Intolerable frequency and pain

[indie]

I'm posting to ask for urology RN help for my sister's symptoms. I'm an RN, but this is not my specialty and do not seem to be able to help her. I've asked her to post here for your help, but she seems not to have done.

She had a hysterectomy a few years ago (no neoplasia type pathology) and since then, seems to have intermittent, but intolerable bladder symptoms, especially frequency and pain, usually worse toward the end of the day.

Urinalysis on several occasions has been negative. No fever. Sometimes feels as if there is a prolapse, but exam. is negative for this. Antibiotics do not assist her.

Severe constipation can be a trigger for these symptoms, but they can occur without. Can go months without symptoms (especially about the time she gets an appt. with a specialist!), but can be frequently in trouble.

Has tried Ditropan without effect. Local heat may provide just a smidgeon of help, but not significant.

Please advise, I need to help her. I've suggested relaxation, suggesting an anxiolytic (primary doctors have been of v. little help or support with this), lots of fluids. Nothing really helps her.

I'm afraid she may have interstitial cystitis which I have not mentioned to her - I'm aware of this because I've worked in oncology.

Please post (even if you are a fellow sufferer, not an RN.) with anything you can think of around this subject. Thanks.

[BarbPick]

Interstitial cystitis is a chronic inflammatory condition of the bladder whose cause is unknown. Inflammation and irritation of the bladder wall can cause chronic pelvic pain and urinary disturbances and may lead to scarring and stiffening of the bladder, occasionally creating ulcers in the bladder lining.

This has nothing to do with oncology, it sounds like you hit it on the head. The only other thing I can think of is adhesions from her surgery or past other surgeries.

There has to be a primary care physician who would be willing to support her, as the toothache always goes away when you see the dentist.

[Geeg]

Pyridium is great for the burning, watch out it will turn the urine oragne-red.

[sehbear]

It does sound like interstitial cystitis.

A cystoscopy and biopsy may be needed for diagnosis.

Urodynamic studies may also help rule out poor bladder compliance or hyperactive bladder.

It is a hard one.

She must see a urologist as soon as possible as fear and anxiety do not help in such cases and a diagnosis is always helpful amd often the first step to recovery!

Good luck