A woman prescribed multiple oral antibiotic courses for “recurrent painful UTI’s” recently came into my office. She wanted to see if I could give her IV antibiotics for the multiresistant bacteria that were being isolated over and over again from her urine (all of the antibiotics that she had been on had “toughened them up”).
She had problems emptying her bladder, and had a suprapubic catheter in place. The pain that she was experiencing seemed to have little to do with her urethra and bladder (which were not tender). Her pain was actually in her deep pelvis, vagina and the sacral area of her back, and had not been affected by any of the multiple antibiotic courses that she had received. Her sacrum was quite tender when I tapped on it.
I was worried about her spine.
Nerve root or spinal cord compression could certainly cause nerve pain to radiate down into her pelvis.
Perhaps she didn’t need any antibiotics at all – just more water to flush out a bladder with nerve problems.
After a long delay due to her insurance company authorizing the test, she went for a spine MRI.
A herniated disc was pushing on one of the spinal nerves, likely causing her symptoms.
She has done fine off of all antibiotics since. We’ll have to see what the spine doctors recommend when she gets to them!