UTI & associated conditions – Page 2

By dint of internet, you probably know about the symptoms of Urinary Tract Infection (UTI). You might have the experience of suffering from UTI. So what do you know about the symptoms of UTI? You will mostly talk about the burning sensation during urination, the frequency of urination, urgency, lower abdominal pain, fever, etc. But do you know, your burning sensation, frequency, urgency may not always be due to UTI? Yes, there are some other conditions that may produce such kinds of symptoms and mimic a UTI. In many of the cases, those diseases become confusing and may cause a diagnostic dilemma, even for the doctor. Here we are going to discuss some of those situations. It will help you to know more about your diseases. And you will be able to help yourself and your doctor to make the right diagnosis and treatment. image source (Wikimedia Commons) Interstitial Cystitis It is one of the common conditions which is often misdiagnosed as UTI. It is also termed as BPS( Bladder Pain Syndrome). You will suffer from similar symptoms like UTI. For example, there will be a frequency of micturition, urgency, lower abdominal pain, etc. This is more common in women compared to men. Though there are symptoms like a UTI, actually, there is no bacterial infection in the bladder. The patient with interstitial cystitis visit to doctor recurrently and often take empirical antibiotics. But the symptoms come back again. Urine routine examination reveals no significant bacterial concentration in urine. You will be astonished when you will see that there are typical symptoms of UTI but the laboratory test found no infection! The exact cause of interstitial cystitis is still unknown. There are some theories from scientists but nothing is proved undoubtedly. Some say that it is due to defects in bladder epithelium, some say that it occurs due to an issue with nerves. It may be an autoimmune condition, too. Because it is often found with other autoimmune diseases. It is difficult to confirm the diagnosis by a single test. Your doctor will try to rule out other conditions through clinical examination and lab tests. As the cause is unknown, treatment is also difficult. The treatment is mostly symptoms oriented. If a secondary cause is found, that need to be treated first. There are multiple treatment options and your doctor will decide the best-suited one for you. for more information about this subject please visit the cystitis vs UTI article. Overactive bladder It is another common condition where you will suffer from frequency and urgency, but there is no infection in the bladder. It occurs due to the overactivity of the bladder muscle. Men with prostate enlargement and women after menopause may suffer from this problem. People with Multiple Sclerosis or spinal cord disease may also suffer from overactivity of the bladder due to a neuronal problem. You will not get any fever or abdominal pain, and there will be no sign of infection in the urine routine examination. Sometimes it becomes embarrassing for the patient and affects day to day life. Don’t worry, there is an effective treatment available. If a secondary cause is found, that need to be treated first. For example, if you have prostatic enlargement, get treated for that. If you have a spinal cord problem, you may need to visit a neurologist or neurosurgeon for proper treatment. If no secondary cause is found, and the muscular activity of the bladder is the only cause, you may need some specific treatment. Exercise to relax the bladder muscle, scheduled voiding technique, etc may be helpful. If the problem persists you may need some drug treatment to control the overacting muscle. A few patients may need neuromodulation therapy or surgical intervention. Your urologist will decide about the most effective treatment plan for you. Bacterial vaginosis As the name indicates, it is the bacterial infection of the vagina. But in some cases, it causes irritation of the vulva and burning sensation during micturition. In such a situation, you may assume it as UTI. The bacterial vaginosis is caused by alteration of bacterial flora of the vagina. The main causative agent is Gardnerella vaginalis, but for UTI the most common pathogen is Escherichia coli. Recent studies show that other bacteria present in the vagina like Mycoplasma, Bacteroides, Mobiluncus, etc also play a role along with Gardnerella. The exact etiology is unclear. But these bacteria replace the normal flora(Lactobacillus) of the vagina. As a result, the vaginal environment is changed. These bacteria produce amine and other degradation products which leads to the characteristic fishy odor. You will suffer from grayish-white, homogeneous vaginal discharge. If you get fishy odor just after sexual intercourse, possibly you are suffering from Bacterial vaginosis. Treatment requires antibiotics for eradication of pathogenic bacteria. Consult with your doctor, take the prescribed drugs regularly, and get cured. even though bacterial vaginosis is a condition that is different from UTI, however, it can lead to a UTI. if you want to know why please visit this article. also if you want to restore your vaginal healthy flora you will need to take probiotics. probiotics products like renew life women's probiotics contains the probiotics strains that live in the vagina which will prevent vaginal infections like vaginosis and also contains strains that will support your overall digestive health and immunity. Ovarian Cysts A cyst means a fluid-filled sac. In a healthy woman with regular periods, cysts may grow in the ovaries without any harm. These are called functional cysts. It is a normal phenomenon and you have nothing to fear about. Mostly they are asymptomatic. But sometimes you may feel lower abdominal pain on the side of the cyst, frequent urge to urinate, etc. These symptoms will make you confused about UTI. Other symptoms are pain during sex and menstruation, unexplained weight gain, breast tenderness, etc. The functional cyst will not cause any problem, but if there is any other pathology, the cyst may grow larger. A large cyst may cause abdominal distension, difficulty in passing stool and urine completely, etc. It may even rupture causing severe pain which will compel you to be hospitalized. If you are unlucky, the cyst may be twisted along with the ovary. It will cause severe abdominal pain with nausea and vomiting. Surgical intervention may be required in such cases of ruptured or twisted ovarian cysts. The pathological cysts are caused by pelvic infections, endometriosis (growth of uterine tissue in abnormal site), malignancy, etc. Another type of condition is Polycystic Ovary Syndrome(PCOS), where you will grow multiple small cysts in the ovary. It is a leading cause of infertility. If a cyst is found in your ovary by ultrasonography, don’t worry at first sight. Wait for a few days and recheck to see whether it is growing larger or shrinking. If the cyst is found growing larger day by day, your doctor will advise further investigation to find out the cause. The treatment depends upon the cause. Functional cysts do not require any treatment. If the cyst is caused by infection, you will need antibiotics. If endometriosis is the cause, your gynecologist will advise some medical treatment. For unlucky women with a malignant cyst, surgical removal followed by chemotherapy and/or radiotherapy may be required. Trichomoniasis It is a sexually transmitted disease caused by a protozoa Trichomonas vaginalis. You may suffer from the frequency of urination and assume it as UTI. The misdiagnosis occurs, especially in men. But it infects mainly the genital tract. You will get a frothy vaginal discharge and/or local irritations. The sex partner is commonly affected. So, both you and your partner need to be examined and treated. Antibiotics are not effective and require antiprotozoal drugs. Don’t forget to take your partner when visiting the doctor’s office. Otherwise, the symptoms may recur. Urethritis(Gonorrhoea and Chlamydia) Though many people consider urethritis as a subtype of UTI, it is actually different. Because urethritis is an infection of urethra only. The urinary tract is not infected and no infection is found in urine. The most common causes of urethritis are Gonorrhoea (by Neisseria gonorrhoeae) and Chlamydia (by Chlamydia trachomatis). Both are transmitted sexually. Both men and women are affected. You may be asymptomatic for many days. The most common symptoms are painful or burning sensation when urinating in both sex, purulent urethral discharge in men and per vaginal discharge in women. In mild cases, the burning sensation is often treated as UTI. In women, the infection may be severe and ascending to the upper genital tract. It may result in pelvic inflammatory disease(PID). In such cases, there may be per vaginal bleeding, pelvic pain, and tenderness. If you are pregnant, it may harm your baby. In men, disseminated infections may cause acute prostatitis(infection of the prostate) and epididymo-orchitis(infection of the epididymis of the testis). In such cases, you will suffer from scrotal swelling and tenderness. For proper diagnosis, you may need a microscopic examination of the urethral or vaginal discharge. A culture sensitivity test will be more confirmatory to identify the organism. To get cured, you will need to take antibiotics. Contact your doctor for proper management. Bladder prolapse This condition is found among women. Your urinary bladder is held in place by some ligaments and pelvic floor muscles. The weakness of those tissues may lead to the bulging of the posterior wall of the bladder through the vagina. Some of the symptoms are similar to UTI and may be misdiagnosed in the early stage. For example, you may suffer from the frequency of voiding, urgency, feeling of incomplete evacuation, pain, etc. You may also suffer from heaviness in the vaginal area and pain during sex. The most common symptom is a feeling of a bulge in the vagina which even may appear at the opening of the vagina in severe cases. The main cause of bladder prolapse is a weakness of supportive tissue. The principal risk factors are multiple pregnancies, pregnancy, and vaginal delivery at old age, prolonged labor, instrumental vaginal delivery, etc. Other factors are frequent heavy lifting, chronic constipation and straining during defecation, chronic cough, any injury or surgery to pelvic muscle, menopause, and aging. The diagnosis is clinical. Some investigations may be needed to assess the severity. Urinary tract infection occurs frequently in the prolapsed bladder. So both UTI and bladder prolapse may coincide. A routine examination of urine will help you to exclude the presence of an active infection. There are multiple treatment options available. Asymptomatic cases do not require active treatment. Lifestyle modification to reduce the risk factors and pelvic floor exercise will be adequate. In severe cases, surgical intervention may be required. Contact your doctor for proper evaluation and management. Stone in the urinary tract You may be afraid but this is true. Your abdominal pain, the frequency of micturition, dysuria may be symptoms of stone formation in the kidney or urinary tract. But, in case of stone in the kidney or ureters, the pain is usually severe, located in your loin and colicky in nature. Especially when the stone is located in the ureter or changing position, the pain aggravates. You may suffer from hematuria (blood in urine) and even vomiting. The presence of stone may lead to frequent urinary tract infections. If you get recurrent UTI, you should be aware of it. Urine RME(Routine & microscopic examination) shows the presence of blood cells in the urine. Ultrasonography or plain radiography of KUB(Kidney, ureter, bladder) region will help to identify the stone. The treatment depends on the size, location, and type of the stone. If the stone is small in size and located in the tract(e.g. ureteric pelvis, ureter, bladder) it may be excreted with urine. Regular physical exercise and some drugs will help you to get rid of the stone. If the stone is larger but the location is favorable, it can be managed by ESWL(Extracorporeal Shockwave Lithotripsy) It is a modern method where the stone is broken into minute parts by a shockwave given from outside the body. The smaller parts will be expelled out with urine. But, if the stone is too large, surgical intervention may be needed to remove the stone. drinking a lot of water can help in getting rid of the stones. kidney stones can also be a cause for a UTI. for more information about that head over to this article. Consult with a urologist for proper evaluation and management. __________________________________________________ So, these are the common conditions which may be misdiagnosed as UTI. We tried to discuss those in brief. You may not be able to differentiate those efficiently from this short discussion. But, hopefully, it will help you to understand your disease and you will be able to help your doctor to treat you. Thanks for reading this long article with patience.