Unusual urges to urinate

[CAlise]

I have read other womans' posts on constant urges to urinate but none seem to match what I am going through. Every couple months this comes back and this time it is unbearable. Instead of a typical bladder squeeze telling me I need to urinate, I have been experiencing the feeling like I am constantly peeing, a kind of tickling of my vaginal area. Every now and then it gets really bad and I go to the bathroom and squeeze out anything I can and at the end, I usually experience a mixture of pain and relief, but the tickling sensation never goes away. The only thing I've been able to think of is that maybe my Nuva Ring is somehow rubbing against my G-spot which usually only makes me feel like I have to pee, but I really don't see how I could be experiencing this sensation so constantly, even when I'm not moving. I've tried taking it out for 15 minutes to see if the feelings change but so far I haven't noted any difference. I am a very healthy person in general, but I just always seem to have something going wrong with my vaginal area.  

[David A Burks, MD]

I recommend you go to the Interstitial Cystitis Association website: ichelp.com.  You can find IC friendly doctors in your area who you may need to see.  Even if you go for a single appointment as a second opinion, you cn get a treament plan established that your local Urologist can follow.  Many patients need to be seen in a special pain clinic and a regimen of pain medication recommended.  Its not uncommon for an IC patient to need a local Urologist and Gynecologist, a pain management specialist and possibly a regional IC expert to help coordinate care make suggestions. Elavil is a good drug to start for IC and the dose often does need to be increased.  Usually 25- to 75 mg is the effective range for IC.  Good Luck. ------------- David  

[Diana641]

From; Diana641        Dr. Burks,I have been diagnosed with intersitial cystitis and I DO get a sensation similar if not identical to what CAlise was describing. I would describe it as a swarm of bees in my vagina stinging though, not tickling. Maybe my perception of this sensation is warped due to the lack of care rendered by the medical community here. I am having a real problem with receiving pain relief as doctors are reluctant to prescribe it and pass me from one to another(and on and on) So, to keep from having a nervous breakdown, I am trying homeopathic meds and they aren't working. Just need a break from the doctors on some sort of control trip for awhile. I did receive some Elavil from one Urologist and it did really help for about 3 weeks. She never said I would need to increase my dose, which makes perfect sense to me. I refuse to go back to her because even with written documentation that I have IC, she wants to do her own cytoscopy test in her office(for insurance money,I feel). I was under general anesthesia for the first one. I don't feel my body can withstand another painful test at this point.Totally burned out! Just had a blood filled cyst on my ovary burst and the tech.(ultrasound) said to get some strong pain meds from my gynecologist(as I had to travel that week) He of course refused, don't you know opiates are addicting!!!! Thank you for the info on Elavil. Sincerely, Diana641

[David A Burks, MD]

Hi, Urgency is a symptom of many disease processes.  A bladder infection can cause urgency by irritating the bladder lining and wall.   Overactive bladder is another common problem seen usually in the elderly but can occur in 5% of 20 yr old women.  You typically get urgency, urinary frequency, and possibly urge incontinence.  Interstitial Cystitis (IC) is an inflammatory condition of the bladder that causes urinary frequency, urgency and pain, pressure or discomfort in the bladder, usually with bladder filling. You didn't mention your age but I assume you are healthy with no neurologic problem like Multiple Sclerosis, or a stroke that can also cause urgency. There are another group of unusual problems that can cause urgency like a bladder tumor or stone, retaining urine in your bladder after voiding, overintake of caffeine or alcohol, poorly controlled diabetes etc. Its unclear whether your "tickling sensation" in the vagina meets the definition of bladder pain.  You need a basic work up for urgency by a urologist or gynecologist to rule in/out the above issues.  Without clear cut bladder pain, its unlikely you have IC.  I would start with your gynecologist to rule out a vaginal infection or other local vaginal problem first.  Good Luck.