[31F] Experiencing recurrent urinary discomfort without UTI diagnosis

Patient Description

A 31-year-old female reports experiencing significant urinary discomfort characterized by frequent urination, a pressing need to urinate, and pain during and after urination. This pain, described as sometimes sharp and sometimes dull, has been rated as severe (8/10) and has been occurring off and on for the past 6 months. The patient notes constant pain that does not vary with bladder fullness and has also experienced chills. There is no reported blood in the urine, fever, back pain, or tenderness in the kidney area. The patient denies any recent changes in sexual activity due to the pain. There is no personal or family history of kidney stones or similar urinary issues, and the patient has no known allergies or adverse reactions to medications. Currently, the patient occasionally uses Azos, a non-prescription medication, to manage the pain, approximately twice a week. There is a history of being prescribed an unspecified antibiotic for a suspected UTI in the past. The patient has no other known pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Interstitial Cystitis (IC): Also known as painful bladder syndrome, IC can cause chronic pain in the bladder and a frequent need to urinate. The exact cause of IC isn't known, but it's thought to result from an inflammation of the bladder lining. IC can mimic a urinary tract infection but won't show any bacteria or infection in urine tests.

    • Treatment often involves lifestyle changes such as dietary modifications, bladder training, and physical therapy. Medications and even surgery may be considered for severe cases.
  • Overactive Bladder (OAB): This condition involves an urgent, frequent need to urinate. It can occur even when the bladder isn't full and can cause discomfort and inconvenience.

    • Treatment typically involves lifestyle changes, bladder training exercises, and medications to manage symptoms.
  • Bladder Stones: These are hard masses of minerals that form in the bladder when the minerals in concentrated urine crystallize. This can cause a frequent urge to urinate, pain during urination, lower abdominal pain, and sometimes blood in the urine.

    • Treatment usually involves removing the stones or breaking them down.

Please note that these are just possibilities and not a definitive diagnosis.

What you can do

  1. Keep a bladder diary: This can help you and your healthcare provider understand your symptoms better. Note down when, how much, and what kind of fluids you consume, when you urinate, the urgency you feel before you urinate, and any incontinence episodes.

  2. Try pelvic floor exercises: These exercises, also known as Kegel exercises, can help strengthen your urinary muscles and improve bladder control.

  3. Consider dietary changes: Certain foods and drinks are known to irritate the bladder. These include coffee, alcohol, spicy foods, and acidic foods. Try eliminating these from your diet to see if your symptoms improve.

  4. Stay hydrated: Drinking plenty of water can help dilute your urine, which might make urinating less painful.

What you should look out for

Please seek immediate medical attention if you experience:

  • Severe pain
  • Blood in your urine
  • Fever or chills, which could indicate a kidney infection
  • Inability to urinate

Remember, it's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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8 mo ago


People Also Ask


What is interstitial cystitis and how is it different from a urinary tract infection?

Interstitial cystitis (IC) is a chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain. Unlike a urinary tract infection (UTI), IC does not involve a bacterial infection, so urine tests will not show bacteria. The exact cause of IC is unknown, and it can mimic UTI symptoms but requires different management.


What lifestyle changes can help manage symptoms of overactive bladder?

Lifestyle changes for managing overactive bladder include bladder training exercises to increase the time between urination, pelvic floor exercises to strengthen urinary muscles, and maintaining a healthy weight. Avoiding caffeine, alcohol, and spicy foods can also help reduce symptoms.


How can bladder stones be diagnosed and treated?

Bladder stones are diagnosed through imaging tests such as an ultrasound, X-ray, or CT scan. Treatment involves removing the stones, which can be done through a procedure called cystolitholapaxy, where the stones are broken down and removed, or through surgery if the stones are large.


What are some common dietary triggers that can irritate the bladder?

Common dietary triggers that can irritate the bladder include caffeine, alcohol, spicy foods, acidic foods like citrus fruits and tomatoes, and artificial sweeteners. Identifying and avoiding these triggers can help reduce bladder irritation and discomfort.

1 Comments


Sachi#95

8 mo ago

My sister had something similar and had to avoid triggers such as caffeine (cut coffee out of her life completely) and do physical therapy for pain management. Have you had any children? For her it started after her 3rd child and doctor said was related to pelvic floor weakening and interstitial cystitis

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