Many people have the tell-tale symptoms of a UTI- that awful burning sensation and the pressure to run to the bathroom frequently.  Then they go to the doctor and have a dipstick test in the office which shows no UTI.  But the doctor says “let’s send it out for a urine culture, just to be sure”, and that test comes back negative too.

But you’ve still got those debilitating symptoms.  Are the tests wrong?  Or Is it something else besides a UTI?  What can you do?

The UTI Tests May be Wrong – Consider Getting The Latest, Most Advanced Testing

The first thing you need to do is ask your doctor for an Advanced PCR test.  And if he/she is unaware of this test, or is unable to do so, then consider ordering this test on your own.

For chronic UTI sufferers, the standard dipstick and urine culture tests are not enough.  The dipstick test only indicates whether bacteria are present in your urine, but does not identify what type of bacteria.  In order to effectively treat the UTI, you need to be very precise about what bacteria are causing the infection and which antibiotics will effectively treat those specific bacteria.

The urine culture, once considered the “gold standard” in testing, has not kept up with the evolution of UTI bacterial strains, or their resistance to antibiotics.  Recent medical research into the “urobiome” has revealed significant limitations with this test, as shown in the chart below.

The Advanced PCR test, once only available to doctors and at a cost of $2500 per test, is now available directly to consumers for $199.  The benefits of this test are highlighted in the chart.

This is one simple step that you can take on your own behalf.  The report will be delivered directly to your email inbox and then, armed with very precise information, you can go to your urologist and discuss a treatment plan.  This test can be ordered by clicking on this link: MYUTI.

If The Advanced PCR Test Comes Back Negative – You Will Now Need To Identify What You’ve Got

The PCR test is definitive.  If the results come back “negative” for all 24 of the tested bacterial strains, then you do not have a urinary tract infection.  That should be good news, but to many who are suffering from pain and pressure, it just makes things more aggravating.

The symptoms of burning when urinating, constant pressure to urinate and pelvic pain suggest that you may be dealing with one of two conditions: Interstitial Cystitis (IC) or Overactive Bladder (OAB) (Note: a very small percentage of people may also need to ask their doctor about kidney stones and/or bladder cancer.)

While they both have similar symptoms, a new article published in BMC Urology in March 2023 shows that scientists were able to clearly identify one condition from the other.   They asked a group of IC patients, and a group of OAB patients, for ratings on a scale from 0 to 10 on four symptoms: pain, pressure, discomfort and urinary urgency.

Here’s what they found out:

IC patients rated all 4 symptoms (pain, pressure, discomfort and urgency) very high (6+).

OAB patients only rated 1 of the symptoms (urgency) very high (6+) and rated the other 3 symptoms (pain, pressure and discomfort) significantly lower (2-3).

So, if your most bothersome symptom is bladder/pubic pain, you likely have Interstitial Cystitis; if your most bothersome symptoms are urinary urgency and daytime frequency it’s likely Overactive Bladder.the latest medical authorities are saying about treatments for IC and OAB.

Below we’ve summarized the latest news from the medical authorities about treatments for IC and OAB.

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Treatments for IC

Mayo Clinic says “No simple treatment eliminates the signs and symptoms of interstitial cystitis, and no one treatment works for everyone. You may need to try various treatments or combinations of treatments before you find an approach that relieves your symptoms.”

As far as oral medications, they offer the following options:

  • Nonsteroidal anti-inflammatory drugs,such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), to relieve pain.
  • Tricyclic antidepressants,such as amitriptyline or imipramine (Tofranil), to help relax your bladder and block pain.
  • Antihistamines,such as loratadine (Claritin, others), which may reduce urinary urgency and frequency and relieve other symptoms.
  • Pentosan polysulfate sodium (Elmiron),which is approved by the FDA specifically for treating interstitial cystitis. How it works is unknown, but it may restore the inner surface of the bladder, which protects the bladder wall from substances in urine that could irritate it. It may take two to four months before you begin to feel pain relief and up to six months to experience a decrease in urinary frequency.

Treatments For OAB

Goodrx provides a good variety of both prescription and non-prescription options for OAB.

Two types of oral prescription medications which do different things:

  1. Anticholinergics: these medications block a chemical in your body called acetylcholine which tells your bladder muscles to contract, causing you to urinate. These drugs block this chemical and control your bladder contractions.  When medications are needed, these are a first-choice treatment.  Look into these brands: Ditropan, Detrol, Toviaz and Vesicare.
  2. Beta-3 Adrenergic agonists: a group of medications that work by relaxing your bladder and allowing it to hold more urine. There are two brand options here: Myrbetriq and Gemtesa.

Non-prescription choices are:

  1. An over-the-counter skin patch called Oxytrol. Two brand names are available: Oxytrol For Women and Oxytrol (for men).  It is FDA-approved and the active ingredient is oxybutynin, which is an “anticholerinergic” and controls bladder contractions.
  2. A variety of herbal supplements: no herbal supplements have been approved or widely recommended to treat OAB due to limited research. Some which may provide symptom relief include:
  • Gosha-jinki-gan (GJG)
  • Hachi-mi-jio-gan (HE)
  • Buchu (Barosma betuline) Cleavers (Gallium aparine)
  • Cornsilk (Zea mays)
  • Horsetail (Equisetum)