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Sudden onset bladder pressure, bloating, discomfort ambulating

31 year old female. 5'6", 115lbs. Non-smoker, 2-3 alcoholic drinks a week. No previous pregnancies. Has been with her husband for 11 years and was married in 2008. Active in dance 3 hours a week, including dancing ballet en pointe. Had a copper IUD inserted in September 2012. Not on any medication. Mentally and physically happy and healthy. Works as a Medical Laboratory Technologist. Experienced sudden onset of pelvic pressure, bladder discomfort and urgency that has not gone away since the beginning of August. The symptoms began on day 2 of a long road trip/vacation. Pressure and bloating discomfort increases to a blinding discomfort as the bladder fills. I am able to sleep through the night without getting up and can will-away the thoughts of needing to void if I am calm and non-mobile. Ambulating creates enormous pressure with each footfall. I have been unable to work.

So far I have been twice treated for a UTI despite a clear urinalysis results on 4 different occasions throughout the month. After UTI was ruled out, I was given 7 days of Vesicare, because a Doctor thought all of the sitting in the car during the trip created muscle spasms. The Vesicare did not ease my symptoms and made me feel "high" and extremely constipated. I had an ultrasound done and a 5cm x 4.2cm x 4.0 pedunculated uterine fibroid was found left of midline. The gynecologist told me it couldn't be the cause of my issues because, "women are designed to carry babies, and they are much bigger than your fibroid".

I experienced a random episode of vomiting one morning during these 3 weeks, which is very unusual for me.

After attempting to work a shift at my lab I broke down in tears because walking was so painful/distressing. I was sent to the Hospital's staff nurse who sent me to my Family Practice walk-in clinic. The Doctor there told me to go back to Emergency because I had a fever of 37.8 and he was concerned about the possibility of PID. I had not had a pelvic exam or swabs taken at this point.

CBC, urinalysis, lipase, glucose, electrolytes and kidney function all appear normal. He said my risk of PID is low despite having an IUD because I am in a longterm monogamous relationship. The cervix did not display any purulent discharge. That Doctor I saw thinks maybe the fibroid is twisted and dying and causing my symptoms. He had me go for another ultrasound just 2 weeks after my first one. He said he could do nothing for me and prescribed me morphine, even after telling him I am not in PAIN like a broken bone or a sore back -- it's crushing pressure around my bladder that gets worse as the bladder fills makes ambulation difficult. I experience relief after my bladder is emptied, but the discomfort builds up quickly as my bladder refills.

I have never missed a day of work in 4 years and since this began I have missed 4 shifts. I was told that they will not take the fibroid out, since it's "not that big". I have a Gyno consult in 3 weeks.

My thoughts:

- could I need pelvic hypertonia with sudden onset? I have had NO incontinence, just mind-numbing pressure and discomfort around my bladder. During a pelvic exam the speculum was inserted without any problems, so my pelvic floor doesn't seem to be too tight.
- could this be sudden onset interstitial cystitis? Do I need to see a urologist? I have no problems starting the stream when I go to void. The foods I eat make no difference in the severity of symptoms. I have lost 5lbs form going 3 days only eating crackers and water, terrified that anything I put in me may make me more disabled. I gave that up after I realized it was pointless. I still do not have much of an appetite and am not drinking as much water as I should because the after-effects are unpleasant.
- could it be chronic appendicitis? During the pelvic exam, when the Doctor palpated to the right of my cervix with his fingers, I howled in pain and started crying. Externally, I only have pain when palpated directly above the pubic bone.
- should the fibroid be removed? Is it really "not that big"?
- I am very depressed and anxious and feel as though my quality of life is very low. I went from being a very happy, active and strong woman to a broken shell of a human who has been passed around to at least 6 different Doctors and nobody has any answers for me. I am scared for my future if I am unable to work. I have lost all faith in the Healthcare system I am a part of and spend the first half of my day crying and the second half being mad and looking for answers.
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Avatar universal
I have a bladder wall infection and am on antibiotic treatment which could last for a long time.  It has taken away most of the pain but I still get the slow flow and pressure plus bladder awareness.  
Infections can get into the bladder wall and then stay in the cells covered in a biofilm  Not many Drs are educated as to this form of infection.  
Unfortunately the infection doesnt always show up in urine as the bugs dont always come out into the urine.  I found out by having a flexible cystoscopy where the inflammation etc could be seen in my bladder wall.
My UTI Dr doesnt believe in putting catheters in or doing invasive procedures as he feels this introduces more bugs and more can be seen from looking at fresh urine samples... I also have POPs and Intussusception plus anal prolapse which did confuse me and the Dr a to why I was getting so much pain.  It will be a long journey to try and cure my infection but I hope to recover.

You can look at '3C bladder infections' which explains some of it.  
I dont know if this is what is happening with yourself but I thought I'd tell you my bladder story.  As I say, Urologists and Urogynes have all sorts of different ideas and if you are still unwell and have no clear reason given for your illness then you may wish to move on and get another Drs opinion.  

I hope you feel better soon
Helpful - 0
Avatar universal
Glad to hear you do not feel pop is your issue...and hopefully with perseverance you will get this figured out...I will send you a pm about something worth investigating...let me know if I can be of further assistance and if nothing else..I am here to support you during a challenging time! xx
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Avatar universal
Thank you for your reply. I don't think I am experiencing any sort of organ prolapse. Everything feels "where it should be" and I do not feel anything bulging into my vagina. I can cough and sneeze my head off with no urine leakage. 3 days before the symptoms began I was doing strenuous ballet, including 30 minutes of continual fancy-jumping with no feelings of possible leakage.

The endometriosis theory is an interesting one. My periods are very heavy (going through a super-plus tampon an an hour or 90 minutes for about a day and a half at the start of my cycle). I always assumed this was because of my IUD (copper, not Mirena hormonal type), but perhaps there are other forces at work as well.

I have done much reading on interstitial cystitis since many of my symptoms fit into that puzzle. I do not believe that is what is going on with me, but I have so much sympathy and respect for the people who do battle with this horrible disease. I truly believe is it affected more men, it would get more attention. My month-long journey has opened my eyes to the disrespect women get treated with in the medical community -- it is shocking and dehumanizing. I can only imagine the strength one has to possess to make it through years of this sort of thing.

Much love to you, and thanks again for the reply!
Helpful - 0
Avatar universal
Hi, I am so sorry that the doctors have not been able to figure out what is going on with you. I too had similar situation as you in 1993 and no one could figure it out...I had fibroid s, but this did not seem to be the issue according to my Dr., my pain was through the roof... I did have blood in my urine, which was eventually diagnosed as Interstitial Cystitis, but that I can manage well with diet so I am not sure that would be what you are dealing with in your body. I went another 13 years before figuring out what was going on in my body besides the IC...I had stage 4 endometriosis which none of the MRI's, Pelvic or vaginal saw anything...but when I had the diagnostic laproscopic surgery I was stage 4 endometriosis and the adhesion's were so severe the the surgeon thought my appendix had burst which it was fine under all the adhesion's, it was also on my bladder which caused alot of my issues as well, I just did not know until it was removed that it too was part of the pain issues I was dealing with...I would strongly suggest you seeing a uro/gyn to check pelvic organ prolapse and/or an endometriosis specialist as it could be either of those and you would need a specialist in this area..It would be ideal if you could find a urogynecologist that is an endometriosis specialist as well. I know how hard it is to keep going to the dr. and not finding the help you need, but keep going and don't give up until they figure out what is going on...It took me a long time but I am finally doing so much better! Let us know what they find and how you are doing!
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