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Urinary Disorders

Urinary Tract

01/05/2010

Question:

I`m a 26 year old and have been very prone to cystitis for the last 6 or 7 years. Over the last 2 years I`ve had a really irritable reaction which feels like the start of cystitis (burning, uncomfortable feeling down below and sometimes when urinating).

I drink a lot of water, but if say, in a period of 3 hours I didn`t have any water, but had a cup of tea and some milk/juice then I would start to get that feeling. Then if I drink lots and lots of water it goes away. It also happens sometimes when I wake up - obviously haven`t been consuming water enough in the night. The same thing happens without fail whenever I drink alcohol - and usually but not always, if I then drink water it goes away and I can drink alcohol without that feeling. I`m just concerned as the GPs I`ve been to don`t seem to be able to advise what it could be…

Thanks

Answer:

You have described the urinary symptoms but have not mentioned whether you have been tested for urinary infection. Recurrent urinary tract infections (UTI) are not uncommon, especially in women (gender detail not provided in your email) and need to be evaluated with a urine culture.

If there is documented recurrent UTI (as per the cultures), then a urologic assessment would be warranted (to look if there is any definite cause for the infection e.g. kidney stones, though a definite cause might not always be present) including a clinical evaluation by a urologist, and an ultrasound exam and/or cystoscopy (look into the bladder) if indicated after the clinical evaluation.

If there is no evidence of infection, then the other possiblity to be be considered would be an overactive bladder which usually presents with symptoms of urinary frequency and urgency but sometimes can be associated with a burning sensation while urination. Overactive bladder can be diagnosed with a test called urodynamics, and is treated with oral medical therepy. Sometimes bladder stones could cause similar symptoms.

As you can infer from the discussion above, the symptoms that you describe could be associated with some form of inflammation or infection in the bladder, urethra or genital area (including the causes discussed in the previous paragraph). Given that you seem to have had these symptoms for a while, I would suggest that you should consider a consultation with a urologist. I have attempted to address your questions based on the limited clinical information available from your email and hope you find this useful, but I would recommend the urology consultation for a detailed evaluation based on your actual clinical situation.

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Response by:

Krishnanath  Gaitonde, MD Krishnanath Gaitonde, MD
Assistant Professor of Clinical Urology
College of Medicine
University of Cincinnati