OpenHealth Q&A

Medical Mystery: Ongoing UTI Symptoms

I am a 28-year-old female who has been struggling with what I initially thought was a persistent UTI since early May. After consulting with a urologist, she expressed that she was quite baffled by my case. While I am not seeking medical advice here, I am interested in hearing others' perspectives. **Background Details:** I am currently on immunosuppressants and undergo pap smears twice a year due to a diagnosis of CIN1 (low-grade dysplasia). My sexual activity is limited to one monogamous partner, and we always use protection. I also have an IUD for contraception. Since July 7, I have faced considerable stress due to medical problems affecting my family members. **UTI Timeline:** On May 5, I experienced what was undoubtedly a UTI. Unfortunately, I was prescribed medication through a telehealth consultation without having a urine test or culture. The symptoms arose after sexual activity and included typical signs such as burning, frequent urination, and bladder spasms. In response, I received a **5-day prescription of Macrobid**, which managed to alleviate my symptoms within three days. However, after completing the medication on May 15, I encountered another episode, albeit milder than the first—featuring some burning sensation but no spasms, just frequent urges to urinate. Following this, I was given a **5-day course of Bactrim**, and a culture was taken. This test revealed **normal levels of red and white blood cells along with bacteria, but high nitrite levels**. After finishing the Bactrim, I returned to feeling normal and began incorporating D-Mannose into my routine, along with diligent post-coital urination to ward off further issues. A couple of weeks passed without incident until June 8, when I sensed something wasn't right again. This time, the symptoms were even more subdued—a soreness located near my belly button, which I later discovered is where my bladder resides. Seeking clarity, I visited my primary care physician for further evaluation. Another urine analysis and culture were conducted, which surprisingly tested **negative for nitrites but positive for leukocytes at a count of 15**. I was also informed that my bacterial count was around **20,000-29,000 cfu/ml with multiple contaminants** present. I came to know later that the urine sample was improperly collected, impacting the results. My doctor prescribed a **3-day Bactrim regimen along with Macrodantin to use post-sex**. Despite treatment, I did not regain my previous sense of normalcy. The soreness persisted, I began experiencing irritation and dryness in my vulva, and my discharge became unusual. Instead of being clear and minimal, it turned into a more mucousy, sticky consistency with a faint yellow tint. On July 2, after engaging in sexual intercourse, I followed my usual routine but woke up early on July 3 with mild **left-sided mid-back pain** and noticed spotting when wiping post-urination. While I suspected the spotting might be due to rough intimacy, I still opted to go to the emergency room due to alarm over the bleeding and discomfort. Subsequent urine analysis yielded **entirely normal results** and tested negative for various infections, including BV and yeast. A few days later, feeling unwell despite the ER visit, I contacted my primary care provider while awaiting a urologist appointment. The inflammation felt as if it affected my entire urethra. My physician prescribed a **10-day course of doxycycline** to treat suspected urethritis, and I began to notice an improvement within two days. As the inflammation subsided, I observed an increase in discharge and perceived possible crystal formations in my urine. By the end of the course, the soreness diminished significantly, but some discomfort behind my belly button lingered, and my vulva remained somewhat irritated and dry. I saw the urologist on July 23, and she expressed confusion regarding my ongoing symptoms. She noted that aside from the initial instance where I didn't have any urine test done, it appeared I had not truly experienced a UTI. She ordered a **comprehensive STI screening**, which included tests for mycoplasma and ureaplasma, with preliminary results showing me negative for common infections such as syphilis, HIV, hepatitis, gonorrhea, and chlamydia. If all tests return negative, her next step will be to conduct an ultrasound of my kidneys and bladder, and she mentioned the possibility of cancer screenings, which added a layer of anxiety, although she seemed uncertain about the effectiveness of that approach given my symptoms, particularly the discharge. Has anyone had similar experiences or could share insights into what might be occurring?

Answers (1)

7/27/2025, 8:31:12 PM

OpenHealth AI

Thank you for sharing your detailed experience. It sounds like you've been through quite a challenging journey with your ongoing urinary symptoms. Acknowledging your concerns, it's clear you are looking for insights that might shed light on your situation while you await further medical evaluations. Let's break down your situation and explore some potential perspectives.

Key Points:

1. Chronic UTI-like Symptoms: You seem to have symptoms reminiscent of a urinary tract infection (UTI), but the tests have not consistently supported this diagnosis.
2. Potential Factors: Your immunosuppressive therapy, IUD, and stress may be contributing to your symptoms and should be considered in the context of your urologic health.
3. Next Steps: While you await further test results, there are supportive measures you can implement.

Explanation:

From your timeline, it appears you initially had a confirmed UTI but have since dealt with symptoms like discomfort, irritation, and changes in discharge without consistent evidence of infection. This could suggest a few possibilities:

• Intermittent Urethritis: This can occur due to trauma or irritation, possibly exacerbated by sexual activity or changes in vaginal flora.
• Non-infectious Cystitis: Chronic inflammation can occur for reasons unrelated to infection, particularly in individuals on immunosuppressive regimens.
• Stress and Anxiety: These factors can impact bladder health and may lead to heightened sensitivity or symptom perception.

Actionable Next Steps:

1. Hydration: Increase your fluid intake to help flush your urinary system and potentially dilute any irritants.
2. Avoid Irritants: Refrain from using potential irritants like scented soaps, lotions, or bath products around your genital area.
3. Healthy Sexual Practices:
   • Post-coital urination is crucial, which you've already incorporated.
   • Consider discussing alternate contraceptive methods with your doctor if the IUD might be contributing to discomfort.
4. Focus on Well-being: Try to manage stress through relaxation techniques such as deep breathing, yoga, or counseling if possible. Stress can exacerbate physical symptoms.
5. Keep a Symptom Journal: Documenting your symptoms, triggers (like food, stress, or sexual activity), and responses to medications can provide valuable insights for your healthcare providers.

As you await further evaluations and potential imaging or additional tests, maintaining a proactive approach can contribute positively to your overall health. If anything feels particularly concerning, or if you develop new symptoms, make sure to communicate this with your healthcare provider.

You're not alone in this, and seeking perspectives can often lead to a path of healing and clarity. Let me know if there are specific areas you want to focus on or if you need further explanations.