Ic, kidney stones ir bad infection

[bubbles410]

Dear doctor
I am a 43 year old women 3 weeks ago I began to have what I thought was a bladder infection. I did some home OZO test that showed some WBC but no nitrates. It began with urgency for 2 days and a feeling that my bladder would not empty.  After 2 days the burning began.  The doctor thougth it was a UTI and presecribed antibiotics and Phenazo.  After 2 days the systems worsened and after a in house strip test the doctor changed my antibitoics because he said it was not working ( however I understand the phenazo can contaminate the sample).  The lab lost the first  urine test and for everyone after I was on anitbiotics and they found no bacteria.  The pain got worse like glass was is my urethra.  5 days after not getting better I went to the walk in cliinc were the doctor took me of the antibiotics after calling the lab and getting the negative growth test. (however I was on antibiotics for these cultures)  Three days later things were worse I felt like I had the flu and the pain was unbearable.  The family doctor put me back on the anitibiotics and sent me to emerg who refered me to a urologist.   After I finished the 7 days of  the 2nd  anitibiotic things are slowly getting better.  However I still have burning not as bad as before exaserbated by sitting.  The bladder fullness is also getting better however I still have some  burning pain in my urethra ( ussually a half hour after I void), pain in my groin and pain in my back it is all on my left side.  An utra sound found nothing unusual.  The urologist thinks it is either kidney stones or the residual effects of a bad infection.  He would like me to get a CT.  I am concerned as I have had 3 CT scans after a PE in both lungs 2 years ago after delivery.  What are your thoughts?  He does not think it is IC because it came on so suddenly. He said that the urine cultures were tainted due to the antibiotics.  I can go 2-3.5 hours between void but I am holding it.  What are your thoughts?

Thanks

[David A Burks, MD]

Hi, You have the typical history of the confusion between IC and a UTI.  What is the diagnosis?.  IC and UTIs often have the same symptoms and can't be distinguished without a urine culture.  What I do in my clinic is to give patients a steril urine cup and the paperwork to submit a urine culture "on demand" when the patient has symptoms, so I always have a culture before treatment.  The patient calls my office and informs my staff that she has submitted the culture and we call in an antibiotic.  If a patient has clear cut UTI symptoms with a negative culture then I  suspect IC. You need a pelvic exam to rule out other causes of burning, and possibly a look into the bladder. If the nitrite pad is positive on the urine dip test, then you probably have a UTI, however if the nitrite pad is negative, that does not rule out a UTI.  IC is a chronic disease, and most experts feel you have to have symptoms for at least 3 month with  negative urine cultures before the diagnosis can be made.  You Urologist was right that a bad UTI can have residual symptoms of inflammation of the bladder wall  for weeks after treatment.  Start with the cultures during symptoms to clear up the issue of UTI vrs IC. If there is a suspicion of a stone in the ureter, a IVP or CT is the best test    Good Luck.  

[bubbles410]

Dear Br. Burks

Thanks for the information.  I have had the ct scan (no dye), transvaginal ultrasound  and a cysto retrograde both showed nothing unusual.  The major issue is burning in my urethra and pain in my lower front were my overies are.  It feels like someon is leaning on my bladder.  
The urologist does not think it is IC because he said that burning is not a symptoms and the symptoms which started with frequency for 2 days and then the burning and pain started.  It  has been going on for 30 days.  Would a cysto retrograde show IC? He still believed it is the residual effects of a UTI.  Do you have any ideas.  In your opinion what should the next steps be?
Thanks so much

[bubbles410]

Dear Dr. Burks

I forgot to mention that the urologist also believes that it is not IC due to the fact that it came on so suddenly which he believes is not a sign of IC.  He prescribed phenzo for the week.  If I take it 2 times a day (200 mg) it provides much relief.  Do you have any insights.  Your comments would be much appreiated