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What Causes Irritation Around Urethra And Vaginal Dryness?
Question: I am a 64 year old female. I had a uti treated with keflex and then macrobid 2 mo the ago. My urine came up neg for wbc ever since, until today. I had it checked because the irritation around the urethra increased some... It never totally went away and I was told it was vaginal dryness... As urine was neg of wbc etc. Now today, one dip said 500 wbc, rest all neg. The subsequent one said 75 with the rest all neg. Freaked me out, but didn't freak out my Dr. He thinks it's probably inflammation and wanted me to drink alot and take iodine. I was gonna do that but remembered I probably am allergic to iodine... So I have a prescription for 7 days of macrobid again but I'm so anxious! Until that last one, I hadn't had a bladder infection for years. I'm not even sexually active. Would like to know your opinion and some reassurance I hope.
Brief Answer:
Need to evaluate the cause of repeated episodes of UTI.
Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have repeated episodes of UTI and have been taking antibiotics as per culture report which helps to eradicate the infection completely but unfortunate to recur again after few days .
I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Was endoscopic examination of bladder (Cystoscopy) done by your urologist any time ?
2) Do you have difficulty in passing urine apart from increased frequency?
3) Are you diabetic?
The common cause of repeated UTI at this age is due to Post Menopausal Urethral Stenosis .In post menopausal age group there is generalized atrophy of all Genito -urinary organs including urethra which causes incomplete emptying of bladder during micturition resulting into some amount of urine to remain in bladder what is called as Post Void Residual urine (PVR).This PVR is the source of getting repeated episodes of UTI.
It is natural for treating Physician to prescribe antibiotics in order to treat infection as per Urine culture report .But I think it is primarily important to find and treat the root cause of getting infection .
Please consult qualified Urologist for clinical examination and get following basic tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Endoscopic Examination of bladder (Cystoscopy) with simultaneous calibration (Dilatation )of Urethra .
Maintaining a urethral dilatation of urethra by doing regular urethral dilatation at home once daily yourself will help in complete emptying of bladder and will prevent from getting repeated episodes of UTI. (This is very simple technique and can be done by yourself at home)
Using Estrogen Cream for local application in vagina will help to get relief from irritation due to dryness .
Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil
Need to evaluate the cause of repeated episodes of UTI.
Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have repeated episodes of UTI and have been taking antibiotics as per culture report which helps to eradicate the infection completely but unfortunate to recur again after few days .
I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Was endoscopic examination of bladder (Cystoscopy) done by your urologist any time ?
2) Do you have difficulty in passing urine apart from increased frequency?
3) Are you diabetic?
The common cause of repeated UTI at this age is due to Post Menopausal Urethral Stenosis .In post menopausal age group there is generalized atrophy of all Genito -urinary organs including urethra which causes incomplete emptying of bladder during micturition resulting into some amount of urine to remain in bladder what is called as Post Void Residual urine (PVR).This PVR is the source of getting repeated episodes of UTI.
It is natural for treating Physician to prescribe antibiotics in order to treat infection as per Urine culture report .But I think it is primarily important to find and treat the root cause of getting infection .
Please consult qualified Urologist for clinical examination and get following basic tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Endoscopic Examination of bladder (Cystoscopy) with simultaneous calibration (Dilatation )of Urethra .
Maintaining a urethral dilatation of urethra by doing regular urethral dilatation at home once daily yourself will help in complete emptying of bladder and will prevent from getting repeated episodes of UTI. (This is very simple technique and can be done by yourself at home)
Using Estrogen Cream for local application in vagina will help to get relief from irritation due to dryness .
Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
This is only the second one... First recurrence. The last one was in XXXXXXX and urine was clear in July. All have been clear since then until now. I didn't have a culture this time. Did last time. Just the white cells. No I'm not diabetic. The urine was otherwise clear. I haven't had any tests since this is basically just 2nd time or possibly first one wasn't completely gone. You've kind of scared me more. I don't have ins. And my doctor does not seem at all concerned. Just said to use estriol cream which I have but haven't been using. Gyno said I was dry and recommended the same thing. I don't think I am retaining urine. I make sure and empty each time and have no trouble passing it.
Brief Answer:
You may use Estrogen Cream for local application .
Detailed Answer:
Hello
Thanks for follow up.
I have suggested my opinion based on patients that we come across in our day to practice and that does not necessarily mean that you have it .
If it is your second episode may do urine culture again and take antibiotics if infection is detected .
I would suggest you to use Estrogen cream for vaginal dryness .
Thanks and Regards.
Dr.Patil.
You may use Estrogen Cream for local application .
Detailed Answer:
Hello
Thanks for follow up.
I have suggested my opinion based on patients that we come across in our day to practice and that does not necessarily mean that you have it .
If it is your second episode may do urine culture again and take antibiotics if infection is detected .
I would suggest you to use Estrogen cream for vaginal dryness .
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I just started the macrobid tonight. I'm thinking I will ask for a culture after Ijhave finished it, regardless of what the urine dip shows. The urethra irritation never really went away before. So I'm wondering if there was something still there that didn't show at all in the dip? Or perhaps the dryness was aggravated by Infection and vice versa creating a vicious cycle? Anyway, is this anything dangerous? My Dr reassured me and said it's an inconvenience but nothing horrible. He keeps saying how healthy I am.
Also the urethra irritation is the main symptom. I don't have bladder pain and not alot of frequency. I go alot because I drink alot of water. But it comes and goes... Depending mostly on fluid intake andlevel of anxiety. I go. What brought me back I was the local irritation was worse. It's not like bad pain... More tingling... And it does feel dry like it's irritated.
Also the urethra irritation is the main symptom. I don't have bladder pain and not alot of frequency. I go alot because I drink alot of water. But it comes and goes... Depending mostly on fluid intake andlevel of anxiety. I go. What brought me back I was the local irritation was worse. It's not like bad pain... More tingling... And it does feel dry like it's irritated.
Brief Answer:
You may take Macrobid .
Detailed Answer:
Hello
Thanks for follow up.
You can take Macrobid keeping in mind that urine culture done after taking antibiotic may be negative if the organisms are sensitive to Macrobid.
Generally we suggest to give urine sample for culture before patient starts taking any antibiotic so that later on he/she can switch on to appropriate antibiotic as per culture report .
Using Estrogen Cream three to four time a day is the only remedy to resolve the problem of irritation of genitals .
Thanks and Regards.
Dr.Patil.
You may take Macrobid .
Detailed Answer:
Hello
Thanks for follow up.
You can take Macrobid keeping in mind that urine culture done after taking antibiotic may be negative if the organisms are sensitive to Macrobid.
Generally we suggest to give urine sample for culture before patient starts taking any antibiotic so that later on he/she can switch on to appropriate antibiotic as per culture report .
Using Estrogen Cream three to four time a day is the only remedy to resolve the problem of irritation of genitals .
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So does this sound overly concerning? Could my doctor be right? He thinks it's probably wbc from irritation and not infection. No nitrates or protein etc. When it was infected, there was protein. Now it's all normal and, as I said the wbc went from 500 to 75 in two hours? Seems strange.
Brief Answer:
Raised WBC count can be due to inflammation .
Detailed Answer:
Hello
Thanks for follow up.
Raised WBC count in detected in Urine analysis can be due to inflammation of mucosa of either Bladder or Urethra without infection. However looking at the previous history of UTI we recommend urine culture to rule out recurrence of UTI
Thanks and Regards.
Dr.Patil.
Raised WBC count can be due to inflammation .
Detailed Answer:
Hello
Thanks for follow up.
Raised WBC count in detected in Urine analysis can be due to inflammation of mucosa of either Bladder or Urethra without infection. However looking at the previous history of UTI we recommend urine culture to rule out recurrence of UTI
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Okay, too late now as I started the macrobid. However, I will have it cultured when the macrobid is out of my system. My Dr said last time, though, that the lab won't culture if the urine is all neg. Is that right? So I'd have to go with the dip in that case. Can there be infection without wbc? As I said it's been clear for over two months. If that's the case then I guess we'd need to wait and see if it recurs? Also, how long after macrobid will the urine show accurate? And how long would you advise I stay on macrobid to be sure it's gone this time? Neither my Dr or I like the idea of going to cipro because it's over kill.
Brief Answer:
WBC in urine analysis is the indication for doing urine culture
Detailed Answer:
Hello
Thanks for follow up .Presence of WBC detected on routine urine analysis is the indication fo doing urine culture and it is the surest way to rule out or confirm the infection .
Macrobid is Urinary antiseptic and can be taken for 2 weeks .
You can get urine culture done as and when you notice symptoms suggestive of UTI.
Thanks and Regards.
Dr.Patil.
WBC in urine analysis is the indication for doing urine culture
Detailed Answer:
Hello
Thanks for follow up .Presence of WBC detected on routine urine analysis is the indication fo doing urine culture and it is the surest way to rule out or confirm the infection .
Macrobid is Urinary antiseptic and can be taken for 2 weeks .
You can get urine culture done as and when you notice symptoms suggestive of UTI.
Thanks and Regards.
Dr.Patil.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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