OpenHealth Q&A

Advice Following TVUS and Pap Smear

I recently consulted with a nurse practitioner at a gynecology office for my convenience—yes, I know that choice has its downsides. At 35 years old and after experiencing recurrent urinary tract infections, I inquired about getting an ultrasound to check for fibroids that might be affecting my bladder. However, she dismissed my concern, stating, "fibroids don’t cause UTIs." I tried to articulate that depending on where fibroids are located, they can restrict bladder space, potentially making UTIs more likely for me than for individuals without fibroids. Given my family history of these growths and how closely my symptoms align, I felt justified in seeking this imaging. After some sarcastic commentary and heavy eye-rolling, she eventually agreed to give me the referral. Despite this, I have no intention of returning to her for interpretation of the imaging findings. Right now, my pressing question is about hydration before my ultrasound. The guideline suggests consuming 32 ounces of water, but with my active UTI, I am uncertain how much liquid I can manage without risking an embarrassing situation during the procedure. During this visit, she performed a Pap smear and returned while I was getting dressed to tell me that no one had ever pointed out I have a large cervix. Taken aback, I mentioned that it was quite the opposite; in my youth, a healthcare provider remarked on how long it took them to locate my cervix. When I asked about the implications of cervical enlargement, she shrugged and said, "I don't know, but it’s just unusual. I’ll make a note for the imaging team to check that out." For the past 20 years, I have been using continuous birth control and frequently experience signs consistent with bacterial vaginosis. Unfortunately, treatments like Flagyl and clindamycin have offered me no relief. Yesterday, I received the results from my Pap, which indicated ASCUS. I had only one previous abnormal Pap result in my teens, which indicated a high risk for HPV; fortunately, I was vaccinated, and a subsequent biopsy returned negative. I'm no stranger to defending myself against dismissive attitudes from medical professionals. However, the absurdity of this entire encounter truly struck me as amusing. It reminded me of the phrase from the show "House," highlighting that someone without proper expertise could perform these tasks just as effectively. Thank you for listening to my experience,

Answers (1)

7/19/2025, 4:40:40 PM

OpenHealth AI

Thank you for sharing your experience; it sounds quite challenging, and I appreciate your resilience in advocating for your health. Let's address your immediate concerns about hydration before your ultrasound and then review some points related to your Pap smear results.

Main Points:

1. Hydration Before Ultrasound: You need to balance hydration with your active UTI.
2. Cervical Health and Pap Results: Consider follow-up steps regarding your cervical health based on your ASCUS result and past experiences.

Explanation:

1. Hydration and Ultrasound: It's common for ultrasounds to require a full bladder, typically around 32 ounces of water, to help create clear images. However, with a UTI, drinking this amount might feel uncomfortable or cause urgency to urinate. Therefore, it's essential to find a balance.

2. ASCUS Result: An ASCUS result means that the cells in your Pap smear were abnormal, but they are not clearly cancerous. Since you have a history of HPV and were vaccinated, this is a good starting point for further evaluation. Regular monitoring is key.

Next Steps:

1. Hydration Strategy:

   • Adjust Fluid Intake: Try sipping water slowly rather than consuming a large amount at once. Aim for about 16-20 ounces an hour before your ultrasound. This might help fill your bladder without overwhelming your system.
   • Plan Timing: Schedule the ultrasound early in the day if possible, reducing the time you need to manage discomfort.

2. Monitor Symptoms: Keep track of any urinary symptoms you have, especially regarding frequency and pain. This information will be helpful for any future consultations.

3. Follow-Up on Pap Smear: Since you have an ASCUS result, it would be wise to discuss with a healthcare provider about potential follow-up tests (like an HPV test) and what this means for your cervical health given your history. Consider finding a provider who values your concerns and provides thorough explanations.

4. Manage Bacterial Vaginosis: Since you've had recurrent bacterial vaginosis symptoms, consider discussing long-term treatment options, including probiotics or lifestyle changes that may help.

Feel free to share your experience if you have more questions or need support in making these decisions. Your health concerns matter greatly, and advocating for yourself is essential.