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What causes painful urination and urge incontinence when suffering from bladder infection?

Jul 2016
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Practicing since : 1971
Answered : 8344 Questions
Sept 23rd diagnosed bladder infection. Dec 1 it came back. First time urine not tested. Given a 3 day antibiotic. Second time it was E Coli. Given a 5 day antibiotic. Urine test done a week after antibiotic finished and it said the infection was gone. On Dec 31st had intense pain while urinating. Urine test showed negative too bacteria. A urine test looking for cancer cells came back negative. Waiting on the result of ultra sound. A little history. I am a 63 year old woman in relatively good shape. Stopped smoking 25 years ago. Only other bladder infection was 35 years ago. My mother died at 78 from bladder cancer. She had smoked most of her life. I have had stress incontinence for years and feel like I also have some urge incontinence. Because of this I had become used to running to the bathroom a lot so it took until the burning started to recognize it was an infection. Even though I felt my urine had a strange smell. I am now at a loss as too why the pain with no infection?
Posted Tue, 28 Jan 2014 in Urinary and Bladder Problems
Answered by Dr. P. T. Patil 4 hours later
Brief Answer: It may be Postmenopausal Bladder Neck Stenosis. Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have painful urination ,urge incontinence. This is may be mainly doe to repeated episodes of UTI secondary to what is called as Post Menopausal Bladder Neck Stenosis. In females after menopause there is atrophy of genital and urinary organs resulting in to narrowing of urinary passage (Urethra) causing incomplete emptying of bladder thereby resulting into stagnation of urine in bladder. This stagnated urine is the reason for getting repeated episodes of UTI. Please consult qualified Urologist for clinical evaluation and get following basic tests to come to conclusion. 1) Urine routine and urine culture. 2) Endoscopic examination of bladder (Cystoscopy) . 3) Ultrasound scanning of abdomen to detect post void urine volume In the mean while take Please take broad spectrum antibiotics like Cefexine along with urinary antiseptic like Nitrofurantoin twice daily and urine alkaliser thrice daily.Later on switch on to appropriate antibiotics as per culture report. Use of anti muscuranic drugs like Solifenacin orDarifenacin will help to control your urge incontinence. You may need to get endoscopic procedure of Urethral Calibration to widen the bladder neck and will be decided by Urologist . 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.
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