Re: question for Dr. Montgomery-
From: Lynn D. Montgomery, MD (anonymous@obgyn.net)
Wed, 16 Aug 2000 12:56:01 -0500 (CDT)
At Wed, 16 Aug 2000, Emme wrote:
>
>My ob/gyn tested for chlamydia and gonnorhea and they came back
>negative...is this what you were talking about or would she have to do a
>specific culture for urethritis? Also, how would you treat urethritis? I
>am going on vacation to Paris a week from tomorrow and just want to be
>feeling better
FOR THE CHLAMYDIAL INFECTION THAT CAUSES NONGONOCOCCAL URETHRITIS, YOU
HAVE TO USE A SPECIFIC CHLAMYDIAL TEST AND SPECIFICALLY SWAB THE
URETHRA. IT CAN BE MISSED IF ONLY CULTURING THE VAGINA. THIS IS
TREATED WITH EITHER A SULFA PREPARATION SUCH AS BACTRIM OR AN
ERYTHROMYCIN PRODUCT. ALSO FOR THIS PARTICULAR INFECTION, I DO NOT LIKE
THE "QUICK" TREATMENTS SUCH AS Z-PACKS, ETC. YOU REALLY NEED A FULL
7-10 DAY COURSE. IF THE CULTURE IS POSITIVE, I ALSO TREAT THE PARTNER.
I WOULD ALSO TRY THE CONDOM THING AND LUBRICANTS. IF THIS SEEMS TO FIX
THE PROBLEM THEN AT LEAST YOU KNOW AND CAN BE SEXUALLY ACTIVE...
LYNN
>
>At Wed, 16 Aug 2000, Lynn D. Montgomery, MD wrote:
>>
>>At Wed, 16 Aug 2000, Emme wrote:
>>>
>>>Do any of the doctors (or posters) have any advice about how to deal
>>>with urethral syndrome? I have to say that out of all the problems I
>>>have had to deal with this one must be the most annoying...especially
>>>since not that much is known about it. According to my urologist, a
>>>cystoscopy revealed no signs of IC, stones, anything like that, so he
>>>says I just have urethral syndrome and to take pyridium when I feel
>>>pain. That doesn't do much for my sex life though. I don't know if I
>>>feel pain because I get "dry" because I'm afraid and expect pain or
>>>what. But now I'm scared of having sex (especially since I'm going on
>>>vacation and don't want to get sick in a foreign country). The funny
>>>thing is once last month we had sex with condoms and a bit of lubricant
>>>three times in one weekend and I was not in significant pain. The last
>>>two times we have tried however (with no condoms- I am on the pill) I
>>>was in pain and felt ill aftwerwards, and the last time my yeast
>>>infection seemed to come back. Could the pH of the semen be affecting
>>>me? Or the friction? Could pain during intercourse earlier in July have
>>>been due to an undiagnosed yeast infection? My primary care doctor
>>>prescribed diflucan when I told him I had yeast infection symptoms, but
>>>my ob/gyn said that he was not a big fan of the drug b/c it only killed
>>>about 50% of yeast infections. He discovered a rather significant yeast
>>>infection at the end of July.
>>>
>>>Also, as I have mentioned earlier, I do not encounter any pain when
>>>urinating, but afterwards (ie. after I wipe and for maybe half an hour
>>>or so afterwards) there is a burning/stinging sensation in the vaginal
>>>area. To what might this be due? I recently started taking cran
>>>supplements again b/c UTIs usually appear in the first week after I
>>>start my new pack of pills, but I have stopped for now because I am
>>>afraid that it is affecting the acidity of my urine and irritating
>>>vaginal tissues. What are you thoughts? Sorry to be so long-winded but
>>>I am just looking for answers. None of my doctors seem to be able to
>>>give me any explanations for these problems. And I hate to keep going
>>>back to them.
>>>
>>>Thank you SO SO much for your time. I really appreciate the service you
>>>provide.
>>
>>Emme,
>>There are several possibilities here. First, there are those who are
>>allergic to their partners-particularly the semen. The fact that the
>>discomfort was absent when you used condoms speaks to that some. You
>>might try a controlled experiment here to rule this option in or out.
>>Additionally, you also used lubricants with the condoms, so this may
>>also be the answer. Many women find that they get dry and irritated if
>>their hubby takes too long during intercourse. The urethral opening is
>>very exposed and vulnerable during vaginal penetration and can be easily
>>irritated with prolonged intercourse. For this one, you may simply need
>>to use some lubricant...
>>Finally, vaginitis can cause the vulva and vagina to be easily
>>irritated. Further a particular infection involving the urethra can
>>cause your symptoms and cannot be detected except by particular
>>culture-chlamydia-nongonococcal urethritis. This also has to be
>>specifically treated or it will not resolve...
>>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 ;-)
>>
--
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 ;-)
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