Urethritis: Symptoms, Diagnosis, and Treatment Concerns

Questions related to urethritis?

Recently, I'm unsure whether I have urethritis or cystitis.
I saw a gynecologist who tested my urine but did not perform a pelvic exam, stating that my white blood cell count was 500 and red blood cell count was 200.
My menstrual period ended on Wednesday, and I felt discomfort from using panty liners for too long, which started on Friday.
I began drinking more water on Saturday, but my symptoms worsened.
Here are my questions:
1.
Is a pelvic exam necessary for diagnosing urethritis, or does the patient have to request it?
2.
On Saturday, I started experiencing abdominal pain (similar to menstrual cramps) and unusual sensations while urinating, along with increased frequency of urination.
The urine test indicated hematuria, but there was no visible blood in my urine.
Additionally, isn't there usually some discharge after menstruation? Could this affect the test results? I also noticed a small amount of blood clots at home.
3.
The white blood cell count of 500 was described as very high.
I've heard that only diabetic patients might reach such levels.
Can inflammation cause such a high count? I'm worried I might have diabetes since I'm overweight and currently taking medication for polycystic ovary syndrome.
4.
The doctor mentioned that a healthy white blood cell count is 0.
Is this the same as urine protein levels? Isn't the normal range for urine protein typically 50-150, or did I misremember the test items (using a colorful test strip for urine analysis)?
5.
On the day of the test, I consumed meat, eggs, and milk.
Could this affect the test results, assuming I am recovering?
6.
The doctor prescribed NYSTATIN, but I feel an unusual sensation after applying it.
I'm unsure if I applied too much.
Is it safe to apply it vaginally?
Thank you for your assistance, doctor.

Ah Hua, 30~39 year old female. Ask Date: 2015/12/13

Dr. Xu Junrui reply Obstetrics and Gynecology

1.
Inflammation of the urethra or bladder does not require a pelvic examination; a urine test is sufficient.

2.
Unless there is still blood in the discharge after menstruation, it should not affect the urine test results.

3.
Diabetes affects urine testing by the presence of glucose, which is unrelated to white blood cells; white blood cells are more associated with inflammation.

4.
White blood cells and urine protein are completely different testing parameters.

5.
Urine testing is not related to food intake.

6.
Nystatin ointment is for external use; it is recommended to apply a small amount and not to overapply.

Reply Date: 2015/12/13

More Info

Understanding urethritis and its associated symptoms, diagnosis, and treatment can be quite complex, especially when symptoms overlap with other conditions such as bladder infections or menstrual issues. Based on your concerns, let's break down your questions and provide clarity.

1. Is an internal examination necessary for urethritis?
Generally, an internal examination is not mandatory for diagnosing urethritis. Urethritis is often diagnosed based on symptoms, urinalysis, and sometimes urine cultures. However, if the physician suspects other underlying conditions or if the symptoms persist despite treatment, an internal examination may be warranted. Patients can also request an internal examination if they feel it is necessary for their diagnosis.

2. Understanding your symptoms and urinalysis results:
You mentioned experiencing abdominal pain, frequent urination, and blood in your urine. It’s important to note that menstrual bleeding can complicate urinalysis results. Residual blood from your period can lead to false positives for blood in urine tests. Additionally, the presence of blood clots may indicate a more significant issue, but it could also be related to menstrual flow. If you have a high white blood cell count (500), this indicates a significant inflammatory response, which can occur due to infections or other inflammatory conditions, not just diabetes.

3. High white blood cell count and diabetes concerns:
A white blood cell count of 500 in urine is indeed high and suggests a possible infection or inflammation. While diabetes can lead to urinary tract infections (UTIs) and other complications, a high white blood cell count alone does not confirm diabetes. If you are concerned about diabetes, it would be prudent to have a fasting blood glucose test or an HbA1c test done to assess your blood sugar levels more accurately.

4. Understanding urine protein levels:
Normal urine protein levels can vary, but typically, a protein level of 50-150 mg/dL is considered acceptable for a 24-hour urine collection. However, urine dipstick tests can yield different results, and a reading of "0" for white blood cells is ideal, indicating no infection. If your test showed protein in your urine, it could suggest kidney issues or other systemic conditions, which should be evaluated further.

5. Dietary influences on urinalysis results:
Consuming protein-rich foods like meat, eggs, and dairy can affect urine tests, particularly protein levels. However, they typically do not significantly impact white blood cell counts. It’s essential to inform your healthcare provider about your diet before testing, as it can help interpret results more accurately.

6. Concerns about Nystatin application:
Nystatin is an antifungal medication used to treat yeast infections. If you are experiencing discomfort after applying it, it may be due to over-application or sensitivity to the medication. It is generally safe to apply to the vaginal area, but you should follow the prescribed dosage. If discomfort persists, consult your healthcare provider for advice.

In conclusion, it’s essential to follow up with your healthcare provider regarding your symptoms and test results. If your symptoms do not improve or worsen, further evaluation may be necessary, including possible imaging studies or referrals to specialists. Staying hydrated, avoiding irritants, and adhering to prescribed treatments are crucial steps in managing your condition. If you have any further questions or concerns, do not hesitate to reach out for more personalized medical advice.

Similar Q&A

Understanding Urethritis: Symptoms, Treatment, and Concerns

Hello doctor, I initially felt a discomfort and slight pain at the tip of my penis, so I went to see a doctor. The doctor diagnosed me with urethritis and prescribed medication. After taking the medication for 7 days, the pain subsided, but the urethra remained red. The doctor wa...

Dr. Du Shixi reply Urology
Hello: In cases of inflammation, a urinalysis is typically performed rather than examining the urethra. Additionally, inspecting the glans and foreskin is important, as swelling could be due to local hygiene issues or allergies. It is recommended to conduct a urinalysis. Furtherm...

Understanding Persistent Urethral Inflammation and Treatment Options

Hello, doctor. I would like to ask how long it generally takes to recover from urethritis caused by non-sexual contact. I have been suffering from urethritis for two weeks, and prior to this, I had no unsafe sexual encounters, not even with my girlfriend. I occasionally masturbat...

Dr. Du Shixi reply Urology
Hello: If there has been no unsafe sexual contact, urethritis should completely resolve with 7-10 days of treatment, so it may not be a typical case of urethritis. It is recommended to continue seeing the same urology department to identify the underlying cause. Remember to drink...

Understanding Urethritis: Symptoms, Treatments, and Concerns

Hello Doctor: About a week ago, I experienced symptoms of urethritis (slight burning sensation during urination). I visited a gynecologist on April 30 and received medication. On May 3, I returned for a follow-up and the urine test results indicated urethritis, with elevated whit...

Dr. Chen Jiansheng reply Urology
Based on your description, it is likely not a kidney infection, as kidney infections typically cause fever and significant lower back pain. It could possibly be bladder inflammation leading to edema.

Understanding Urethritis: Symptoms and Possible Causes Explained

Hello, Doctor. At the end of March, after using a masturbation sleeve (which I only use myself), I started experiencing frequent urination and a feeling of incomplete emptying about one or two days later. Occasionally, I also feel a dull pain in the urethra. This situation has pe...

Dr. Du Shixi reply Urology
Hello: Gonorrhea is unlikely, but urethritis is possible. Sometimes, a urine test may not provide a complete assessment. It is recommended to drink plenty of water, maintain regular exercise, and avoid irritating foods. If symptoms persist, please seek medical evaluation. Wishing...