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Urology/Urinary problems/sciatica?

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Question
Hi So I am a 28 year old female who has been having urinary issues for the past 4 months. May was when everything seemed to have started. I am a pretty active female who goes to the gym. I was taking zumba classes at the time. One night I may have overdone it. I remember waking up the next day and feeling slightly terrible. That Thursday, I remember I started having urinary symptoms. I thought I may have had an infection. I started having urges to urinate, sometimes only a little would come out. My back was also pretty sore. Went to the doctor the next week and they seemed to have thought the same thing. I was put on Bactrim for a week but it ended up being negative. I had no infection in the first place. For weeks I couldn't figure out what was wrong with me. I landed up going to the ER in June with intense back pain. Again, they tested everything and it was still negative. They diagnosed me with lower back pain. My bladder would spasm very badly during that time It felt like. Almost like a muscle thing. Very hard to describe. To make a long story short, I went to a chiropractor who told me I have sciatica because the pain started going down my leg. My leg would get tingly and sort of numb. He worked on my back and since then, my urinary issues seemed to have dissipated a little. I was way out of alignment. I still have some issues though. When I do go, I go a lot now but I feel like the urge is still present. Almost like a pressure thing. What I want to ask is, could this be related to my back somehow? I didn't tell my chiro because I figured he wouldn't know and I thought it would get better. I'm thinking about seeing a urologist. What the heck is wrong with me?

Answer
Jenny, you do indeed need to see a urologist to sort out your problems.  There are many causes for urinary frequency &/or urgency.  The common ones include urinary tract infections, excessive fluid consumption (especially coffee, tea and beer which produce an additive diuretic effect), diabetes, urinary stones, a variety of kidney disorders associated with inability to concentrate the urine properly, urinary stones, several types of urinary bladder diseases (ie neuropathic bladder, stones, interstitial cystitis, etc.), overactive bladder syndrome and anxiety.  Some individuals develop frequency induced by chemical residues from soaps and detergents in the bath water that may wash up into the bladder and urethra causing inflammation. Therefore, if you are a bath person, discontinue this practice immediately and take only showers.  The practice of sitting in a hot tub (especially at spas or health clubs) may cause a similar problem.  Frequency can also be induced by urethral trauma from sexual intercourse.  If you are still having sex, stop until your urinary problem is resolved.  Kidney stones that get lodged in the lower ureter can often have this effect (frequency).  Although typically they cause severe pain and blood in the urine, sometimes they only cause severe frequency until passed.  Inflammatory or other masses in the pelvis can rest on the bladder and produce the constant urge to void.  There are unusual local conditions such as urethral diverticulae that can become inflamed and cause severe frequency.  

Because frequency has so many etiologies, I suggest you see a urologist in consultation.  Basic evaluation would include a history, physical examination, urinalysis and, if indicated, a urine culture.  Other tests that might be needed to find the cause include imaging of the kidneys, cystoscopy and urodynamic studies.  Good luck.

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Arthur Goldstein, M.D.

Expertise

Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.

Experience

I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

Organizations
American Medical Association, American Urological Association, American College of Surgeons

Education/Credentials
College degree - BS Medical degree - MD Master of Science - MS

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