I’ve had bladder issues for a while now. I’m notoriously bad at keeping track of time in any context, but I know a few months ago, it had been at least a year as I had mentioned it to my rheumatologist. It seemed to be just another symptom I had to deal with. Things worsened over the year, and so recently I got a referral to urology to get to the bottom of the issues. My doctor was concerned that I was having such a tough time so young, as he would expect symptoms of this severity in someone much older. (Then again, that happens quite a bit with diseases like lupus, doesn’t it? Haha.)
Mainly my issue is feeling the urge to urinate a lot, but then when I actually get to a toilet, nothing comes. Sometimes I am there for an awful long time trying to go as my bladder feels very uncomfortably full or sore, but it’s often just a little dribble every few minutes, or nothing at all, or I finally manage to go after feeling like I can feel the urine inching along very slowly along the urinary tract. Often, when it does come, it’s in spurts rather than a steady stream. When it flares up to its most intense, I can void fairly small amounts many times an hour, probably six or seven, so not as severe as I know some people with bladder issues have it, but very frustrating as I am dealing with the discomfort and pain of a full bladder all the time and can’t relieve it. Some TMI perhaps: I keep a bucket upstairs during the night for times when I’m going so frequently; it’s not easy for me to go up and down the stairs anyway, never mind so often. It’s very hard trying to get to sleep as well when you feel you need to pee so desperately. I’ve had many urine tests but they all come back clear.
I finally visited the urologist yesterday. I had been afraid that when I went, things wouldn’t be too bad (as can often happen when you have appointments for symptoms with a disease that can vary a lot from day to day), but actually, it was even more ridiculous than usual! I was to do a flow test before seeing the urologist, which should be a “simple” thing of peeing in a special toilet that can be moved up or down as you need it, and you can use a commode-style seat over it if you need. I spent about ten minutes in there the first time, before telling the nurse it just wasn’t happening, although I’d been happy on the way up because I felt like I needed to go (and hadn’t been since the morning). She gave me some water to drink as it’s not too rare an occurrence that someone can’t go. I had literally eight plastic cups of water, spent about another 15-20 minutes across two more trips in the toilet, and still nothing. I was meant to have an ultrasound after the flow test to see if any urine had been retained.
The nurse was great, and she asked the urologist if he’d see me now without the flow test results. He did, and did an ultrasound anyway, which was pretty uncomfortable pressing down on a very full and tender bladder! That and my intake/output chart didn’t bring up anything particularly abnormal. He explained to me a few things he suspects might be the case, such as bladder stones. I guess he thought it was reassuring when he mentioned cancer to say that he thought it unlikely as I’m young and have never smoked, but to be honest, it hadn’t even crossed my mind so it was a bit unnerving to have him mention it in the list of possibilities so casually. (A colleague of mine was recently diagnosed with cancer when no one was expecting it to be the result of the investigations, so it’s quite fresh in my mind!) However, both I and the urologist are pretty convinced it’s interstitial cystitis. As it’s an inflammatory condition, it is comorbid with various other autoimmune diseases, including lupus, of course, as well as some secondary conditions I have, such as Sjögren’s syndrome and IBS. It fits my symptoms and seems the most likely culprit.
The urologist doesn’t want to start me on any medications for my bladder yet until I have a cystoscopy to see what’s going on. When I go to the hospital for that, I will have the flow test repeated and finally have the ultrasound to check for urine retention. I’m hoping we get some answers from the cystoscopy, which I’m sure I’ll blog about at the time. The urologist was fantastic and very reassuring, including patting my hand, haha! Happily, I will get to see the screen as the cystoscopy is done, which is perfect for an anatomist, right? 🙂
Anyway, currently I’m off to try to pee, haha!
Life of a Lupie 