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What Causes Burning Sensation While Urinating?

Posted on Tue, 30 Sep 2014

Question: Recent History: In May 2014 I had my pace maker changed for one Dr. said was a better one. A month later I had a mild heart attack, had a heart XXXXXXX and two stents. While still in hospital, I was treated for a hematoma. After being discharged from hospital, I had no appetite, felt weak, dizzy & fate. I also began to have a burning sensation while urinating along with urgency and frequency. I went to primary Dr. who done yearly pap exam along with blood & urinalysis tests. He stated I had a bladder & kidney infection. He prescribed CIPRO which I took but did not work for me. He then prescribed another antibiotic which too did not work. While I continued to feel weak, I was admitted in the hospital and was treated for low sodium. I'm feeling better now since my Coumadin has also been regulated. Although, I continue to have the burning sensation in my vaginal area which has gotten worse since I seem to have it with or without urination. At times it feels as if my bottom is going to fall out. My primary Dr. has continued to do blood & urinalysis tests but show nothing. I am a widow and have not been sexually active in over a decade so I am not worried about any std's. Any possible diagnosis? Past History: Congested heart failure & quintuple heart bypass in 1997.

Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Brief Answer:
explained

Detailed Answer:
Hello and Welcome

I appreciate your concern.

You have been started empirically on antibiotics but there is no point in changing antibiotics without knowing the organisms responsible.
I would advise a urine culture , before going for another anti biotic course.

The feeling of the bottom falling out is serious and requires workup as it indicates Pelvic relaxation ( uterine and vaginal prolapse). The diagnosis is clinically done via bimanual pelvic exam.

Kegel exercises, estrogen replacement, pessaries or surgery (colporaphy and hysterectomy ) may be advised after diagnosis is confirmed.

If the burning symptoms persist, a yeast infection can be suspected, treated by fluconazole ( single dose). If that does not improve the symptoms a biopsy of the vulva or the adjoining cervix may be indicated to rule out any serious cause.

Let me know if you have any query

wishing you best of health

Thanks

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Sorry I forgot to mention, I had a hysterectomy several years ago and have been taking hormones. I was recently started on a hormone cream for vaginal dryness.

Answered by Dr. Dr. Muhammad Sareer Khalil (10 hours later)

Brief Answer:
explained

Detailed Answer:
Hello again,

Long-term effects of hysterectomy on the pelvic floor are: pelvic organ prolapse, urinary incontinence, bowel dysfunction, sexual function and pelvic organ fistula formation. These outcomes are particularly relevant as life expectancy has increased and sequela may occur a long time after the surgical procedure and severely impair quality of life.

Consequently, an increased number of women will present with pelvic floor dysfunction, such as urinary incontinence and pelvic organ prolapse, and women with previous hysterectomy seem to be at particular risk.

So I would still recommend the previous suggestions, in consultation with your doctor.

Bimanual pelvic exam to look for any complications of pelvic floor
Fluconazole for yeast infection empirically
Urine Culture before starting antibiotics
Ultrasound abdomen and pelvis

Thanks

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Above answer was peer-reviewed by : Dr. Ashwin Bhandari