Doctors Lounge - Urology Answers
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Forum Name: Urology Topics
|Lizzie990 - Sun Jul 11, 2010 3:11 pm||
I have had continuous UTIs and baceterial vaginosis for several years along with leakage of urine. Ater urinating, I will feel a gush of urine coming out of my vagina upon walking out of the restroom. I performed my own test by taking a pill that makes my urine turn orange, inserting a tampon and then urinating. After urinating, I remove the tampon and it is soaked 3/4 of the way from the top all the way down. This happens every time I urinate. There is no leakage from the urethra after urinating.
In the past, I have always had a weak bladder, meaning I can't hold my urine very long or I will leak. This I have had all my life.
I went to a urologist, I had a CT scan, voiding cystogarm and a blue dye test including a cystoscopy. The doctor saw nothing unusal. He told me I have incontinence and he will be placing me on medicine to control it.
If I have incontinence, how is urine getting into my vagina while urinating?
|Dr.M.Aroon kamath - Sun Jul 11, 2010 11:06 pm||
Your history strongly suggests a fistulation between the genital and urinary tracts.It is possible that you may have a vesicovaginal or even more so, a urethrovaginal fistula. Symptomatology in this condition depends upon location.
A vesicovaginal fistula certainly causes incontinence of urine.
Urthrovaginal fistulae close to the bladder neck are often associated with incontinence. Inspection will usually identify a large fistula, whereas urethroscopy, cystoscopy and vaginoscopy may be needed to detect a smaller one. It is important to rule out an associated an vesicovaginal fistula in these cases.
A detailed pelvic examination usually reveals clear fluid pooling at the apex of the vagina. On close inspection, a pinpoint opening at the vaginal apex is often seen in mature fistulas. In immature fistulae, an inflamed erythematous vaginal mucosa is often visible, with pinkish granulation tissue surrounding the fistulous tract. The fistulous opening is often difficult to identify in immature fistulas. In certain situations, pelvic examination under general anesthesia may be indicated.
Like any investigatory modality in medicine, false positives and false negatives do continue to occur from time to time. It is possible that in your case, a false negative situation might have occurred.
So, a detailed gynecological examination apart from a review by the urologist is probably indicated under the circumstances.
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