Rare Female Prostatitis: Symptoms and Treatment Insights - Urology

Urinary tract issues

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Hello, Doctor.
I have been suffering from urethral disease for nearly 10 years, and it has recently become particularly severe.
I have spent a lot of time in the emergency department and receiving treatment at Taichung Cheng Ching Hospital, but there has been no improvement.
The pain often reaches an unbearable level.
Recently, a physician specializing in female urology examined my urethra during a vaginal examination and suspected that I might have a rare case of female prostatitis.
She prescribed tetracycline for one month, and I have been taking it for two weeks now, but there has been no improvement.
Below are the symptoms I provided to the physician, and I hope to gain some insights through this medical consultation.
Daily water intake: Approximately 3,000 to 5,000 c.c.

Duration of symptoms: Approximately 10 years
Tests performed: Bacterial culture (Taichung Veterans General Hospital), cystoscopy (Taichung Hospital), renal imaging (Cheng Ching Hospital)
Most frequently visited hospital: Taichung Cheng Ching Hospital (Ping Deng and Zhong Gang campuses)
Most frequent emergency visits: Taichung Cheng Ching Hospital (Zhong Gang campus)
Description of symptoms:
A.
General time:
A1.
If I do not drink about 500 c.c.
of water within 2-3 hours, I feel a constriction and discomfort in the urethra, and I need to drink water immediately to force urination.
If I do not drink water, it quickly escalates to unbearable pain.

A2.
There is no difficulty in urination; there is no typical burning sensation before or after urination, nor is there a stinging sensation, but rather a discomfort due to urethral constriction.

B.
During episodes:
B1.
Urethral constriction, extreme discomfort, and pain, with urine tests showing no significant inflammation.

B2.
In the past two months, I visited the emergency room twice, with each episode lasting about 5 hours without interruption.

First episode (around 7/16) - I held my urine for about 20 minutes 6-7 hours before the episode, but after drinking a large amount of water (about 4,000 to 5,000 c.c.), the urine tests showed no significant inflammation upon arrival at the emergency room.
Despite receiving anti-inflammatory and pain relief medications, there was no improvement.
Later, a renal imaging test was performed to check for stones, and the results were normal (coincidentally, the pain symptoms completely resolved at that time).

Second episode (8/22) - I held my urine for about 10 minutes 3-4 hours before the episode, but after drinking a large amount of water (about 4,000 to 5,000 c.c.), the urine tests again showed no significant inflammation upon arrival at the emergency room.
I received four doses of anti-inflammatory and pain relief medications, but there was no improvement.
The physician believed the pain was not due to a typical inflammatory condition and suggested consolidating my medical history for referral to a hospital like Veterans General for more detailed examination.

Emergency visits aside from these two - Not caused by holding urine, but due to not drinking large amounts of water for over 2-3 hours.
Sometimes, pain relief injections can alleviate the symptoms, while other times, even morphine and several doses of pain relief and anti-inflammatory medications do not stop the pain.

B3.
Other notes: The pain symptoms differ from typical urethritis symptoms.

1.
When there is severe urethral constriction, the moment the urethral muscles relax during urination, the pain disappears (for about 1 second).

2.
When there is severe urethral constriction, during bowel movements, the moment the anal muscles contract, it compresses the urethra, and the urethral pain disappears.
After the anal muscles relax, the intense discomfort returns.

3.
During renal imaging, after the contrast agent was administered, the pain symptoms completely resolved (coincidentally at that time).

4.
If a vaginal examination is performed during or a few days after an episode, when the speculum compresses the urethra, I feel discomfort, which resolves shortly after the speculum is removed.

C.
1-2 weeks after an episode: There is often some degree of discomfort (tolerable), and I must drink more large amounts of water to alleviate it.

This is my description of symptoms, and I hope to receive some insights from the physician.
Thank you very much!

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Kandi, 30~39 year old female. Ask Date: 2005/09/06