WOMENS-HEALTH Messages for July, 2000: Re: uterine fibroids or uti's or both

Re: uterine fibroids or uti's or both

From: Lynn D. Montgomery, MD (anonymous@obgyn.net)
Wed, 5 Jul 2000 22:56:48 -0500 (CDT)

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At Wed, 5 Jul 2000, Dave wrote: >
>I am a 38 yr. old who has had several uti's within the last 2 months. I have taken several antibiotics with the most recent being Levoquin (500mg.) It feels better for awhile then returns within 3to 4 days after finishing the meds. Recently I had a really bad period with alot of clots and cramping. I went to the ER. and upon examination the doc thought she felt uterine fibroids. My question is can the two be connected in any way and if in fact fibriods are pressing on my bladder what forms of treatment are available? I have had a tubal ligation so kids are not a concern.I have also heard that with hormonal therapy the fibroids can grow back. I am going for a pelvic ultrasound and an IPV next week. Could endometreosis be a possibility also? No one seems to know whats going on and I have been dealing with this for well over 2 months with no solution. I'm getting very stressed about all of this. Any insight you may have would be greatly appreciated. Lisa

Lisa, First, the uti's. It is possible to have a chronic infection/inflammation of the bladder that routine 7-10 day courses of antibiotics will cure. If this is the case, prolonged antibiotic therapy is required (several weeks). There is a systematic approach to this kind of problem. First, one must assure that there is urine culture done. This is to assure that the appropriate antibiotic is being used. If the offending organism isn't appropriately treated, the infection may be suppressed by will return. Second, if an infection recurrs in a short period of time when treated appropriately, then an IVP is indicated to look for genitourinary abnormalities. Next, if this is unremarkable and the infections persist, then cystoscopy is indicated (looking into the bladder) to determine if indeed there is a chronic infection and further that there is nothing being missed. My final point would be related to intercourse. If the infections are related in any way to sexual activity, it could be that you are experiencing the infections secondary to the sexual activity. Many women have to take special precautions following intercourse to prevent infections, i.e. voiding immediately after intercourse and taking an antibiotic after intercourse.

The second issue is the fibroids. Fibroids are muscle tumors with a very low malignancy potential that occur in some women. They can vary in size from small to extremely large. If located near where the bladder sits on top of the uterus, they can certainly cause urinary symptoms, i.e. frequency, but they will not cause infections in the bladder. Hormones can influence their growth.

Endometriosis could also cause urinary symptoms, but not an infection.

I would proceed with the IVP and ultrasound and see what they reveal and go from there... Lynn

--
Lynn D. Montgomery, MD
Director, Maternal-Fetal Medicine
Rocky Mountain Perinatal Center
Missoula, Montana

**Note:  Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship.  This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.

**Thank you for your understanding ;-)

Next message: Lynn D. Montgomery, MD: "Re: one-sided epidurals"
Previous message: sharon: "Inducing Labor"
In reply to: jwang, M.D.: "Re: Tender tum & period problems & a bit of a moan - for DR Wang - correction!"
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