Some women have repeated episodes of all of the symptoms of cystitis, but the urinalysis and culture is always negative. Some doctors believe that these symptoms are brought on by infection of the urethra caused by organisms that do not grow in routine cultures. These include Chlamydia trachoma, Ureaplasma urealyticum and Trichomonas vaginalis. In order to diagnose the first two, special blood and urine tests are needed. Trichomonas is easy to diagnose because it can be seen under the microscope.
When there are repeated episodes of these symptoms with normal urinalyses and cultures, some doctors call the condition urethral syndrome. This is a fancy word that means nothing more than you have symptoms and a normal urinalysis.
Infection of the vagina is called vaginitis. The usual symptom is vaginal discharge and itching, but sometimes there may be burning on urination (dysuria) and urinary frequency as well. The usual explanation for the dysuria is that the some of the urine spills over to the inflammed vagina and causes pain. If you do have dysuria, it is possible that vaginitis might be misdiagnosed as cystitis. The only way to make the distinction is with urinalysis and culture. If these are normal and there is a vaginal discharge, the diagnosis is vaginitis.
The causes of vaginitis are:
The diagnosis is made by examining the vaginal discharge under a microscope. The color of the discharge may be white, clear, or brown/grey, but you can’t tell the cause just by looking at the discharge. It has to be examined under the microscope. If the characteristic appearance of yeast or Trichomonas is seen under the microscope, the diagnosis is certain. If not, a culture is necessary. Treatment depends on the cause. Trichomonas and bacterial vaginosis are treated with a medication called metronidazole (Flagyl). Yeast is treated with antifungal medications such as miconozole (Monistat).
Kidney infections are much less common than bladder infections and are often associated with more serious underlying condition. These conditions include vesicoureteral reflux in women and girls and urethral obstruction in men and boys. Vesicoureteral reflux means that once urine gets into the bladder, it backs up into the kidney. It is due to a faulty valve between the ureter and the bladder. Most of the time you are born with this condition and, in time outgrow it. However, if it persists, corrective surgery might be necessary. In men, if there is urethral obstruction casuing the infection, corrective surgery is almost always necessary.
The symptoms of kidney infection are high fever and pain in the back or flank. There is often malaise and nausea as well. Patients are usually very ill and hospitalization may be necessary. Antibiotic treatment usually cures the infection within 48 – 72 hours.
The urologists at the Uro Center in New York are experts in their field, bringing academic and research based innovation to the clinical forefront. Our urology team specializes in areas of treatment such as: robotic surgery, reconstructive urology, men’s health & infertility, kidney stones, urologic oncology, penile implant surgery, urethral stricture, BPH, Urinary incontinence treatment, Mesh complications, Enlarged prostate treatment, Urodynamics, vesicovaginal fistula and female incontinence in New York.