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  • Pelvic Pain
  • Interstitial Cystitis (IC)
  • Urinary Tract Infection (UTI)
Pelvic Pain

There are many possible reasons for one to experience ongoing pain in the bladder and genital area. The causes of pain and the perception of pain severity vary tremendously from person to person. Because there are so many structures that pass through the pelvis it is often difficult to determine the underlying source or multiple sources of the pain. Because both urologic and gynecologic sources may be involved it is very important to see the “whole picture” and not approach this only through the eyes of a gynecologist or  urologist, therefore a Urogynecologist, like Dr. Thompson is most capable of developing a treatment plan for your chronic pelvic pain.

Some of the main pain categories include:

INTERSTITIAL CYSTITIS (IC) – also known as the painful bladder syndrome. It affects women of all ages. In general it feels like a bladder infection (UTI) that never seems to go away. It is often misdiagnosed as a recurrent UTI. Patients often experience pain in the mid lower pelvis and or in the vaginal area. Please see the Interstitial Cystitis section of our website for more information.

VULVODYNIA – This condition results in ongoing vaginal pain. The pain is often exacerbated by any contact to the vaginal area such as wearing tight clothing or sitting on a hard seat. It often times makes sexual intercourse very painful or impossible.

Helpful links: https://www.nva.org/what-is-vulvodynia/

LEVATOR SYNDROME (pelvic floor dysfunction) – This condition is thought to be caused by spasms in the pelvic floor muscles. These muscle spasms result in ongoing vaginal pain that is often felt deep in the vagina or at the bladder. Often times pelvic floor muscle spasms will feel like a urinary tract infection. Stress, sexual intercourse, a full bladder, constipation or any of the many pelvic pain syndromes often exacerbates it. In addition to pain, the tightening of the pelvic floor (levator) muscles may make it difficult to pass urine and stool.

ENDOMETRIOSIS – This condition often results in either constant pain or more commonly pain that fluctuates with the menstrual cycle. It is believed to be caused by abnormal deposits of endometrium (the hormone sensitive lining of the uterus) throughout the pelvis. The endometrial tissue may even deposit in the bladder and cause you to have blood in your urine at the time of your period.

Helpful links: http://endometriosis.org/endometriosis/

URETHRITIS / URETHRAL SYNDROME – Pain that originates from the urethra- often results in burning during urination and sexual intercourse. Again, the symptoms may be similar to those of a UTI however the urine culture is negative.

Helpful links: https://www.healthline.com/health/urethritis-chronic

URETHRAL DIVERTICULUM – The urethra is the tube that carries urine from the bladder out of your body. A diverticulum is an out pouching or a pocket that forms in the urethra. It may present as a firm mass protruding from the vagina. It is associated with causing pain during sexual intercourse, recurrent UTIs and dribbling urine when you stand after urinating (post void dribbling). When they are symptomatic that may be treated surgically. In many cases they are found during a gynecological exam and otherwise do not cause any symptoms- and can be left alone.

Interstitial Cystitis (IC)

INTERSTITIAL CYSTITIS (IC) – also known as the painful bladder syndrome. It affects women of all ages. In general it feels like a bladder infection (UTI) that never seems to go away. It is often misdiagnosed as a recurrent UTI. Patients often experience pain in the mid lower pelvis and or in the vaginal area. IN GENERAL the pain is worse as the bladder becomes full. For some people it may be triggered by stress, certain foods (tomato based foods, spicy foods, acidic foods- certain juices) and by sexual intercourse. Patients typically must frequently urinate to help reduce the pain. The symptoms often increase and decrease over time for no apparent reason. The only way to help differentiate IC symptoms from those of a UTI is to have your urine sent to a laboratory for a culture (NOT an in office urine analysis). There are many effective treatments for IC- unfortunately there is no standard treatment for everyone. Treatment becomes a process of trial and error to establish what treatment works specifically for you.

Dr. Thompson, has had tremendous success treating IC symptoms with various medications, bladder instillations, pelvic floor rehab and nerve blocks. Here are some links you may find helpful for more information on IC or chronic pelvic pain:

The IC Network: https://www.ic-network.com/
Interstitial Cystitis Association: https://www.ichelp.org/

Urinary Tract Infection (UTI)

UTI’s occur when bacteria migrate up the urethra and into the bladder. The bacteria irritate the bladder (cystitis)-resulting in frequent urges to urinate small amounts of urine and burning with urination (lower tract symptoms). If the bacteria migrate out of the bladder and up to the kidneys (pyelonephritis) this may result in back pain, fever, chills, nausea and vomiting.

UTIs often occur after sexual intercourse and or they may occur sporadically without associated triggering factors. Some of the underlying causes of recurrent UTI’s include: incomplete bladder emptying, foreign bodies in the urinary tract (sutures or other surgical materials in the bladder from prior surgery) stones, urethral diverticulum, etc.

A urine CULTURE confirms the diagnosis of a UTI. The culture report will indicate the name of the bacteria causing the infection AND the type of antibiotic(s) that will treat your specific UTI. If your UTI SYMPTOMS do not improve after given a random antibiotic it may mean that you don’t really have a UTI.

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