Need Opinion!!!

[glassd18]

I was prescribed antibiotics for urethral polyps (not the removable type -indicates inflammation) after a cystoscopy some time ago. The idea behind this is that the skene glands in the urethra may have a low grade infection, and it is usually treated with long term antibiotics. I was given macrobid at first, but it made me feel awful, then Keflex, and then Bactrim. I took these for three months (I was suppose to take them for 6 months), but I didn't see any difference in symptoms so I stopped. Now I'm wondering if I should try it again and do it for the whole six months without switching around. I keep having hope that I have this low grade urethral infection (not detectible in urine) and that maybe I could get better. I don't know if my uro will let me try it again. Any opinions on the subject would be appreciated.

[ABliske]

I hate to say this, but it sounds like you already tried it. The 6 month trial may not do anything and you sound very sensitive to antibiotics. I don't really know much about the infection of the glands or what it is exactly you're referring to.
I took antibiotics for a long period of time to keep away my frequent UTIs. It did help, now I'm off them and have been infection free. The main pain is from the IC though and I'm constantly dealing with it.
Best of luck to you!!!!!!

[glassd18]

I guess you could say I was hoping that I just didn't do it right the first time. I'm a chicken when it comes to medications because I read everything about them including side effects etc...A little info is a dangerous thing :tsk: I guess I'm hoping for a miracle of sorts!!! That maybe because I didn't follow the strict regime with one med that maybe I screwed up the result. Anyhow I know I'm probably grasping at straws. I left my uro a message today, and I'm always worried when they are going to have enough of me and give me the axe!! Thank you for your input.

[dbritts]

The most important thing is to find out what bacteria that caused the low-grade infection in your Skene Glands and which antibiotic shows the most sensitivity for that bacteria. Infection in the Skene Glands is one cause of recurrent urethritis and UTIs. A follow-up with your uro sounds like the best course.

Good luck,
Debbie

[glassd18]

How do they detect an infection in the skene's glands anyway? All of my UTI tests come back negative. Would a swab test find something? I know it's of extreme importance to treat it with the proper anti. This stuff baffles the heck out of me. The uro just prescribed macrobid first, then when I told her it made me feel icky I got the Keflex, and I think the Keflex made me flare so I was given the Bactrim which seems to do fine, but I don't think it did much, but then again I wasn't on any of these long enough to find out probably....or maybe it's just IC. Thanks!!

[dbritts]

My uro checked me Skene Glands to see if they were a possible reason for my chronic UTIs. He said that he would feel a definite knot because they would be enlarged and tender. If that had been the case, then he would have made an incision, drained the abscess and cultured the fluid to find out what antibiotic to use. I didn't have any nodules, so they were OK. It's hard to tell the difference between a low-grade infection and IC, so a follow-up with your dr. is probably a good idea. Hope this helps.

Debbie

[glassd18]

She saw the polyps on my urethra during the cysto which she said were an indication of inflammation, and that's why she prescibed anti's. Their office called me back and said that if I wanted to try them again it's okay. She never mentioned that you could check the skene glands, and I had my annual physical today, and asked my md about it too, and he said there wasn't really anyway to check the skene glands that way. I'm surprised your uro knew to do that. I'm going to google this one. Thanks for the info!!!

[dbritts]

I found a link which has some good info--the picture is kind of graphic, but it's a good article. Good luck--I had to have my Bartholin glands removed because they became inflamed and were contributing to my vulvadynia pain.

http://www.brooksidepress.org/Products/Military_OBGYN/Textbook/Vulva/Skenitis.htm

[glassd18]

I wonder if it's just urethral syndrome (inflammation). She said they weren't polyps per say, but that they are little raised bumps indicating inflammation. Urethral syndrome or urethritis is treated with long term anti's. This fits much more with her line of treatment. Maybe it's not actually the skene's glands then that are inflammed and just the urethra.

[dreamy]

Okay glassd18, did you do an in office cysto or the hospital cysto to see the urethral polyps? What are your symptoms and where does it feel like its coming from? I am having severe ticklish tender feeling underneath my urethra opening. Is that where you are having issues with? I also noticed they are swollen and it causes me to feel a pressure tickle itch.. it also feels like this behind my pubic bone where the g spot is it is kinda hard to explain but its like an irritation slight itchy feeling you cant scratch and it feels like an extreme urge to pee all the time. When I took cipro the glands went down, I went off of cipro and now its back. I dont get it! Anyway, how does one uro know to swab the glands for bacteria and another not know to do that? It makes it hard to get treated when the doctors do it differently like that.

Is anything helping you? If so what? I hope we find an awnswer to these puzzling issues. Dbritts where are you located? Where exactly would these knots be? Your doctor seems very smart.

[dbritts]

Dreamy,

I'm in NW Florida. I don't understand why all uros don't do the same things. The Skene glands will have knots or nodules that the uro can feel. I've had a persistent infection so my uro was ruling out stones, Skene gland infection, structural abnormalities--any of the physical things that could cause an infection to keep coming back. I have a lot of vaginal and urethral itching, burning and the feeling that I need to pee all the time. Your symptoms sound very much like mine. When I'm on Cipro all of that goes away, but it keeps coming back!! My numerous cultures continually show enterococcus faecalis and staph, so I'm having a hard time getting rid of them.

The link I found is one of the best as far as treatment and a picture of where the glands are located.

http://www.brooksidepress.org/Produc...a/Skenitis.htm

Debbie

[dreamy]

Hey dbritts I am puzzled by the symptoms too. I also got a urine broth culture that said I had staph coagulase. I am trying anything to help this. Has anything helped you? Are you still having symptoms? I have seen that web page before trying to look up skenes gland infections. My glands are swollen but not like that. Mine are slightly puffy I guess and I feel like I have to pee and it actually excentuates sexual arousal for some reason. Its very uncomfortable though because of that itchy tickle feeling although sometimes I cant tell if its the urethra or the bladder neck. When I press on the glands under my urethra I feel the sensation. Let me know anything that has been helping you.

[dbritts]

Dreamy,

Wish I could say something helped, but this has been going on since 2004. My IC started around 1989--no UTI history before it started. This felt alot different than my IC because of the constant urethral and vaginal symptoms, and my frequency increased so much. My uro did my culture at the hospital and it came back with the e.faecalis and the methillin-resistant staph. I also has staph coagulase on one of my cultures. He ran all sorts of tests, my PT for PFD was stopped, but the infection kept coming back. He's sent me to 6 Infectious Disease drs. and the only thing they say is that the bacteria has colonized, so I will need life-time antibiotics. They think it's something to do with my immune system, so I'm having all kind of other tests right now. I've just finished a round of Rifampin for the staph, and now I'm back on Cipro for the enterococcus. If I can get a clean culture, then we're going to try antibiotics 1 every 3 days. The staph is in my right kidney, but the enterococcus colony is in my bladder, I think the enterococcus is in my urethra and gets in my bladder because I never had urethral pain with my IC. I had IC for 14 yrs. with no UTIs, so I don't know where this is coming from. My urologist has had other women get enterococcal UTIs and he's successfully gotten rid of theirs--but they didn't have IC! Wish I could be of more help. The only thing that helps is the Cipro and Femdophilus. I'm going to ask about an antibiotic cream to apply directly in the vagina and see if that makes a difference! What antibiotic was your staph sensitive to?

Debbie

[glassd18]

Hi Dreamy, welcome to the urethra conversation!!!!

I had my cysto done in the doctors office. I haven't had a hydro yet. I had another cysto in hospital with mild distention back in 1987, and they dilated my urethra at that time. It was this last cysto that the uro found what she called polyps, which she explained are raised bumps found at the opening from the bladder to the urethra. She told me they are not the type that are removed, but are an indication of inflammation so she gave me anti's long term (6 months), but I switched around my anti 3 times because the macrobid made me feel like garbage, the Keflex flared me, and now I'm doing the Bactrim. I started it again today (nothing ventured, nothing gained). My uro has been highly recommended from many other doctors in the area so I know she has a good reputation. I had my urethra cultured by my gyno also, but it was for ghonnorea and/or clamydia that they were searching for. I have not had a swab of anything else since. I've been tested for yeast several times and it comes back negative every time.

My symptoms are extreme pinching in the urethra. I have itching and burning in and around the vaginal area to the perrenial. I have extreme hesitancy (trouble starting my urine flow), and it pinches. Sometime these symptoms are more pronounced, and other time its more bladder symptoms like pressure, and urgency. I understand about the arousal feeling because I get that too, but I know it's my darned urethra (what a pain). My symptoms always started with that extreme pinching in the urethra and then they move around, come and go. It's maddening. I just wish they could figure this out. It's torture.

[dreamy]

Well around here its like pulling teeth to get cipro for some weird reason and I am so sick of it. I mean whats the big deal? Its not pain pills or anything like that. Im sitting here trying to save myself and they are hindering me from doing so it seems sometimes. I want to do a test to show if I am dealing with urethral diverticulum. Most of my discomfort is right where you squeese when doing a kegel. Im sick of this what is it going to take to get help?

[dbritts]

That's not right that you have to fight to get tested to rule out urethral diverticulum. That's part of the basic testing when you're dealing with recurrent UTIs and urethral symptoms. My urologist ordered a CT scan but it was negative. He called one of the IC drs. at UAB and they said they were doing a MRI with vaginal probe, so he ordered one of those about 6 months ago. His nurse made a mistake and ordered one with a rectal probe!! My urologist had no clue that they used a rectal probe on me until my follow-up visit!! I was not a happy camper to say the least. Anyway, these tests are standard procedure, so I don't understand why your dr. wouldn't try to rule out the easy things first. Sorry that you're having to fight to get testing. And they say IC patients need to keep their stress levels down!! Any chance your primary would order a CT scan for you.

[dreamy]

Thats horrible! I know I should have had this test already. I am going to ask for the test. I havent really did any tests so far. Thats why I am so annoyed. I want tests done to rule out other things. I think that would be only right to do that!

I did the vaginal ultrasound is this the same procedure? They used a vaginal probe on me but she said that they checked for cysts and I aksed if she could check the urethra area and she said they cant really test for that with that procedure. Let me know!

Have you tried any antibiotic creams? I heard that can help and I am trying to get some to try it. So, what has your doctor said about the urethra glands? What is he going to do for you and what meds are going to help?

[dreamy]

Hey Dbritts, I had my urine tested and they found staph coagulase and strep b. The staph was sensitive to ciprofloxin, ampicillin and amoxicillin, bactrim, doxycycline, and vancomycin. What about you?

I have heard that an iv with vancomycin and bladder instills and tissue penetrating antibiotics helps. I am wondering why some doctors arent on to that yet. It seems to make sense. I am trying now to find a doctor that will do this without having to travel. I think that its rediculous to have to do that when they can easily do this too.

[dbritts]

My uro started with a CT scan of kidneys, bladder, etc. to look for any structural problems or stones. This has been going on for 4 yrs. so he's done a lot of tests. I had a manual exam so he could feel for knots on the Skene Glands. I had a procedure done under light sedation so he could make sure my urine wasn't backing up into my kidneys, and to take urine samples from the kidneys and bladder so they could be cultured. An ultrasound with a vaginal probe isn't quite the same as an MRI with a probe. I think the MRI was overkill because I'd already had so many other tests.

For some reason, even the Infectious Disease docs oppose IV antibiotics--don't really understand why since I have MRSE. My uro did 3 wks. of vanco/gentamicin instills into the bladder--didn't work, but at least he tried. I'm going to ask about antibiotic cream because enterococcus can colonize the vagina and urethra. Maybe with the oral and a cream antibiotic, plus Femdophilus I can get the enterococcus under control. Don't know what to do about the staph.

Hope you don't have to run all over the country to find help. Just my opinion, but a comprehensive culture should be Urology 101!!

I've heard about the treatment plan you mentioned and I don't understand why others aren't doing it--I see my uro in early Dec.--think I'll put that question to him!!

Debbie

[dreamy]

So you have both staph and enteroccocus? Is staph coagulase a methillin resistant staph? That has me worried. Ive been seeing a lot about staph infections and people can get them in the bladder. So, what are you doing right now to help with everything? Are you using any meds at all to control the symptoms? I am having a very hard time with this. I need tests done asap and I need in my opinion an antibiotic cream. I read that it can help for the right kind of situation. One of the doctors I deal with has to let me try it to see if it will help. Although I have two situations going on at the same time. I also want to get the fem dophilus.

[ABliske]

I know there are a lot of people with other problems and diseases out there. My pain is all the IC though - vaginal and all. I tried the antibiotic creams, douches, antibiotics, a laparoscopy, a CT scan, and tons of other things. I think it's terrible my OB didn't refer me to anyone and let me spend sooooooo many days and so much $ in his office!!!!!!!

[dreamy]

Hey ABliske what antibiotics have you tried and for how long? Also what creams? I dont understand what you are trying to say really. Let us know what you are trying to get across exactly. I would be glad that you have been able to have those tests and try the medications that you have tried. If your saying that you have wasted your time with a doctor then I would say Im sure we all have or not so much wasted time but it took more than one doctor to get proper treatment or a better awnswer. I dont know many that have been only dealing with one doctor with this kind of condition. I wouldnt feel comfortable doing that when there are so many different ways to treat it and many opinions on IC. How are you doing now? I hope that your feeling better.

[glassd18]

Sorry dreamy that your having a rough time getting the help you need. I am pretty lucky that my uro prescribes just about anything I require. I started the Bactrim and now I'm having the flare from hell. I started Nexium, Bactrim and Culturelle probiotic to offset antibiotic. I decided to leave off Nexium and Bactrim this a.m. and my bladder is feeling a bit better. I'm now afraid to try either again because I thought I was gonna die last night!!!

[dreamy]

I hope you start to feel better. I am going to get help it just takes time. And when you havent been feeling good for that long it gets stressful. It will get better I have some appointments coming up. I should get the help I need.

[ABliske]

I took Macrobid for about 2 months. Then, I switched to another type of antibiotic (because of the nausea from the Macrobid). I can't remember the name of that one. I took it for about 4 months off and on.
The cream I was prescribed was for a vaginal infection. My OB just looked at me and said I looked very red and irritated in that area. I don't think I had an infection though because the creams, yeast infection suppository treatments, and everything else didn't help. Now I use lidocaine when needed.
I was basically trying to say that hoping there's a low grade urethral infection (1st post) might not be very realistic. It's always best to get checked out, but in my experience all the urethral, vaginal, and pelvic pain all stems from the IC.
I was diagnosed with endo and another pelvic disorder but, when I got the hydro it all made sense. I don't think I really do have endo because my dr. only found a few spots of it and the pain didn't revolve around my period.
I'm now with a good uro. :angel: I've been to 9 doctors counting the times I went into urgent care. I guess you're right that I should be grateful for all the types of treatment I've been able to try. It can be so frustrating though when it seems like the answer is just around the corner and then it isn't. I tried a capsacian install under anesthesia and it caused me to be in horrible pain for a week or so. I think botox would be then next step, but now I'm very weary of new things like that.

[Krisi]

Dreamy,

Your comment about "Is staph coagulase a methillin resistant staph? " was answered when you wrote "The staph was sensitive to ciprofloxin, ampicillin and amoxicillin, bactrim, doxycycline, and vancomycin" Your staph looks like it wasn't resistant to anything, so there is nothing to worry about. The reason they don't want to to give IV vancomycin is because it is one of the last resort anti-B's and there are things that are becoming resistant to it also. It also has some nasty side effects.

I feel for you. I have been dealing with recurrent uti's etc, but alot of mine are resistant to at least one or two drugs and then I have the problem of being allergic to others so it doesn't really help make matters better. In fact I believe alot of uros are over perscribing cirpo (which i am now allergic too). A lot of offices are just like you have a UTI, here take some cipro and then we will culture your urine instead of waiting. I know this is becoming true because I had a cirpo resistant bacteria like 6 months ago and they gave me cipro before the culture which I had to stop taking since it was swelling my throat.

I am more concerned about what is wrong with our immune systems that is making us get these stupid uti's. Because I have another one .. that is resistant to at least ampicillin but I haven't seen the results I will see them tomorrow. I am interested in seeing what bacteria it is, because I forgot to ask him on the phone.

I hope everyone is feeling better.

[dreamy]

I see that now. I was just curious about what she knew about it. I guess I already knew the awnswer though.

[dawn217]

Hello- this looks like a good place to post this. Do you all know what would cause a urethral burn AFTER peeing only and not during? Also, it stings when I push OUT during a kegel. Not in.

I have had this 2 other times in my life. It starts with a UTI and I treat that, then the urethral irritation lasts for about 18 months. Caused one divorce already!

This all cleared up on it's own the other two times. I don't understand it! I was checked by Dr Gittes at Scripps, who researched and found the Skenes gland infection (I think that he's passed away now). He said I had it - just based on touch/palpitation, but NEVER mentioned draining or cutting (which I probably wouldn't allow anyway). This is like a male prostate infection - could be chronic and doesn't really ever resolve. My dad has it and just takes Cipro on and off forever.

Anyway, mine does go away, until I get another UTI- the last UTI was simple ecoli from sex.

I am beginning to wonder if this could be residual inflammation/irritation and/or some sort of pelvic muscle issue. Especially since the kegel out-pull is irritating.

Interesting thread... Any input is appreciated. Oh, and I'm sending sample to United lab for broth culture today!

[glassd18]

I can not do kegels anymore because of urethral spasms. I don't have burning while doing kegels, but I do have very uncomfortable spasms that feel like an alien has invaded my nether regions. I do on occassion having burning while urinating, or/and after, but my urethra can burn without urination too.

I was told to urinate after sex to clear the urethra of any bacteria, and that does help to avoid UTI's contracted after sex.

I am suppose to take 1 bactrim every day for 6 months, but had to stop because of a flare. I haven't started back yet.

I get urethral burning really bad right before I flare. Generally if this starts happening I know I'm in for it.

I started Elavil 5mg a week ago, and It hasn't done much for my bladder. It has helped me sleep which is good because at least now I'm rested. I'm on a very low dose though, and will go up to 10mg in a week or so.

[ABliske]

Dawn,
Hope you are feeling better soon!!! So sorry about your struggles and the divorce.
Where is/are the Skenes gland? I'm curious. I think I may have had the same thing which went away after a long period of time. It felt like all the pain was coming from my cervix.
That made for a very tough time getting diagnosed.
Now my pain is mostly in my bladder.

[dawn217]

The skenes glands are along the urethra on the sides. Also known as the female prostate.