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Abdominal pain after 1st morning void & decreased urine flow

  Hello.. I am a 41 yo female with a history of kidney stones. I have been plagued by symptoms that a mystery to me and my doctor. The urge to urinate wakes me early in the morning, and soon after I void, I experience moderate abdominal pain. Also, my urinary steam has decreased no matter how "bad" I have to urinate. There are times that I have to "push" in order to void. I've also noticed that occasionally, my skin has a "stale urine" smell. Any suggestions as to what this problem may be?
Dear Whims,
Pain with urination (dysuria) can occur due to urinary tract infection or bladder inflammation. I assume that your urine is uninfected since you said the situation is a mystery to you and your doctor. Urinary tract infections are the most common cause of the symptoms you describe. Other causes include bladder stones, ureteral stones, and interstitial cystitis
Bladder stones are uncommon in women particularly young women with sterile urine. They can cause slowing of the urine stream and forcing to urinate. Though rare, a urachal cyst might be a consideration.
Ureteral stones can cause urgency and frequency with small volumes and yet the urinalysis is clear.
        You might also consider a problem outside of the urinary tract, such as spastic bowel or diverticulitis.
Interstitial cystitis is a condition characterized by sterile urination. Patients have frequent urge to urinate, pain with urination and low volumes with each void. This disease can be quite debilitating to patients with it. It is a diagnosis of exclusion after others are ruled out.
It sounds as though you need to see a urologist.
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
*keyword: dysuria, voiding dysfunction, ureteral stones

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