

Third stop - urologist who diagnosed me with overactive bladder & put me on Gelnique (oxybutnin gel).  

My nightime symptoms have gotten much better - I am able to sleep for longer periods of time

I still have the feeling that I have not completely emptied my bladder - that feeling comes and goes.

I do not feel I have overactive bladder because I do not go to the bathroom as much as the literature says, nor do I have any urgency or feelings that I can't make it to the bathroom.

I do feel that the lack of vaginal estrogen may play a role. I have been on Vagifem for 6 weeks and feel a bit better, but just got back from dr. today and he says (and I agree) that it is not quite doing the trick.  He is switching me to a vaginal estrogen cream.

In the meantime, I am going for a second opinion with another urologist.

Fortunately, I have insurance.

My best advice would be to go to a free clinic where they might be able to help with at least the menopause piece and perhaps they can try the vaginal estrogen.

I'm sorry I can't be of more help.

If you can go to the dr., I would.

Good luck - I hope you feel better soon.

RHR

[cathytn]

Thank you sooo much for responding, This night time feeling is driving me crazy, I,ve tryed antibiotics and azo and it has been no help. I've had this feeling before but never to this extreme or for this long, If it is just a matter of things falling (bladder) with age I guess I'll learn to live with it since I sure don't have money for surgery to tack it up. I was just afraid it might be more serious, like cancer of the bladder or ovaries since these symptoms seem to fit more then one thing(but those two also have symptoms I don't have) . I'm still not sure what to do but I do want to thank you for your help. It was a relief to know this same thing was happening to someone else and I wasn't alone . I will check back here when I can, so let me know if you find any help and I'll do the same.
Thanks,
Cathytn
P.S. Did they say what exactly the vaginal estrogen would do? I thought that was for some of the symptoms of menopause like hot flashes and mood swings. Just wondering what their thinking is.

[RHR]

It could be a number of things, from what I understand.

I have had the following tests (in this order) and would advise you to do the same to rule things out.  Then they will check you for things like overactive bladder, interstitial cystitis (which was ruled out for me because I have no pain).

Ultrasound of bladder, pelvis and kidneys - that will look at ovaries, too.

Cystoscopy - basically an endoscopy of the bladder to check to be sure everything is ok

The way I understand it, the vaginal estrogen is that it is just for that area - it is not hormone replacement therapy (HRT) which is prescribed for hot flashes and mood swings.  It just treats the vaginal atrophy that may accompany menopause.  My dr. told me it may get into the bloodstream a bit, but not to be concerned because it is nothing like the HRT. He feels that the bladder definitely needs estrogen and that this may help.

Hang in there!

[cathytn]

I made an appt yesterday with a gyn for Monday morning. It will cost me money I don't have. But I'm just going nuts with the symptoms but more so worrying about what it could be.I'm a little scared so wish me luck! Good luck to you and keep me posted. I think we could both use a good word from a doctor about now.:)
Thanks,
Cathytn

[cathytn]

Went to the Dr today and he found no infection or prolapse of the bladder so...... he believes it is  interstitial cystitis which has no cure but several ways to treat. there is a real expensive med. Elmiron since i have no ins we ruled that out for now. He has me on a low dose of  Elavil at night.He wants me to come back in 2 months. I found this aritcle on it  http://www.everydayhealth.com/health-information/interstitial-cystitis-treatment.aspx   Not really feeling that this is going to work but willing to try. Let me know what you find out.
Thanks,
Cathytn

[cathytn]

Trying to list link again


http://www.everydayhealth.com/health-information/interstitial-cystitis-treatment.aspx

[RHR]

Good luck - I have had no pain so they ruled out interstitial cystitis, but I have heard that Elavil does work.

I hope it does for you.

Take care,.

[cathytn]

I don't have any pain either just pressure and a need to go feeling, worse when i sit down or lay down on my side.  There is no pain,no leaking and no feeling i won't make it to the bathroom. I have noticed a little less intense feelings without drinking coffee. I'm trying to narrow down what might irritate my bladder and cause some of this. My Dr said he would send me to a Urologist but they are expensive without insurance and IC can't always be seen in a scope unless it's severe or ulcered. He said he wants me to see a Uro if it becomes painful or blood shows up in the urine.  He wants me to come back in 2 months to check the progress of the symptoms and the meds effect.
Cathy

[missrdl]

I'm 55, post memopausal and having the same symptoms as you. I just had rectocele surgery and hoped that would fix the pressure problem, but I'm still up several times a night. The urge to go almost always involves a hot flash. I used estrace for several years,(which always left me uncomfortably itchy and feeling like I had a yeast infection) and recently switched to Premarin which doesn't seem to make me so itchy. But still can't sleep all night. Also have a lot of anxiety from this. so I take Klonopin at night to sleep, so at least I fall back to sleep now instead of laying awake wondering if I'm ever going to get to sleep all night again!
The rectocele surgery has allowed me to sleep on my belly again (it relieved my intense backache). I also seem to have urinary retention problems during the day, oh and did I mention vulvodynia?
I have to admit I wasn't a fan of the estrace due to side effects and didn't use it as often as prescribed. I'm hoping the premarin cream will k\make the difference.
How are you doing now? It's been a couple of months since you posted?

[ciao7576]

I have never participated in this type of blog but its good to finally hear others  with my symptons. Symptoms began after menopause at about 52, now I am 59. About 6 years ago I began treating with antibiotics.   That worked for a while but stopped working. Last year,  I began taking Vagefem 2x a week and think that is the trick.  Then I decided to decrease the Vagefem to 1x week and the symptoms are back was symptom free for almost a year.They are usually worse at night, was told I had Interstatial cystitis.  Me and My big ideas to cut Vagefem.  So Now I am back to 2 x a week and hope my symptoms will go away again.

Will keep you posted.

[Shelly1957]

I am a 55 yrs. old. I was having the sensation of having to urinate almost every 2 hours. Sometimes I had the sensation even after urninating. I have had bladder surgery in the past and everything there is still in place. The dr. put me of Toviaz which helps some. I can usually make it 4 - 5 hrs. without having to pee. I do get increased pressure on my bladder at night when I lay on my side. It seems to be worse laying on my right side. It's very annoying. I get up to pee and lay back down and still feel like I have to go. I think I too have been concerned that it may be someting more serious. I went to the GYN 2 weeks ago and had an exam. I'm thinking if there was something going on with my ovaries (enlarged or anything), he would have noticed. I have had a partial hysterectomy so I have no uterus. I guess I am relieved tto hear that others are having very similar symptoms. ***** to get older. If anyone has had any luck with anything to help I would sure like to hear about it.

[cathytn]

The Elavil has been working for me for the last two years. I only have to take 25 mgs. at night. I have no side effects and sleep like a baby even at that low of a dose. Good luck to all you ladies who are dealing with this and please ask your Dr. about Elavil it is a safe well known drug and it worked and is working for me.
Have a Great day,
Cathy