Sudden urinary urgency, but no UTI?

April 6, 2017 5:38 PM

Last Tuesday, I experienced my first ever issue with urinary urgency. Since then, it's only gotten worse. Both visits to urgent care have yielded negative urine samples and a "have a nice day!".. but this problem is getting worse, and causing some significant life problems.

I called my urgent care again today after they informed me I had a clean sample. After the first visit, they put me on one antibiotic, which while it didn't clear it after four days, marginally improved it or didn't make it worse. I called this past Monday to check in on my urine test, and got a "Oh, it came back last Thursday and there was no infection! You're good!" I asked them if I should discontinued my antibiotics, and they said I would need to come in for them to tell me that. So, I trudged in, took another urine test and was prescribed a new antibiotic.

After the call today, I called them back and asked what my next step was, and they told me to come in for another urine test. I asked if I should stop taking the antibiotics, and they told me I would need to come in for them to tell me that...

So, I have absolutely no clue what this could be, or what to do next. I'm done with that urgent care place (obviously), but my primary care doctor doesn't have an opening for another three months "no matter how urgent it is". So.. I feel like I'm between a rock and a hard place. Do I go to the hospital? Do I call around to different urologists and ask if they can see me on short notice without a referral from my primary care doctor? Should I be seeing a gynecologist instead?

Or, should I just suck it up and keep going? I have a job where I do in-depth, recorded interviews over the phone. I *cannot* leave in the middle of a call, so I've taken some really lackluster recordings. I also, unfortunately, had an accident while stuck in traffic. I'm barely sleeping, I haven't had sex with my husband since it started, and I've been sleeping on the couch because it's close to the bathroom. I'm tired, angry and frustrated.

Has anyone had this symptom before (without it being a UTI?)
I'm terrified that it's OAB or IC, which have no known cures. I really don't want to live like this for the rest of my life.. but from what I understand, they usually don't come on suddenly.


Extra details:
- I'm a late 20's female, normal-average weight
- There's no pain or burning, just a sudden STRONG urge to pee.. and sometimes I actually do.
- I've been incredibly dehydrated due to this, and very dizzy/nauseous
- I take Wellbutrin and oral Birth control, but it's been six + months since I first started taking those
- **The only thing that's somewhat helping is Uristat.. which is supposed to be for UTI's. **

Thank you for any and all help.

posted by oxfordcomma to Health & Fitness (25 answers total)

I've been incredibly dehydrated due to this, and very dizzy/nauseous

Are you trying to control your symptoms by drinking less? Urinary urgency by itself should not cause dehydration, dizziness, or nausea.

Dehydration that makes you very dizzy and/or nauseated is not safe. If you're fluid restricting, stop. If you're not, I think you would be justified in visiting the ED.

I am personally familiar with how awful and miserable this can be, but just for the time being while you are dealing with logistics, Depends adult diapers are pretty comfortable and surprisingly discreet under clothes.
posted by telegraph at 5:53 PM on April 6, 2017 [2 favorites]

Are you constipated?
Do you feel like when you pee you are going a lot and getting it all out?
My son was constipated (despite going normally every day) there was so much poo it was blocking something so he couldn't fully go and had the urge with no burning , etc. Each time he went he couldn't get it all out so he still had the constant urge.
posted by ReluctantViking at 5:54 PM on April 6, 2017

Go to a gynecologist if that's easy for you to do without referral hoop-jumping. Go to Planned Parenthood if that's the only way you can get seen sooner rather than later. (As a woman, you're just more likely to be listened to by a gyn.)

Get yourself some incontinence pads so you can at least function in the short term.

And just a very random thing, based on a weird set of symptoms I had some years ago: if you don't take a routine antihistamine, try it for a couple of days. I don't think the type matters.

You could also ask your pharmacist, on the off chance Wellbutrin offers this as an unusual side effect.
posted by Lyn Never at 5:54 PM on April 6, 2017 [3 favorites]

Likely overactive bladder, which is easily treated, but you should see a urologist.
posted by Dashy at 5:55 PM on April 6, 2017

Do I call around to different urologists and ask if they can see me on short notice without a referral from my primary care doctor?

Since your primary care doc doesn't have any openings, they should be able to write you a specialist recommendation without requiring a preliminary visit. Call your docs office and say you have records from your previous urgent care visits, ask for a recommendation, and once you have it in hand have the urgent care facility send your records to the specialist. You may need to sign forms (if you haven't already) allowing the urgent care facility to share your records.
posted by late afternoon dreaming hotel at 5:56 PM on April 6, 2017 [3 favorites]

Apologies if you've already done this, but in your situation I'd try calling the primary care office and stressing that this is a problem that is negatively impacting your job as well as your home life, and that antibiotics have not resolved the issue and ask if there is *anything at all* that they can do to help you. At the very least I would hope that they could put you on a cancellation list in case another patient does not make their appointment, or give you a referral to a urologist without a primary care visit.

If your health insurance has a nurse line, that's worth a call.

Other than that, check and see if your insurance requires a referral at all - some don't. I've at times had pretty good luck getting in to see a specialist with no referral.

I'm sorry you're dealing with this and I hope it's resolved soon.
posted by bunderful at 5:56 PM on April 6, 2017 [3 favorites]

I meant to also write: this started for me feeling just like a UTI, so I went to my gyno, who sent me to urology after my pee was negative for bacteria. So yeah, that's exactly how it feels! It's a common problem.
posted by Dashy at 6:01 PM on April 6, 2017

When you say you sometimes actually do pee, do you have any urinary incontinence, or is it just urinary frequency and urgency? Does your discomfort improve once you actually pee?

Based on what you've written here, I'd guess interstitial cystitis, which has urinary frequency with negative urine cultures. While the majority of patients experience a gradual onset, a subset of patients have a relatively acute onset and can pinpoint when their symptoms started. However, to get an official diagnosis, you need to experience those symptoms for at least six weeks.

Unfortunately, I don't think you're going to get a more helpful answer by going to the hospital. I agree with going to your gynecologist or planned parenthood if they can see you sooner.
posted by gemutlichkeit at 6:07 PM on April 6, 2017 [3 favorites]

I had chronic UTIs for a year and my gynecologist was the doctor who recognized that I needed to see a specialist. I think my primary care doctor would have let me keep seeing him to be treated for UTIs forever. Go to your gynecologist.
posted by CMcG at 6:36 PM on April 6, 2017

I had UTI symptoms followed by lower back/flank pain which ended up being diagnosed as kidney stones, a kidney infection, a bladder infection, and a UTI. From start to finish (aided by antibiotics/painkillers/Pyridium) was I think around two weeks, maybe a little longer? Also FYI the first antibiotic prescribed was apparently not the right type and I needed a second, different type. I now don't take any vitamins that have calcium in them to hopefully prevent kidney stones in the future.
posted by vegartanipla at 6:50 PM on April 6, 2017 [1 favorite]

Has anyone had this symptom before (without it being a UTI?)

My husband had frequent urination and dehydration and was treated for a UTI by a walk-in clinic, but it actually turned out to be type 1 diabetes. Have you had any blood work done? Also, since you say that you are not able to get into the doctor, are you close with any diabetics? They would have a glucose meter, and might be able to let you test in order to rule it out.
posted by to recite so charmingly at 6:54 PM on April 6, 2017 [3 favorites]

I've been incredibly dehydrated due to this, and very dizzy/nauseous

This also made me think of Type 1 diabetes.

If you can get in to your gyn in a reasonable time, absolutely do that.
A urologist should absolutely be willing to see you without a referral (assuming they have openings), but your insurance may not pay for the visit without one. Not all insurance plans require a PCP referral (mine just requires a higher copay). So check with your insurer about what is required. <>
posted by jeoc at 8:13 PM on April 6, 2017 [1 favorite]

Omg, do not suck it up - you do not have to put up with this!

I have OAB (diagnosed at 30, symptoms started at 29) and I went in thinking I had a UTI (negative), then tested me for a Pelvic Infection (negative), kidney scan (neg) etc. It took eight months from onset to a prescription and I completely validate everything you're feeling and you have this internet strangers permission to do anything you need to get treatment. My lord, feeling like you need to pee all the time (and not being able to!) is like drowning. It's terrible.

All good recommendations above - please do rule out Type 1 diabetes, that could be time-critical. Thirst and whatnot is a symptom of Type1; although I know at one point I was pretty dehydrated because the thought of drinking liquid (which would result in sooooo much discomfort) made me literally, physically, nauseated.

I was diagnosed by a uro-gynecologist who did an ultrasound and a bladder stress test that ruled out everything else, including IC. You will be relieved to know that I was on Ditropan for several years which worked well, and just switched to a transdermal patch which is even better.(Fwiw, I continued my meds and had no trouble w/urinary frequency while pregnant - I was really worried about that.)

If you are in the U.S. know that oxybutynin patches (that I have a prescription for here in Oz) are available over the counter - not sure if you have to talk to the pharmacist, I think they're just on the shelf with the Azo cranberry tablets and stuff. Of course *this is not a substitute for proper medical care* but provided there's nothing critical afoot and you end up waiting between appointments, this could make it tolerable.

Also, maybe try Period Panties? They were developed to absorb menstrual blood, but imagine they would do for leaks too. One of the complicating factors, for me, was certainly increasing anxiety over toilet proximity!

MeMail me anytime, for any reason. Hang in there!
posted by jrobin276 at 8:55 PM on April 6, 2017 [2 favorites]

I sometime experience urgency if I'm even a little bit constipated, and if you're dehydrated, you're more likely to be constipated. You should be drinking enough so that your urine is pretty pale. Drinking lots of fluids also helps reduce any infection, whether bacterial or yeast. Add some whole grains, bran and fruit to your diet if needed. Cranberry juice always helps me if I have any sort of UTI and there's no downside. Foods with a lot of dyes may irritate the bladder, also spicy food, so eat a little more carefully for a few days. To cope, set a timer on your phone for every 90 minutes and go pee; keeping your bladder emptier will help.
posted by theora55 at 9:32 PM on April 6, 2017

Find a way to see a doctor, a urologist if possible. This is something you're likely going to need bloodwork done for if you haven't had it done in the last few months. Get seen as soon as you can.
posted by azpenguin at 10:34 PM on April 6, 2017

Some of your symptoms sound all too familiar. If you had a prostate, I'd wonder if it was prostate trouble! I can't help diagnose you, but I can suggest you try an OTC anti-inflammatory. Sometimes this feeling can be because of inflammation down in the nethers, and NSAIDs can help a bit. Also, try a sitz bath, or at least a nice long normal (not bubble!) bath. I don't know why baths help pee problems feel better, but somehow they do.

Also, try having some orgasms. (TMI alert:) When my prostate stuff is bad, orgasms kind of flush things out down there, and give me some relief during the act. Obviously my bits are different from your bits, and I may be totally wrong about this helping. But it can't hurt to try.

You're wise not to go back to that urgent care place, they sound like they suck gorilla balls. I'm not too crazy about your PCP either. Three months is waaaay too long to leave you twistin' in the wind. I'm sorry you're going through this. I've been sick with many, many illnesses, and pee stuff can be one of the most awful things to deal with. So don't feel like a wuss if this is driving you crazy, it really sucks. I hope you get it sorted pronto!
posted by Ursula Hitler at 12:20 AM on April 7, 2017

in your situation I'd try calling the primary care office and stressing that this is a problem that is negatively impacting your job

Yes, in my experience doctors do tend to take you a bit more seriously if you tell them that your problem is keeping you from working.

But unless your insurance requires it, you don't need to go through your primary care doctor to go to a specialist. You can either check your insurance company's provider list or call around to local urologists to find one who accepts your insurance and make an appointment for yourself. Or, as others have suggested, starting with your GYN is also a good way to go.

Have you had a lot of UTIs in the past? After about a year of one UTI after another, I would occasionally have symptoms that turned out to be nothing. But they were nowhere near as serious as what you're describing.
posted by The Underpants Monster at 3:48 AM on April 7, 2017

This was my preliminary symptom for my first kidney stone, because the stone was causing blockage. Have they checked for blood in the urine in addition to infection?

Regardless of the cause, I have always found that drinking lots and lots of water makes this feeling easier to deal with, if only because feeling like you have to pee and not having anything come out is less pleasant.
posted by a fiendish thingy at 6:24 AM on April 7, 2017 [1 favorite]

Ibuprofen- YES.

Just understand that with all of those antibiotics and ibuprofen, start eating lots of probiotic foods and take probiotic supplements. Both antibiotics and ibuprofen disrupt your natural biome.

Please start drinking water, and I would go to a different urgent care for a diabetes screening while trying to see a urologist. My first thought was kidney stones, but you really really want to make sure its not diabetes. Ibuprofen will help immensely with the discomfort in the meantime.
posted by jbenben at 6:27 AM on April 7, 2017

This happened to me right after I retired. I finally made the connection to GREEN TEA, which I had started drinking in an effort to improve my health. Stopped the tea, got better immediately.
posted by raisingsand at 6:56 AM on April 7, 2017

nthing a visit to a urologist but you might want to read up on interstitial cystitis because it sounds pretty similar to my symptoms. I have had some success with removing dietary triggers. I hope it resolves quickly.
posted by absences at 7:02 AM on April 7, 2017

Are you taking a calcium/vitamin D supplement? Once I laid off the high doses of Vitamin D, this problem went away for me. It was horrifying--I'd be driving or working and it would feel very suddenly like my bladder was going to explode RIGHTTHISINSTANT. It turned out that anything over 700 IUs of Vitamin D is way, way too much for me personally. Definitely talk to a urologist but maybe check any supplements you're taking.
posted by corey flood at 8:01 AM on April 7, 2017

Another option to ask your primary care doctor: do they have any appointments TODAY? I called my dr for a mildly urgent issue trying to get an appointment for tomorrow or the next few days and I was given the 3 weeks answer. I waited the 3 weeks and the dr himself was appalled when I told him that: he always keeps at least 1/3 of his schedule open for same-day appointments, but if you try to book in advance, you can't get them, even at 5pm the night before. Not sure why the receptionist didn't tell me that.

(I'm going to contact his email portal and suggest that they offer the same-day appts after 4pm the day before).
posted by CathyG at 9:56 AM on April 7, 2017 [1 favorite]

I recently had extremely similar symptoms caused by an abnormal strain of BV. The nurse at urgent care didn't want to test me for BV because the symptoms seemed to indicate interstitial cystitis, but I refused to leave until I was tested. The test came back positive and the general antibiotics for BV cured my symptoms. At least make a visit to urgent care to rule out BV. I'd also recommend Azo while you're ruling out possible causes.
posted by Penguin48 at 1:56 PM on April 7, 2017

I had a similar problem for a long time and tried everything- I think it started as a nerve (or infection?) issue after a specific incident (being trapped on public transport) and just became tied up with anxiety (so I couldn't tell the signals apart- emergency vs anxiety). The only thing sort of working is finally (I'm talking 10 years) having a schedule that allows for 'training', i.e. Waiting between visits without worrying re emergencies and generally being able to lower my anxiety around the issue as a result... Bad news: it's still not gone and flares up when I'm out/stressed about being able to access restrooms. Do all the medical stuff first, then hopefully your schedule allows for training and general relaxation... Caveat: I never (knock on wood) actually had an accident, this more likely indicates a physical underlying cause that needs to be addressed first.
posted by bquarters at 4:00 AM on April 8, 2017