Vaginal Infections: Persistent Pain and Treatment Options

Painful urination, vaginal infection?

Hello, Dr.
Chen: I would like to ask you about my condition.
Since August 20, I have been experiencing pain during urination.
I visited a urologist and was prescribed antibiotics, but the issue was not resolved.
The doctor mentioned that my urine test results showed the presence of substances typically found in the vagina, so I was advised to see a gynecologist.

During my first visit to the gynecologist, I had redness and swelling in the genital area, and I still experienced some pain while urinating.
The doctor only prescribed a topical ointment.
After two months without improvement, I returned for a second visit, and the doctor prescribed antibiotics, phenazopyridine, and a topical ointment.
My condition improved somewhat, but it was still not resolved.

On my subsequent visits, I continued to receive the same treatment: antibiotics, phenazopyridine, and a topical ointment, but I still did not achieve a complete resolution.
During my fourth visit, I received the same medications and was advised to take "U-RELAX." I have finished all the medications and am currently only taking "U-RELAX." I feel that my condition has improved, as I only occasionally experience issues during the day.
However, I find it strange that I experience a burning sensation when urinating while standing in the shower or after showering, and I also have some discharge.

I am worried that I might get reinfected after my next menstrual period, as I am not sure if "U-RELAX" can completely resolve my issue.
Additionally, is it safe to take "U-RELAX" during my menstrual period? Furthermore, since I have no sexual experience, the gynecologist advised against applying the ointment inside the vagina.
Is there a method to apply the medication to the vaginal area? Are there any spray or liquid medications available?
(Note: Since my spinal curvature correction surgery on November 5, 2009, I have been required to wear a brace, which has led me to wipe from behind after urination for several months.
I later learned that this could lead to reinfection.) Thank you, Dr.
Chen.

DOROTHY, 20~29 year old female. Ask Date: 2010/11/30

Dr. Chen Changfu reply Obstetrics and Gynecology

After reviewing your detailed description, it can be inferred that the use of a "back brace" may have made urination and cleaning of the external genitalia more inconvenient, potentially leading to urinary tract infections and vulvar inflammation, which have since been treated and improved by a physician.
Clinical experience suggests that women who have never had sexual intercourse have a very low chance of vaginal infections; therefore, vaginal medication is not necessary.
"U-RELAX" is classified as a health supplement and is a probiotic product, which should be considered as having health benefits rather than medical efficacy.
There are no known contraindications regarding the consumption of "U-RELAX" during menstruation.

Reply Date: 2010/11/30

More Info

Understanding vaginal infections and their associated symptoms, such as persistent pain during urination, can be quite complex. Your experience, which includes recurrent pain during urination, discomfort in the vaginal area, and the use of various treatments, highlights the challenges many women face when dealing with these issues.

Firstly, it’s important to understand that vaginal infections can manifest in various ways, including symptoms like pain during urination, unusual discharge, itching, and inflammation. The presence of bacteria in urine that is typically found in the vagina suggests a possible urinary tract infection (UTI) or a concurrent vaginal infection. The fact that you have been treated multiple times with antibiotics and topical medications indicates that the infection may not have been fully resolved, or there may be an underlying issue that needs to be addressed.

The medications you have been prescribed, such as phenazopyridine, are typically used to relieve urinary pain and discomfort. However, they do not treat the underlying infection. Antibiotics are essential for treating bacterial infections, but if the infection persists, it may be due to antibiotic resistance, an incorrect diagnosis, or a need for a different class of antibiotics. It’s crucial to follow up with your healthcare provider to reassess your condition and possibly conduct further testing, such as a culture, to identify the specific bacteria causing the infection.

Regarding the use of "U-RELAX," it’s important to clarify that this product is marketed as a probiotic supplement and is not a medication designed to treat infections. While probiotics can support overall vaginal health by maintaining a balanced flora, they should not be relied upon as a primary treatment for infections. There is no contraindication for taking probiotics during your menstrual period, but they should complement, not replace, standard medical treatments.

As for the application of topical medications, if your healthcare provider has advised against inserting medications into the vagina due to your lack of sexual experience, it’s essential to follow their guidance. However, there are alternative methods for applying medication, such as using a vaginal applicator, which can help deliver the medication more effectively. Discussing this with your healthcare provider can provide you with options that are safe and appropriate for your situation.

Your concern about recurrent infections, especially around your menstrual cycle, is valid. Menstruation can create an environment that may predispose some women to infections due to changes in pH and moisture levels. Maintaining good hygiene, wearing breathable cotton underwear, and avoiding irritants such as scented products can help reduce the risk of infections.

In summary, persistent pain and discomfort related to vaginal infections require a comprehensive approach to diagnosis and treatment. It’s essential to work closely with your healthcare provider to ensure that you receive appropriate care tailored to your specific needs. If symptoms persist or worsen, do not hesitate to seek further evaluation, as timely intervention can prevent complications and improve your quality of life.

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