Desperately need help with possible diagnosis Hello everyone! I really need your help to figure out what could be wrong with me. Sorry for long post but I don’t want to miss any details because they might be important. Please take time to read my post and reply if you can. I am really desperate to know what could be wrong with me because I won’t see a urologist soon and basic doctor (I guess he is called GP in English) says he did everything he can and I have to see a urologist. Even when I see a urologist I doubt I would get a proper diagnosis if there is somerhing wrong with me like for example Interstitial cystitis or Overactive bladder because I live in a country where even in a capital city medicine is really backwards and I don’t even live there, I live in a small city. To go private I can’t afford and as I said even in the country capital medicine is way backwards than in the West, so there’s no point to go private. I would be told as doctors always tell in my country when they lack knowledge or don’t believe in patient actually having a problem that this is psychological or that I have to get pregnant and it will go away. About two months ago I started to have an increased urination frequency, few episodes of urgency and also few times a day I had a feeling in urethra like it’s full, like I want to urinate, it is different from the feeling of wanting to urinate that comes from the full bladder. After about 10 days of starting to have those symptoms I called the doctor and was told that I most likely have a UTI, he didn’t test me because it was over the phone because of the coronavirus situation and he prescribed me antibiotics for 3 days, they didn’t cure me. On 3rd day after stopping taking antibiotics I had a dipstick test, I don’t know what exactly the dipstick test showed, the doctor just said that I don’t have a UTI and that it is normal to still have symptoms for few days after completing the course of antibiotics. After 4 days I was given the same antibiotics for 7 days by another doctor who said that I probably still have a UTI because dipstick tests are not reliable and that it could have been affected by the antibiotics I took. That also didn’t cure me and I was given another antibiotics also for 7 days and had a dipstick test again and the doctor said that one of the things that points to a UTI is positive, unfortunately I don’t remember which one but I guess it was white blood cells. My urine was also sent for a culture which came back negative. I had an abdomed CT scan which came back normal. And I had an ultrasound to check if I empty my bladder completely after I urinate and it was also normal. This course of antibiotics also didn’t help me and I was given another antibiotics again for 7 days and had one more dipstick test which was negative but doctor said that could be because I am on antibiotics. Last antibiotic also didn’t cure me. I had a urine microscopy done on the last day of taking antibiotics and it was negative with just high epithelial cells. 12 days after finishing antibiotics (that was last week) I had urine microscopy done which again had high epithelial cells but that time it also had high white blood cells. Because of that my urine was sent for a culture which came back negative again. Few days after I started having urinary symptoms I was prescribed Pregabalin (Lyrica) 150mg twice a day to take everyday for my shoulder pain. After a while of taking it I realised that on all the days that I took it (in the beginning I kept forgetting to take it everyday) I was feeling about 70% better in terms of my urinary tract symptoms. At first I thought that was because of antibiotics but after I finished taking them I realised that I felt better because of Pregabalin because I still continue to feel that way when I take it. But after finishing all of my four antibiotic courses I felt at least 30% better than I did in the beginning, even if I didn’t take pregabalin on that day. But I am not sure if this is due to antibiotics, maybe it is because of Pregabalin build up in my system? Can it build up even if not taken everyday? At the beginning I was taking it for few days in a row, then I forgot to take also for few days in a row, then the same process repeated, and overall it was like that for about one month and a half. For about three or two years sometimes when I went to urinate I couldn’t start urinating straight away so I had to push myself a little bit, also the urine flow would sometimes stop even if the bladder wasn’t empty and I had to start urinating again. That didn’t bother me because I had no other urinary tract problems. But since yesterday I have to push myself everytime I go to urinate and I have to push myself hard not a little bit like before, and urine flow stops few times. Also since yesterday when I am urinating I have an uncomfortable feeling, I wouldn’t say pain, just uncomfortable, like feeling something sharp. So my question is, what do you guys think could be wrong with me? I was thinking about different things one of which is Interstitial Cystitic but I didn’t find having to push yourself to starting urinating and urine flow stopping to be IC symptoms. Also why would Pregabalin help urination frequency due to IC if Pregabalin is nerve related medication while if I’m not wrong (if I am – sorry) frequent urinaton due to IC is because the bladder is inflamed. I couldn’t find any conditions that have that symptom of urethral feeling of wanting to urinate because I don’t know how to put it in proper words, all the results of googling about this are about urethral pain but I don’t have it. Oh and I forgot to say, maybe this will be the key to what’s wrong with me, most of the time I have that urethral feeling straight after urinating, I even had it when I urinated before an ultrasound to see if I have urinary retention which as I already mentioned I didn’t, but even though my ultrasound showed that I emptied my bladder I was feeling through my urethra like I wanted to urinate, weird. Also I was thinking about having another infection, maybe for example urethritis, because of high epithelial and white blood cells, but again why would Pregabalin be helpful in that case? By the way about Pregabalin, I was already taking it for my shoulder pain about two years ago for a month, I was on the same dosage that I am on now 150mg twice a day and back then it didn’t affect my urination in any way, so what Pregabalin is doing now for it is definitely not a side effect, maybe I have some nerve urinary disease? Some additional information which might also help: I am 23 year old female, never was sexually active, apart from Pregabalin I also take Tramadol 2x50mg 4 times a day also for shoulder pain and I take 2 laxative sachets a day because if I don’t I would have constipation as a side effect of Tramadol. Thank you very much in advance for reading and reacting to this. I really hope all of us will get better soon!

I’m so sorry you’ve been hurting and going through so much with tests and meds. There could be some things that are either causing symptoms or aggravating them and might be worth checking into. One is the tramadol you’re taking since it has a list of side effects that includes not only constipation but also difficulty urinating: https://www.mayoclinic.org/drugs-supplements/tramadol-oral-route…

One of the side effects of Pregabalin (or Lyrica) is also constipation, and moms have mentioned that as being a factor with urinary tract pain: https://www.webmd.com/drugs/2/drug-93954-1903/pregabalin-oral/pr…
It sounds like you’re taking a laxative to help with GI slowdown, but fighting this side effect from both meds might be a bit of an uphill battle. I think the problem with constipation is not only that it places weight and stress on the pelvic floor and UT areas, but a slower GI process also allows yeast (Candida) to grow, and that has also been linked with UT issues. Here’s an article from the IC site about that: https://www.ic-network.com/could-flares-be-caused-by-candida/

Just an idea – if you can find an alternative, more natural way to treat the shoulder pain, that could help so much. We apply Arnica cream to the skin area and it seems to help quite a bit. I think there is a Capsicum cream or gel that can also help with muscle discomfort, and taking Cissus extract may help with muscle and tendon repair in a natural way. These are all over the counter supplements if you would like to look into that option.

Another thought – some of us on this site have found that taking care of gut inflammation helps to calm inflammation in other areas of the body (like urinary tract and pelvic areas) and can contribute to healing. Here is one mom’s post from this site about that: https://www.inspire.com/groups/interstitial-cystitis-association…
And, Dr. Jill Carnahan explains why gut inflammation can cause so many other symptoms and problems: https://www.jillcarnahan.com/2014/07/07/leaky-gut-syndrome-linke…
Getting away from pesticides in foods that are toxic to the UT system is also a good idea to think about. We’ve tried to go organic as much as our budget will allow for that reason.

Seeing a female pelvic floor therapist might be worth considering since pelvic floor muscle tension can cause urinary tract pain. And – low estrogen levels can definitely lead to painful UT conditions, inflammation and white blood cells in urine, and UTI’s since the UT and pelvic areas are so dependent upon adequate estrogen (especially estradiol) levels to function. Taking birth control for acne or any other reason can lower estrogen, weight loss or extreme exercise, and heredity can all be factors. For example, women in my family tend to run low E and have UT / pelvic issues if that is not addressed. I don’t know whether your gyn would ok taking a natural estrogen vaginal cream since you’re young, but it might be worth asking a doctor who has experience with testing for and treating hormone imbalance if that is an issue.

One last thought – it might be worth ruling out Vesicoureteral Reflux as that leads to the kinds of symptoms you are experiencing and can be treated successfully with surgery. VUR requires very specific testing beyond the typical scans and labs done for other ut conditions. Our friends’ daughter was diagnosed several years ago and is doing really well after having the surgery done. Btw, their daughter was referred to a pediatric surgeon since VUR is usually discovered in childhood or teen years, and so that type of doctor tends to have more experience with it. Here is a Mayo Clinic link with more info about that if you’d like to see: https://www.mayoclinic.org/diseases-conditions/vesicoureteral-re…

Well, I hope that wasn’t too much info 🙂 and am praying that the Lord leads you in His peace and to the things that He knows will help to bring healing for you soon. ~Sending hugs to you, Cookie