04-09-2013, 10:01 AM #1
Got Urethral Pain? Common causes & treatment ideas!
Got sharp, shooting pain in the urethra? Here are the common sources of urethral pain with tips on what you can do to reduce that discomfort!
Infection - The most common, predictable source of urethral pain is from an infection and it's the urethral symptoms that often help an IC patient determine the difference between the two. In urinary tract infections, a hallmark symptom is a strong urethral burning sensation DURING urination where as during a typical IC flare, the worst symptoms occur BEFORE urination when urine is touching the wounds in the bladder. If you suspect that you have a UTI, you can use AZO Bladder Test strips (https://www.icnsales.com/urine-test-kits/) to check your urine. If it's positive, call your urologist and ask for a urine culture so that they can identify the bacteria involved and, most importantly, determine which antibiotic will best kill that specific infection.
Infection of the Prostate / Paraurethral / Skene's Gland - Both men and women have glands near the urethra that can become infected and irritated. For men, it's the prostate at the base of the penis. For women, it's the paraurethral or skene's gland that are halfway up the urethra and, you might be surprised to learn, is the female equivalent of the male prostate. Both glands are like sea sponges, very dense tissue with small drainage ducts that can easily become blocked thus allowing bacteria to flourish inside. In men, an infected prostate often swells into the urethral thus blocking flow and making it difficult to urinate. In women, an infected skene's gland is more like a hard, deep painful pimple that hurts with touch or pressure. Women can often feel an infected gland if they stick their finger (washed, of course) up into the entrance of the vagina.. about an inch or two.. and rub gently along the front side of the vagina. It often has the consistency of a small, firm and painful pea. If you have an infection of any gland, doctors may need to drain it and/or express the fluid/pus to get it to calm it down. Please talk with your doctor about the various treatment options available. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1303542/ and http://en.wikipedia.org/wiki/Skene's_gland
Hormones - The bottom half of the urethra is very hormone sensitive. When estrogen levels drop, it can become more irritated. If you're having painful periods, on the pill or perhaps struggle with endometriosis, that might be worth exploring with your obgyn!
Chemical irritation - Never underestimate the role of chemicals in causing urethral discomfort. Some men and women are very sensitive to spermicides or latex condoms while others react badly to something as simple as soap or fabric softener. Chemicals can irritate the skin and our already super sensitive nervous system. If you struggle with any skin or urethral sensitivity, you should not be using any bathsalts or bubble baths. Try different spermicidal products or, perhaps, latex free condomes. BASIS for Sensitive Skin is a hypoallergenic soap ideal for anyone with sensitivity "down there" (https://www.icnsales.com/soaps-bath-shower/) are hypoallergenic. For laundry detergent, try using the very mild baby detergent, DREFT, and always rinse your underwear twice to remove any residual detergent or fragrances. Do not use any extra rinses or fabric softeners. Even the chlorine in swimming pools and hot tubs can provoke urethral irritation.
Pads and Pantiliners - Contrary to some feminine hygiene companies, dryness is not the natural state of the skin in the crotch. For women, the surface of the vulva, vagina and bladder are supposed to be covered with mucus which provides essential protection for the more sensitive skin beneath. Wearing pantiliners or pads everyday can remove some of this mucus and make your skin more tender. Worse, though, are some of the chemicals used in pads for absorption and odor removal. When these become wet, they can "off gas" chemicals which can irritate your skin. A diehard ALWAYS customer, I cannot wear the new ALWAYS INFINITY pads because they make my vulva burn due, I believe, to these extra chemicals. So, if you don't need to wear pad, don't. But if you do, try using chlorine free pads is a viable option, such as the Seventh Generation line of products. https://www.icnsales.com/pads-liners/
Pelvic Floor Tension - Consider, as well, the role of muscles in urethral pain. The pelvic floor muscles wrap around the urethra as they support the bladder and uterus. If you're tense, these muscles become tight and squeeze the urethra, vagina and rectum thus it making it harder to void, have a bowel movement or enjoy intimacy. Every patient (men and women) should request a pelvic floor assessment to determine if the pelvic floor muscles are contributing to your pain and discomfort, especially if you are having difficulty with intimacy and sexual intercourse. PFD is very treatable using pelvic floor physical therapy. We have two great books that can help you understand the role of the pelvic floor in causing pain and discomfort as well as a variety of exercises and stretches that you can use to help reduce that tension: Heal Pelvic Pain and Ending Female Pain. https://www.icnsales.com/pelvic-floo...n_pelvic_pain/
Catheterization & Procedures - Each time you are catheterized, undergo a bladder examination or have a bladder treatment, the urethra is mildly traumatized. The end result is pain, often sharp and stabbing, in the urethra during the first few voids afterwards. Ideally, your physician is already using small, less traumatic catheters but, even then, urethral discomfort is inevitable and every patient eventually learns how to cope with it. Some doctors suggest sitting in a warm tub and perhaps even urinating into the bathwater to help ease that discomfort. Others use heating pads or cold packs. The prescription medication Pyridium or OTC AZO Bladder Pain Relief Tablets (https://www.icnsales.com/analgesics/) can help numb the urethra as well. As a teen with frequency/urgency, I underwent dozens of urethral dilations and eventually developed a "bite my lip" strategy that worked for me. I simply drank a large glass of water after the procedure, waited until my bladder was full, sat on the toilet, bit my lip, and just let it go out fast. I found that dribbling urine out in stops and starts just prolonged the pain. The good news is that this kind of urethral irritation generally improves with each void until, 24 to 48 hours later, it has resolved completely.
So what can you do about it?
#1 - Be prepared! If you are going to have procedure, make sure that you put your feet up, rest and relax afterwards. Stay near a restroom for the first several hours.
#2 - Drink water to keep your urine dilute and less irritating to your bladder and urethra.
#3 - Use some heat to relax and ease the pelvic floor muscles.
#4 - Take a warm bath using some baking soda in the bathwater or Great Mothers Sitz Bathes (https://www.icnsales.com/great-mothers-sitz-bath.html)
#5 - Rinse yourself off with cool, soothing water during and/or after every void using a simple periwash bottle (https://www.icnsales.com/restroom-supplies/). This is very calming and soothing to urethra and tissues.
#6 - You might find an aloe gel helpful though, fair warning, the brand is important! Cheap brands contain ingredients and preservatives that can irritate. We suggest trying Desert Harvest Aloe's Personal Gel. (https://www.icnsales.com/desert-harv...sonal-gel.html)
#7 - Avoid harsh, irritating soaps, cleansers and wipes. BASIS Soap (https://www.icnsales.com/soaps-bath-shower/) gets rave reviews. If you would prefer a wipe, we suggest the unscented and chlorine free Seventh Generation Baby Wipes or Natracare Intimate Wipes (https://www.icnsales.com/restroom-supplies/).
#8 - If needed, use pain medication or other medication as prescribed by your doctor.
#9 - If your symptoms are not resolving within a reasonable period of time, please talk with your doctor! Remember, in the new AUA Guidelines for the Diagnosis and Treatment of IC, they strongly encourage patients to revisit their diagnosis if they are not responding to treatment. It's time to ask your medical team what else could be contributing to your urethral discomfort!
Do you have some self-help tips that work for you??? Please share them here! The more the better!
- Jill O, ICN President & Founder
From our office in the hills of Northern California where the trees are gently blowing and the sky is a bright, bright blue!
Last edited by icnmgrjill; 04-09-2013 at 10:33 AM.Would you like to talk with someone about your IC struggles? The ICN now offers personal coaching sessions that include myself, Julie Beyer RD on the diet and Dr. Heather Howard on Sexuality. http://www.icnsales.com/icn-personal-coaching/
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