Womens Health

Persistent symptoms after treatment

I constantly feel like I have to urinate. I had a urinary tract infection about four weeks ago for which I took one week of antibiotics that relieved the major symptoms.

The urine test was negative for infection after one week but I still have a constant sense of urgency. The doctor did an exam and diagnosed bacterial vaginosis although she did not seem to confident of the diagnosis.

I took Flagyl® (metronidazole) for one week, with no change. The doctor recommended I see my gynecologist who in turn thinks I should see a urologist - no one seems to know what to do.

The only other symptoms I have are backaches late in the day (possibly unrelated), a vague feeling of pressure in my lower abdomen which makes me feel like I need to urinate, and an outbreak of acne on my face. Nothing seems to exacerbate or alleviate the feeling of having to urinate

It sounds as if the pressure and feeling of need to urinate started with the urinary tract infection. It may be just a residual from that or perhaps you had some vaginal/pelvic infection at the same time. Be sure your doctor does a culture for sexually transmitted diseases (STDs).

The acne is unrelated, the back pain may or may not be.

Options would be:
1) see urologist to look for other urological problems such as urethral syndrome (but you would have some burning urination) or interstitial cystitis (you would have a lot of urinary frequency) or perhaps a chronic bladder infection (except your culture was negative).

2) Have empirical treatment with another course of antibiotics in case the infection is not quite cleared.

3) If tolerable, do nothing unless the symptoms get worse or fail to resolve over another 4 weeks, and in either case you need to return to your doctor.

Burning on urination

My daughter was taking Provera last week for 5 days to bring on her period and she got it this morning. She said when she goes to the bathroom it burns. Could that be just from her period or a urinary tract infection. How can they tell if she has her period if they took a culture?

The burning may be from the period but it depends on where the burning is. If it burns as the urine hits the outside, it is probably just related to the menses.

If she were to sit in a bath tube and void and there was no burning, that would confirm it. If there is burning with voiding in a tub, then it is internal in the urethra and she needs to be treated.

It is very difficult to get a culture while one menses without a catheterization. If she has symptoms of internal dysuria, most offices will go ahead and treat with antibiotics unless she has some chronic problem that needs more certainty in diagnosis.

Table of Contents
1. Urinary tract problems
2. Burning sensation
3. Vaginal strep
4. Rare: strep viridans
5. E. Coli
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