Chronic bladder infection

[Totie]

38-femal. I have always had the constant urination for at least the last 7yrs. I go any where from 20-35 times in a 24hr period. I get up at least twice at night to go. All of my previous doctors always told me to quit drinking a lot of liquids. Despite me arguing that I did not drink any more than 50 oz of liquid a day they did not believe me. I just learned to live with the constant urination, it is not painful, unless I try to hold it in. It does not hurt when I urinate either.  I finally got a doctor who was smart enough to refer me to a urologist. They did a cystoscopy and told me my bladder wall is badly infected. What exactly does that mean? I have been put on a 6 month regime of Bactrim & also put on Sanctura XR, that was back on Oct. 31,2008. I have not seen a difference in how many times I go yet. I go back to the urologist in two weeks for a follow up.

Here are my questions. I had so many urine tests, and they never came up with any kind of infection. Was the cystoscopy the only way to detect the bladder infection? Could this infection be the cause of my night sweats?

Like I said I have learned to live with it. I drink no more than 40 oz of liquid a day, and I stay away from water. Water makes my bathroom visits increase by 10 fold. I do not drink my liquids fast either, that will also increase my urges.

Will the infection ever go away? I do not have any pain, i just go too much.

[David A Burks, MD]

Hi, You need a second opinion with a face to face doctor.  Cystitis cystica can take months to resolve on antibiotics. Generally the infection is limited to the bladder wall. There are other options for the frequency and urgency if the antibiotics don't work.  Your second opinion Urologist can review them with you.  Good Luck.

[Totie]

Thanks for your reply. The urologist did do a cystoscopy. It turns out I have cystitis sciatia (sp?).  Reading the cystoscopy results it seems like it is all over the area of my bladder and other areas as well.

Can i send you the results and get your opinion? I love my urologist and trust her, but never hurts to get a second opinion.

My question is can this infection spread if the antibiotic does not kill it? I have been on antibiotics since Oct. and still see no change except starting to experience the pain.

Again thank you.

[David A Burks, MD]

Hi, you have the frustrating but common problem of a chronic bladder wall infection. In some patients the bacteria get deep into the bladder wall, under the lining where they bacteria are protected from the antibiotics in the urine. Urine cultures show no bacterial growth.  These colonies of bacteria grow in the bladder wall, casuing frequency and urgency, plus cause an inflammed bladder wall appearance. These colonies then  rupture back into the bladder lumen and cause the next infection in the urine,perpetuating the problem. Long term antibiotics are only sometimes helpful. The bladder can get scarred, stiff and loose capacity if the problem persists.  The Sanctura XR is being used to try to reduce the urgency/frequency symptoms. There are other agents to try if the Sanctura doesn't work.  One option is a cystoscopy and bladder biopsies in the operating room if you haven't had one to diagnose exactly what is happening in the bladder, and to rule out other problems.  It's unclear what is causing your night sweats. This can be a difficult problem to resolve and it may take months of treatment to eliminate the problem. If it's safe to do so, try adding an antiinflammatory agent to the antibiotic to help reduce the symptoms as well.  Your Urologist should be able to hold you with this. Good luck.