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The organisms associated with vaginitis, urethritis, cervicitis and PID are different from those causing cystitis and pyelonephritis. The laboratory markers associated and the clinical expression are slightly different.
A clean catch urine collected without vaginal contamination and a gynecological examination with vaginal and cervical swab collection is optimal for a starting point.
It's unclear what the findings were and it's unclear what the diagnosis was. I am sure all the doctors you have seen have made a diagnosis which you refer to as no help. If the doctors suggested a urological referral for IC then I would go that route. IC is different from PID for which you were treated for. Vaginal discharges are also different from IC.
I've had more than one clean catch urine tests along with 3 cervical swabs done over the past couple of months and everything is normal. I remember my gyno also saying that vaginal discharges are different from IC, which made me more frustrated because then what the hell could it be from and why is it accompanied by pain...
I've had more than one clean catch urine tests along with 3 cervical swabs done over the past couple of months and everything is normal. I remember my gyno also saying that vaginal discharges are different from IC, which made me more frustrated because then what the hell could it be from and why is it accompanied by pain...
Vaginal discharges are abnormal. If the swab is a vaginal swab and representative of the discharge then one looks to see an increase in the number of white blood cells indicative of vaginitis, the "itis" part meaning inflammation. White blood cells are inflammatory cells so an increase indicates the presence of inflammation. If the swab were to be a cervical swab then again the presence of an increase in white blood cells then that would indicate cervicitis. When you say normal I take it to mean then that the presence of white blood cells are normal and thus no inflammation present. Bacterial vaginosis can occur with normal white blood cells present. The flora that one sees is also altered and one looks for the presence of clue cells. There's also the typical smell associated with bacterial vaginosis. This can be detected with "the whiff test" where one adds a drop of potassium hydroxide to discharge fluid and takes a whiff to smell it. The wet prep saline examination of a vaginal swab is also searched for trichomonas, yeast and clue cells. The modern version which take longer is the multi panel nucleic acid probes for organisms associated with vaginitis(osis). There's also separate swabs for chlamydia and gonorrhea if so desired. A urine test for those is also available.
On the other side of the spectrum unrelated to discharges is IC which is a bladder condition. Most of the time the urinalysis is normal and sometimes there is blood or a superimposed infection. Sometimes what a person eats can irritate the bladder and if it's acidic then try antacids. There's usually urgency and pain with IC.
It appears that you started off with symptoms associated with a UTI and at present it is one of essentially no urinary symptoms and simply a discharge with pain. Sometimes as mentioned previously by another poster that a yeast infection can turn up after antibiotic use or BV because of altered flora with the use antibiotics.
The differential diagnosis is one of acute pelvic pain with a discharge and if the pain is continued up to six months then it is called chronic pelvic pain. Of concern is obviously PID and one needs to make sure that was adequately treated for. Included in pelvic pain is IC and PID along with endometriosis and other gynecological things. It is hoped that once the discharge is gone that the pain will also be gone.
An ultrasound might be an option for evaluation of pelvic pain if it isn't going away.
Female, 26 here. About 2.5 months ago I got my first UTI. Was put on 3 courses of antibiotics until the right one worked. After about a month and a half I began noticing pelvic pain (seemed like ovary pain that radiated down my inner thigh at first). I would sometimes feel burning urethral sensations AFTER urinating and in the mornings I would wake up cramping until I emptied my bladder. I've had a papsmear done, I've been tested for all the STDs, UTIs, BV, any bacteria really that could be within my urine. I've had bloodwork done as well. I've also taken a full course of antibiotics for PID. All is normal! Currently I am getting cramps when it is not my time of the month and either orangey discharge or white discharge (not gunky but definitely thicker than normal). There is no increased frequency to urinate, though sometimes there is a sudden urge/pressure that sometimes is accompanied by slight cramping. There is a new urine smell, but it's not fishy. I've seen several GPs, and a gynaecologist. No help. I'm wondering if it's IC. But could this have all started because of my UTI?? My next option is a urologist, but I just wanted to see if anyone had any idea what's going on? Please any advice would be great!
Sounds to me like kidney stones. That can cause UTI's and ALL of the other symptoms you have described. Go see an urologist first and ask to be sent for a CT scan and/or ultrasound to look for stones (of any size from the size of a tiny grain of sand and larger) causing blockage in the kidneys, ureters, bladder and urethra.
When you get the abdominal cramping do you sometimes also get lower back cramping that sends pains from the back, through the abdomen and down to the inner thigh(s)? If you do that's another indication of kidney stones stuck in the ureter(s).
Drink lots of water whenever you experience any of the above noted discomforts you mentioned. Whenever you urinate, do so more forcefully than usual and use a urine strainer to urinate into and that will catch any possible pieces of tiny grit that have flushed through you. Or else if you don't have access to a strainer (available at any pharmacy) then before disposing of toilet paper into the bowl and flushing, closely look first at the bottom of the toilet bowl to see if there are any visible specks of small black, brown or yellow pieces of sand/grit sitting on the bottom. If you see any of that then fish it out of there with gloved hands and take it with you to the urologist. The urologist will arrange for lab test to determine what type of stone it is. If you have kidney stones you will need to make some changes to your diet to eliminate the foods that cause kidney stones to develop.
Vaginal discharges are abnormal. If the swab is a vaginal swab and representative of the discharge then one looks to see an increase in the number of white blood cells indicative of vaginitis, the "itis" part meaning inflammation. White blood cells are inflammatory cells so an increase indicates the presence of inflammation. If the swab were to be a cervical swab then again the presence of an increase in white blood cells then that would indicate cervicitis. When you say normal I take it to mean then that the presence of white blood cells are normal and thus no inflammation present. Bacterial vaginosis can occur with normal white blood cells present. The flora that one sees is also altered and one looks for the presence of clue cells. There's also the typical smell associated with bacterial vaginosis. This can be detected with "the whiff test" where one adds a drop of potassium hydroxide to discharge fluid and takes a whiff to smell it. The wet prep saline examination of a vaginal swab is also searched for trichomonas, yeast and clue cells. The modern version which take longer is the multi panel nucleic acid probes for organisms associated with vaginitis(osis). There's also separate swabs for chlamydia and gonorrhea if so desired. A urine test for those is also available.
On the other side of the spectrum unrelated to discharges is IC which is a bladder condition. Most of the time the urinalysis is normal and sometimes there is blood or a superimposed infection. Sometimes what a person eats can irritate the bladder and if it's acidic then try antacids. There's usually urgency and pain with IC.
It appears that you started off with symptoms associated with a UTI and at present it is one of essentially no urinary symptoms and simply a discharge with pain. Sometimes as mentioned previously by another poster that a yeast infection can turn up after antibiotic use or BV because of altered flora with the use antibiotics.
The differential diagnosis is one of acute pelvic pain with a discharge and if the pain is continued up to six months then it is called chronic pelvic pain. Of concern is obviously PID and one needs to make sure that was adequately treated for. Included in pelvic pain is IC and PID along with endometriosis and other gynecological things. It is hoped that once the discharge is gone that the pain will also be gone.
An ultrasound might be an option for evaluation of pelvic pain if it isn't going away.
Thank you for more insight. Correct, my white blood cells were normal. The last tests I had to check for BV and yeast infections were also normal. However, can antibiotics affects the results aka produce a false negative? I've had countless swabs done to check for different STIs as well, but again could antibiotics produce false negative results?
I should also say that in certain positions or exercise I experience more pelvic pain.
I've also already received a vaginal ultrasound whereby they also said everything looked "normal". I'm thinking I just bite the bullet and get a cystoscopy done due to increasing random bladder pressure to rule out any bladder complications. Could other bladder infections cause alterations in vaginal discharge?
Sounds to me like kidney stones. That can cause UTI's and ALL of the other symptoms you have described. Go see an urologist first and ask to be sent for a CT scan and/or ultrasound to look for stones (of any size from the size of a tiny grain of sand and larger) causing blockage in the kidneys, ureters, bladder and urethra.
When you get the abdominal cramping do you sometimes also get lower back cramping that sends pains from the back, through the abdomen and down to the inner thigh(s)? If you do that's another indication of kidney stones stuck in the ureter(s).
Drink lots of water whenever you experience any of the above noted discomforts you mentioned. Whenever you urinate, do so more forcefully than usual and use a urine strainer to urinate into and that will catch any possible pieces of tiny grit that have flushed through you. Or else if you don't have access to a strainer (available at any pharmacy) then before disposing of toilet paper into the bowl and flushing, closely look first at the bottom of the toilet bowl to see if there are any visible specks of small black, brown or yellow pieces of sand/grit sitting on the bottom. If you see any of that then fish it out of there with gloved hands and take it with you to the urologist. The urologist will arrange for lab test to determine what type of stone it is. If you have kidney stones you will need to make some changes to your diet to eliminate the foods that cause kidney stones to develop.
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I have chronic lower back pain in general but don't believe that it is exacerbated by my other symptoms. I've already had a vaginal ultrasound where there was no obstructions found.
I have chronic lower back pain in general but don't believe that it is exacerbated by my other symptoms. I've already had a vaginal ultrasound where there was no obstructions found.
Chronic lower back pain in general IS a classic symptom of kidney stones. Chronic lower back pain can exacerbate all your other symptoms. Did you not tell your other practitioners about your chronic lower back pain?
A vaginal ultrasound is irrelevant to kidney stones. You can NOT get kidney stones in the vagina so a vaginal ultrasound isn't going to show any sign of kidney stones causing any obstructions in the vagina because it's not possible for there to be any stones there. The vagina is in no way connected to the urethra, bladder, ureters or kidneys.
Do some solid, extensive research about kidney stones and their mineral compositions and look up lists of what foods cause them, including looking at images of stones online, then go see an urologist. Be very exacting in telling your urologist about all of your symptoms, even any minor symptoms you might assume are trivial or unrelated.
Chronic lower back pain in general IS a classic symptom of kidney stones. Chronic lower back pain can exacerbate all your other symptoms. Did you not tell your other practitioners about your chronic lower back pain?
A vaginal ultrasound is irrelevant to kidney stones. You can NOT get kidney stones in the vagina so a vaginal ultrasound isn't going to show any sign of kidney stones causing any obstructions in the vagina because it's not possible for there to be any stones there. The vagina is in no way connected to the urethra, bladder, ureters or kidneys.
Do some solid, extensive research about kidney stones and their mineral compositions and look up lists of what foods cause them, including looking at images of stones online, then go see an urologist. Be very exacting in telling your urologist about all of your symptoms, even any minor symptoms you might assume are trivial or unrelated.
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My lower back pain comes in episodes and goes when I'm more rested and is mainly one on side. I've had this pain for 6+ years since I've been consistently going to the gym. Wouldn't I have passed a kidney stone or had any other related symptoms in that time? Just seems so unlikely to me. I'll still mention it though just in case, so thanks for that advice.
I should also say sometimes when I bend a certain way I experience more pelvic pain.
My lower back pain comes in episodes and goes when I'm more rested and is mainly one on side. I've had this pain for 6+ years since I've been consistently going to the gym. Wouldn't I have passed a kidney stone or had any other related symptoms in that time? Just seems so unlikely to me. I'll still mention it though just in case, so thanks for that advice.
I should also say sometimes when I bend a certain way I experience more pelvic pain.
Yup, you are just confirming my own assessment more and more. Everything you're describing that I've bolded is indicative of kidney stones. Going to the gym is actually a good thing because the activity there helps to shatter bigger stones into smaller stones and that makes it easier for the smaller pieces to pass through un-noticed by you, but the passage of the smaller stones exacerbates all the other symptoms. You may easily have been passing kidney sand and grit for the past 6 years and didn't know it, but may have larger pieces still left behind now and causing worse symptoms.
I forgot to mention what can happen if you get life-threatening renal colic and the most hideous excrutiating pain in the world if the symptoms of kidney stones are ignored or trivialized and then start causing ruptures or slicing up the ureters with the sharp points on them. And I'm not going to tell you about that here either, you can look up renal colic for yourself to find out how awful it is and why it can be life threatening.
Go see a urologist really soon to either confirm or rule out kidney stones, don't put it off. If you have kidney stones there are ways to get rid of them.
I'm thinking I just bite the bullet and get a cystoscopy done due to increasing random bladder pressure to rule out any bladder complications.
There are so many possibilities with pelvic/abdominal pain in a female of reproductive age and it can take a while to figure it out and require a long process of elimination. It sounds like you've done a number of things coming at it from the Gyno angle, so I think seeing a Urologist for a work up and possibly getting a cystoscopy is a logical step.
I've had 2 cystoscopies done for recurrent UTI's and associated bladder pain, one in 1998 and one about 2005. Both showed my bladder to be irritated and inflamed, but no other anatomical problems, masses etc. It's a quick and easy procedure done in office that allows the Urologist to eliminate a lot of possibilities if normal. I will tell you that the procedure is not particularly pleasant, but it's not awful either (my second was significantly less uncomfortable than my first). Really, the worst part is that urination is quite painful for a day or two afterwards.
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