Kidney and Bladder Issues: Seeking Clarity on Symptoms

I'm not sure if there is an issue with the kidneys or the bladder?

Hello, on July 2nd, I woke up from a nap in my office and suddenly had to use the restroom over twenty times that afternoon.
I experienced significant pain in my genital area, with a sensation of wounds and bleeding.
Even after urinating, I still felt the urge to go.
The next day, I started to feel pain in my right kidney.
That evening, I immediately went to the urology department at a local hospital, where the doctor prescribed anti-inflammatory medication and requested a urinalysis.
After taking the medication, the kidney pain subsided, but the frequency of urination did not decrease.

About three days later, I returned to review the urinalysis report, which indicated that I had acute pyelonephritis (a serious condition) and that it was caused by urinary retention.
However, I have never held my urine and drink a large amount of water daily.
The doctor insisted that my condition was due to urinary retention, which left me speechless.

On July 19th, I had a follow-up appointment because my left kidney also started to hurt, preventing me from sleeping, and my nighttime urination increased to more than five times.
This time, the doctor did not prescribe any medication and requested another urinalysis, again advising me not to hold my urine, but I am not doing that! I am very concerned that the doctor's diagnostic approach may be flawed and that the real issue might be overlooked.
Could you please provide me with some advice? Thank you!

tutu, 20~29 year old female. Ask Date: 2002/07/19

Dr. Song Zhixian reply Urology

Acute cystitis is characterized by symptoms such as bladder pain, painful urination, and increased frequency of urination.
In more severe cases, hematuria may occur.
The condition is commonly caused by Escherichia coli and can be treated with oral antibiotics.
Holding urine and sexual activity can trigger cystitis.
Women have shorter urethras, and improper hygiene practices, such as sitting baths or wiping from back to front (which should be done from front to back), can increase the risk of infection, which is also related to individual immunity.
Acute pyelonephritis presents with the aforementioned symptoms, along with flank pain (on the affected side) and high fever.
Hospitalization for intravenous antibiotic treatment is necessary, and a renal pelvis imaging study with intravenous contrast should be performed to check for complications such as kidney stones, ureteral strictures, or vesicoureteral reflux.

Reply Date: 2002/07/19

More Info

Hello,
Thank you for sharing your concerns regarding your recent kidney and bladder issues. It sounds like you have been experiencing significant discomfort and confusion regarding your diagnosis and treatment. Let’s break down your symptoms and the potential underlying issues, as well as the importance of proper diagnosis and management.

From your description, it seems that you have been experiencing frequent urination, pain in your genital area, bleeding, and pain in your kidneys. These symptoms can be indicative of several conditions, including urinary tract infections (UTIs), kidney infections (pyelonephritis), or even bladder issues. The fact that you were diagnosed with acute kidney inflammation is concerning and warrants further investigation.

Acute kidney inflammation can occur due to a variety of reasons, including infections, obstruction, or even autoimmune conditions. The suggestion that your symptoms are due to "holding your urine" may not fully capture the complexity of your situation, especially since you mentioned that you drink plenty of water and do not intentionally hold your urine. It’s important to consider that even if you are drinking enough fluids, other factors such as bladder sensitivity, infections, or anatomical issues could be contributing to your symptoms.

Frequent urination, especially when accompanied by pain and bleeding, can often indicate a urinary tract infection. UTIs can cause inflammation and irritation of the bladder and urethra, leading to the symptoms you described. If left untreated, a UTI can ascend to the kidneys, resulting in a more serious condition known as pyelonephritis, which can cause kidney damage if not addressed promptly.

Given that you have experienced pain in both kidneys and an increase in nighttime urination, it is crucial to follow up with your healthcare provider. Here are some steps you might consider:
1. Seek a Second Opinion: If you feel that your concerns are not being adequately addressed, it may be beneficial to consult another urologist or nephrologist. A fresh perspective can sometimes lead to a more accurate diagnosis.

2. Further Testing: Request additional tests such as urine cultures, imaging studies (like an ultrasound or CT scan), and blood tests to assess kidney function. These tests can help identify any underlying issues that may not have been apparent in your initial evaluation.

3. Symptom Diary: Keep a detailed diary of your symptoms, including the frequency of urination, any pain levels, and any other associated symptoms. This information can be valuable for your healthcare provider in understanding your condition.

4. Hydration and Diet: Continue to stay well-hydrated, but also pay attention to your diet. Certain foods and beverages can irritate the bladder, so it might be worth discussing dietary adjustments with your doctor.

5. Medication Review: If you are prescribed medications, ensure that you understand their purpose and any potential side effects. If you experience adverse effects, communicate these to your doctor.

6. Lifestyle Modifications: Consider lifestyle changes that may help alleviate symptoms, such as pelvic floor exercises, bladder training, and avoiding irritants like caffeine and alcohol.

In summary, while your doctor may have provided a diagnosis based on the information available, it is essential to advocate for your health and seek further clarification if you feel that your symptoms are not being adequately addressed. Kidney and bladder health is complex, and a thorough evaluation is necessary to ensure that any underlying issues are identified and treated appropriately. Don’t hesitate to ask questions and express your concerns during your medical visits. Your health and comfort are paramount, and you deserve a comprehensive approach to your care.

Best wishes for your health and recovery.

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