Monday morning one of our phone nurses receives a phone call from a patient. The patient says, “I know I have a bladder infection. I have these same symptoms 3 or 4 times per year. Can you please call me in an antibiotic?”
Our phone nurse declines to call in the antibiotic until the patient comes in for a urine culture. The patient gets frustrated because she needs to fit an appointment with our office into her busy day. We empathize with your frustration and want to explain why we would like you to be evaluated.
I want our patients to understand why our providers want you to come in for a urine culture. Although burning with urination and frequency can suggest a bladder infection, these symptoms can also be caused by other conditions. It is important to identify the actual cause of recurrent urinary symptoms. If the symptoms are proven to be caused by an infection seen in the urine culture, then we might consider suppress therapy if appropriate and the infections are recurrent. We can help you or refer you for further evaluation with a urologist.
In other cases, the recurrent urinary symptoms are not caused by bacteria. These patients complain of urinary frequency, urgency, burning or pelvic pain, but the urine cultures are negative. These patients should be worked up for a condition called Interstitial Cystitis (IC). IC is a bladder pain syndrome. The exact cause is unknown, but the symptoms are manageable. After we confirm that your symptoms are not gynecology related and your urine cultures are negative, we will often refer you for further work up with a urologist. The urologist will provide the final diagnosis. If diagnosed with IC, there are multiple treatment options ranging from pelvic physical therapy to oral medications.
We want our patients to have the most accurate diagnosis and receive the best medical care. We look forward to helping our patients feel better.