[21F] Experiencing urinary retention and severe pain during urination

Patient Description

A 21-year-old female presents with a history of urinary retention and severe pain during urination, rated 9/10, which has been occurring intermittently for approximately one to two years. The patient describes the pain as pressure on the lining of the vaginal opening and a sensation of incomplete bladder emptying, leading to frequent, urgent needs to urinate. This is accompanied by lightheadedness, particularly when standing, and an increase in headaches that sometimes lead to nausea and vomiting if not managed with Advil. The patient reports that these urinary symptoms come and go, with periods of remission lasting a few months. There is no history of urinary tract infections, sexual activity, or pelvic injuries. The patient has not been prescribed any medication in the past year and has no known allergies to medications. The patient also experiences cramping more frequently than usual, but there is no associated fever, blood in urine, or significant lower abdominal pain that would suggest a kidney problem.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Urinary Tract Infection (UTI): This is an infection in any part of your urinary system — your kidneys, bladder, ureters, and urethra. Most UTIs are caused by bacteria, but some are caused by viruses and fungi. UTIs are more common in women than men. They can occur at any age but are more common in people who are sexually active, pregnant, or menopausal. UTIs can cause symptoms like a strong, persistent urge to urinate, a burning sensation when urinating, passing frequent, small amounts of urine, and pelvic pain.

    • Treatment typically involves antibiotics to kill the bacteria causing the infection. Drinking plenty of water can help to flush out the bacteria.

  • Interstitial Cystitis (IC): This is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain. The pain ranges from mild discomfort to severe. IC is a part of a spectrum of diseases known as painful bladder syndrome.

    • Treatment typically involves lifestyle changes, physical therapy, medications, bladder instillations, nerve stimulation, and in severe cases, surgery.

  • Overactive Bladder (OAB): This is a condition where the bladder can't hold urine normally. Symptoms include a sudden urge to urinate that's hard to control, frequent urination, and urinary incontinence.

    • Treatment typically involves lifestyle changes, bladder training, medications, and in severe cases, surgery.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to relieve your symptoms:

  1. Drink plenty of water to help flush out any potential bacteria causing a UTI.
  2. Avoid caffeine, alcohol, and spicy foods which can irritate the bladder.
  3. Try over-the-counter pain relievers to help manage the pain.

What you should look out for

Reasons to see a doctor more urgently:

  • If you notice blood in your urine
  • If you develop a fever (temperature over 100.4°F)
  • If your symptoms worsen or do not improve

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare professional for a formal diagnosis and treatment.

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9 mo ago

People Also Ask

What are the common symptoms of interstitial cystitis (IC)?

Common symptoms of interstitial cystitis (IC) include bladder pressure, bladder pain, pelvic pain, a persistent urge to urinate, and frequent urination. The severity of these symptoms can vary from mild discomfort to severe pain.

How can overactive bladder (OAB) be managed or treated?

Overactive bladder (OAB) can be managed through lifestyle changes such as reducing fluid intake before bedtime, avoiding bladder irritants like caffeine and alcohol, and practicing bladder training exercises. Medications may also be prescribed, and in severe cases, surgical options might be considered.

What lifestyle changes can help alleviate urinary tract infection (UTI) symptoms?

To alleviate urinary tract infection (UTI) symptoms, it is recommended to drink plenty of water to help flush out bacteria, avoid irritants like caffeine, alcohol, and spicy foods, and use over-the-counter pain relievers to manage discomfort. Cranberry juice or supplements may also be beneficial for some individuals.

When should someone with urinary symptoms see a doctor urgently?

Someone with urinary symptoms should see a doctor urgently if they notice blood in their urine, develop a fever over 100.4°F, or if their symptoms worsen or do not improve with initial self-care measures.

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