Urethritis Symptoms and Fertility Concerns in Women

Unsure if it is urethritis?

Hello Doctor: I am currently being treated for infertility.
On the evening of October 28, I had intercourse, and the next morning, October 29, I experienced pain in my lower abdomen after urinating.
When I wiped with toilet paper, there was a very small amount of pink blood.
The pain felt similar to my previous urinary tract infections (I frequently have urinary tract infections, about every 3-6 months).
By the afternoon of October 29, the pain began to subside, and the pink blood appeared only twice when wiping.
By the evening, I hardly felt any pain.
On the morning of October 30, I visited a gynecologist who performed a urinalysis.
The doctor said all the results were normal and even congratulated me, stating that the timing of intercourse on October 28 was good because I had ovulated, which made me more sensitive and caused the pain during urination.
Since the pain symptoms resolved on their own without treatment, the doctor prescribed Scopolamine (Buscopan) for me, saying I should take it only if I felt uncomfortable.
However, my basal body temperature, ovulation test strips, and cervical mucus all indicate that I have not yet ovulated.
The doctor insists that I have ovulated and that these are symptoms of ovulation, but I am quite confused.
I would like to ask the doctor: 1.
If I drank a lot of water before the urinalysis, resulting in nearly clear urine, could this affect the accuracy of the test? 2.
Can a urinary tract infection resolve on its own without medication? 3.
Am I at risk of chronic recurrent infections (even though the urinalysis shows no issues), which could lead to pelvic inflammatory disease, adhesions in the fallopian tubes, and consequently infertility? 4.
Is it possible to experience pain symptoms of a urinary tract infection on the day of ovulation? 5.
I also have bladder hyperactivity (frequent urination, urgency), could this be due to years of urinary tract infections? I am afraid of infections, so I drink a lot of water and avoid holding my urine, which has led to the inability to hold even a little urine now.
Since the gynecological urinalysis showed no issues, should I consider seeing a urologist? Thank you, Doctor, and I apologize for the many questions.
I appreciate your help!

Shu Hui, 20~29 year old female. Ask Date: 2017/10/30

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I am currently dealing with infertility.
On the evening of October 28, I had intercourse, and on the morning of October 29, after urinating, I experienced significant pain in my lower abdomen.
When wiping, I noticed a very small amount of pink blood.
The pain felt similar to my previous experiences with urinary tract infections (I frequently have urinary tract infections, about every 3-6 months).
By the afternoon of October 29, the pain began to subside, and the pink blood appeared only twice during wiping.
By the evening, the pain was almost gone.
On the morning of October 30, I visited a gynecologist who also performed a urine test.
The doctor said all the results were normal and congratulated me, stating that the timing of intercourse on October 28 was good because I was more sensitive due to ovulation, which could explain the pain during urination.
The doctor mentioned that the pain would resolve on its own without treatment, so they prescribed Scopolamine (Buscopan) for me, advising that I should take it only if I continued to feel discomfort.
However, my basal body temperature, ovulation test strips, and cervical mucus all indicated that I had not yet ovulated.
The doctor insisted that I had ovulated and that these were signs of ovulation, which left me quite confused.

I would like to ask the doctor:
1.
If I drank a lot of water before the urine test, resulting in nearly clear urine, could this affect the accuracy of the urine test?
Answer: No, this will not affect the accuracy of the urine test.

2.
Can a urinary tract infection heal on its own without medication?
Answer: A mild urinary tract infection can heal on its own without medication.

3.
Could I be experiencing chronic recurrent infections (but with normal urine test results), and not treating the symptoms could lead to pelvic inflammatory disease or adhesions in the fallopian tubes, causing infertility?
Answer: Chronic recurrent urinary tract infections are not related to pelvic inflammatory disease or fallopian tube adhesions.

4.
Can I experience pain symptoms of a urinary tract infection on the day of ovulation?
Answer: Yes.

5.
I also have bladder overactivity (frequent urination, urgency), could this be caused by years of urinary tract infections?
Answer: Bladder overactivity (frequent urination, urgency) is not related to years of urinary tract infections.

6.
I am afraid of infections, so I drink a lot of water and frequently go to the bathroom, which has now led to an inability to hold even a little urine...
Since the gynecologist found no issues with the urine test, should I see a urologist?
Answer: It is normal to frequently go to the bathroom if you drink a lot of water.
If you have bladder overactivity (frequent urination, urgency), bladder training or anticholinergic medication treatment may be appropriate, and you should consider consulting a female urologist.

Reply Date: 2017/10/30

More Info

Understanding urethritis symptoms and fertility concerns in women is crucial, especially for those experiencing recurrent urinary tract infections (UTIs) and related complications. Based on your detailed description, let's address your concerns systematically.

1. Urine Test Accuracy: Drinking a lot of water before a urine test can dilute the urine, potentially affecting the concentration of substances that may indicate infection, such as white blood cells or bacteria. However, a clear urine sample does not necessarily mean there is no infection. If you suspect an infection, it is advisable to provide a midstream urine sample after adequate hydration but not excessively so, to ensure accurate results.

2. Self-Healing of Urethritis: Urethritis can sometimes resolve on its own, especially if it is caused by non-bacterial factors. However, recurrent infections may indicate an underlying issue that requires treatment. If you have a history of frequent UTIs, it is essential to consult a healthcare provider for appropriate management, as untreated infections can lead to complications.

3. Chronic Infections and Fertility: Chronic or recurrent infections can potentially lead to pelvic inflammatory disease (PID), which may cause scarring or adhesions in the reproductive organs, including the fallopian tubes. This can affect fertility. If you have ongoing symptoms or recurrent infections, it is crucial to seek medical advice to prevent long-term complications. Regular monitoring and appropriate treatment can help mitigate these risks.

4. Pain During Ovulation: It is possible to experience discomfort or pain during ovulation, known as mittelschmerz, which can sometimes mimic UTI symptoms. However, if you are experiencing significant pain or bleeding, it is essential to differentiate between ovulation-related discomfort and potential infections. Your healthcare provider can help clarify this through examination and possibly imaging studies.

5. Bladder Irritability and Urethritis: Your symptoms of bladder irritability, such as urgency and frequency, may be exacerbated by a history of UTIs. Chronic irritation can lead to a condition known as interstitial cystitis or bladder pain syndrome, which can cause similar symptoms. Drinking excessive amounts of water to prevent infections can lead to a cycle of urgency and frequency, making it feel like you cannot hold your urine. It is important to balance hydration with bladder health.

Given your concerns, it may be beneficial to consult a urologist, especially since you have a history of bladder irritability and recurrent UTIs. A urologist can provide specialized care, including further diagnostic testing to rule out any underlying conditions that may be contributing to your symptoms.

In summary, while some urinary symptoms may resolve without treatment, recurrent infections warrant a thorough evaluation to prevent complications that could affect your fertility. It is essential to maintain open communication with your healthcare providers, ensuring that all your symptoms are addressed and that you receive appropriate care tailored to your specific needs.

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