I don't know what to do, but my bladder is making my life awful. I need to find out what's wrong and have it fixed. I've had these problems for 8 years now.
I'm a 28-year old woman. These are my symptoms.
* Slow urine stream (varies from day to day, though)
* Stream stopping and starting
* Splitting of the stream
* Feelings of pressure, as if I have to urinate, occurring anywhere from below my belly button to my genitals - these happen day and night - sometimes they abate for a few weeks, and then they come back
* Occasional feelings of stronger urges, like spasms, but even if I try to let go and just go with the spasm, either there's no urine behind it or the urine isn't able to get out, because I never have incontinence
* Passing small amounts of urine and then feeling like I have to go again within 30-60 minutes
* Being unable to have sex - painful penetration, feelings of having to urinate, or feeling like I get a little excited and then I get blocked up - these problems started before the urinary problems - I can't even masturbate now
This is what I don't have:
* No incontinence
* No pain
These urinary symptoms started in 2000, after a UTI for which I received sulpha drugs, which I turned out to be allergic to and had to stop early. But since then, no infections have shown up in urine samples. But the sexual stuff started a few months prior. Both started after a fall on my tailbone (in winter 1999), but I don't know if they were caused by the fall or just happened to occur afterwards.
I went to a gynecologist/"bladder specialist" a few years ago and she did a uroflow test. It was really hard, as the catheter was very painful. She said that my stream was about 1/3 as fast as it should be, and I saw that the pattern of voiding (this was after water was put into my bladder and then it was drained, through the catheter) was a zig-zag rather than the single curve you're supposed to have. The doctor told me I probably had a narrow urethra, and that the procedure for that was to get my urethra stretched.
I've been afraid of going through with that procedure, because:
(a) I've heard that the procedure can make it easier for infections to find their way into your bladder
(b) I've heard the benefits could only be temporary
(c) I'm worried about possible damage to the urethra
(d) I haven't had anyone actually look at the bladder or urethra yet - no cytoscopy, no visit with a urologist
(e) I don't know if the urethra width is the problem or if it's, say, a muscular issue - either the pelvic floor being in spasm or an issue with the nerves that go to the bladder, say because of compression in the lower back - shortly before I had my first sexual problems, I had a fall on my tailbone, and I keep wondering if that threw me off - I have a rotation in my hips now, which makes one leg look like it's shorter and the foot be at a slight outward angle while resting, and occasionally I feel dull pain in my lower back
I'm scared of having to go for more invasive tests, but I want to resolve this somehow. First I was thinking of having a pelvic ultrasound, though I don't know what they look for. Then I thought I could ask a urologist if they could give me some kind of sedation drug (where you're in dreamland for 45 minutes and then you wake up not remembering what happened) while a cytoscopy is performed, and sedation again if they need to perform any stretching or other procedures. But I'm really nervous that they'll be overlooking something. How do they know which problems are structural and which are functional? If I do have some kind of muscle/nerve problem, would they pick up on that? I already had an MRI done of my lower back, and they said it was fine, but again, I don't know what they were looking for. On MRI's, can they discover if nerves are compressed?
I saw a pelvic floor physiotherapist for a while, and she treated some trigger points in that area, and also told me to do Kegel exercises. I try the exercises sometimes, but when I squeeze too much, my tailbone hurts. I think they were supposed to calm down the bladder by tightening the urethral sphincter so the destrusor muscle (the antagonist) would relax, but I'm not sure if they're doing much of anything.
Can anyone relate to my symptoms? I read websites, but it seems that nothing matches the symptoms that I have. I don't have incontinence, which rules out overactive bladder. And I don't have pain, which seems to be a major feature of IC. Could I have a urethral stricture (the narrowing the doctor talked about)? What else could it be? What tests should I ask for to make sure all possibilities are covered?
I'm at my wit's end. I hope someone can help.
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