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Frequent Urination, all tests negative, any ideas?

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Old 01-12-2011, 10:38 AM   #1
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Frequent Urination, all tests negative, any ideas?

Dealing with frequent urination for the last 2 months. Have had urinalysis, blood tests, ultrasounds, xrays, and cystoscopy. All are negative. No UTI, no diabetes, no cancer, no BPH, no stricture, no urethritus, no Kidney stones, bladder stones, no STD, no bladder infection. Has anyone ever had anything like this? Any suggestions on what could be causing my frequent urination or what avenue to pursue next? Not too excited about the vague "Overactive Bladder" diagnosis if that's all that's left. Thanks

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Old 01-12-2011, 12:05 PM   #2
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Re: Frequent Urination, all tests negative, any ideas?

First off, because it might be relevant (although I'm sure you're doctor would know better than any of us), how old are you?

You can check out the "Prostatitis" forum on these boards for more info, because it sounds like you're one of us now. Although, to be honest, I wouldn't recommend it, nor Googling the term, either. There's a lot of disinformation out there about the disorder, which is usually misdiagnosed when as prostatitis when it's actually chronic pelvic pain syndrome, or CPPS.

The ways I've found to deal with the condition, and hopefully conquer it, are to just try and relax, and in extreme circumstances, find a physical therapist who specializes in pelvic floor therapy (I recently started seeing one this week, and my muscles down there, as I anticipated, are extremely shortened and tight). The condition is usually brought on by stress or anxiety, causing an unconscious tension of the muscles down there, which eventually results in the frequent (or, in my case, constant) urge to urinate, despite a fairly empty bladder. This, unfortunately, only makes the sufferer more anxious, and the resulting tests (some of which are pretty uncomfortable and embarrassing; I've undergone the same battery as you, so trust me, I know what you've been through) and such can cause a horrible anxiety loop that only furthers to exacerbate our symptoms.

So my recommendation to you for the time being, seeing as how you've already checked everything else out, would be to try and relax and stay away from the Internet, as least in regards to your symptoms. Go about your day as normally as you would otherwise and don't let your symptoms control you. Stay out of doctors' offices, too, if you can avoid it. For myself, anyway, I know the constant reminder that I was "sick," coupled with the anticipation of seeing a new doctor every other day probably didn't do my nerves any good at all early on in my prognoses. The more relaxed you remain, the more you can keep your mind off of your troubles, and the better the chances are that you'll be feeling normal again soon.

I, sadly, still have the problem to this day, six months out from its onset, but I sort of blame myself for that at this point. I was a pretty big mess after the first month of suffering, and I spent the following two combing the Internet day in and day out looking for a quick-fix, which only resulted in raising more questions, dashing my hopes, and leaving me thinking about my condition at nearly all hours of the day and night. I was also taking so many medications at the time, all in futility, by the way, from bladder relaxants to alpha blockers, that I felt like someone in their 90s (I'm 28, by the way), and as one ER doctor put it, I had, "Taken enough antibiotics to knock over a racehorse." None of that served to make me a calmer, more relaxed person, obviously.

So stay cool, and take solace in the fact that your tests show that you don't have anything more serious. You also don't have a bacterial infection, despite what some others who have convinced themselves otherwise on the Internet might say. I truly believe this is as much a mental condition as it is a physical one, so it's very important that you believe you'll be okay soon, and not dwell on the suspicion that you have some incurable, untraceable bacteria in your system that will plague you for the rest of your life. You don't. And though there are physical treatments you can take to help relieve your symptoms more quickly, the key to conquering it for life, I believe, is to learn to relax and not think so much about your current troubles down there. I've read enough success stories at this point to believe that healing is possible, it just takes time and continued optimism.

Finally, to leave you on a more positive note, it sounds like your symptoms are relatively minor in comparison to mine, even early on in my dilemma, so I don't expect you'll have the problem as long as I have. In fact, about two months into my initial diagnoses of prostatitis, before I had truly come to understand that what I had was actually CPPS, I had nearly conquered the condition, but made the mistake of seeing just one more urologist, who only put a bunch more new bugs in my ears (metaphorically speaking, of course) and did a whole new battery of uncomfortable and embarrassing tests on me. No surprise that over the course of the following week, my symptoms slowly crept back to where they were before seeing said urologist, and they eventually got even worse. That week is actually one of the reasons why I've come to the conclusion that this is largely a mental thing, at least in my case.

So hang in there and feel better soon. Better still, believe you'll get better soon, and I'm sure that you will.

The following user gives a hug of support to Ropes End:
echonoble (05-16-2011)
Old 01-12-2011, 01:21 PM   #3
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Re: Frequent Urination, all tests negative, any ideas?

Hey Ropes End,

Thanks so much for your detailed reply to my post. I really appreciate it. I am 36 yrs old and although I probably have had to urinate more and more as the years have gone by I have noticed that the last 2 months have brought about very frequent urination. At least once every hour but at times every 20 minutes. Like with you, the problem has weighed heavy on my mind and this has likely only made my situation worse.

So as for prostatis being a diagnosis, my urologist hasn't indicated that. He also said the prostate was normal and the PSA test was also normal. As for CPPS, this is new to me. Does this come with pelvic pain? I don't think I feel any pelvic pain.

I have done as you have, searching the internet for solutions and diagnoses. Just had a cystoscopy yesterday under GA and was told everything was normal. Urinating razor blades now, but the pain is decreasing. I have also taken my share of meds as well for this. Not too many but an antibiotic called metra-something for UTI, Toviaz, and have a prescription for Imipramine but haven't started. The Toviaz was to help with overactive bladder but I don't think it did anything. The Imipramine is also a bladder relaxant but it is also an anti depressant - which I am not too excited to start since I am not depressed and don't want to go down this road unless completely out of solutions.

Although the urination may be made worse by my psyche, the need to urinate excessively is certainly real and mostly physical. I don't think my mind could trick me into this to this degree, but who knows. I can have the urge to void anywhere from 4 ounces to a few tablespoons of urine.

The last few things I suppose it could be are something external pushing on the bladder, but I'm sure my Urologist will let me know if that is a possibility or overactive bladder syndrome. Perhaps he will say that CPPS is also a possibility. He is being proactive and trying to find a solution for me but so far nothing has been determined.

Thanks again for your reply and any more info/advice you have.

Old 01-12-2011, 03:33 PM   #4
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Re: Frequent Urination, all tests negative, any ideas?

No problem, Laoks. I hope my words helped ease your mind at least, if even just a little bit, because I know how concerned I was when all this first started for me.

As far as your diagnoses, I can absolutely tell you that my results were the exact same as yours. Everything was normal, from prostate size, to blood sugar level, to PSA level, to urine, to semen; I even had my thyroid levels checked! Plus, two cystoscopies, the first being wide awake, which, by the way, I definitely do not recommend. I think that actually made me worse in the long-run, as it was a pretty traumatic event for me. Anyway, everything was normal. I've since come to learn that the word "prostatitis," namely the "non-bacterial" variety, is more or a less a urological catch-all term for, "We really don't know what the hell is wrong with you."

That said, prostatitis is an actual bacterial disease, and can and will be cured by antibiotics when found (usually by a urine or semen sample). The problem, then, is that by using this term to describe an illness that just happens to share a lot of the same symptoms (constant urge, frequent urination, pain in the urethra, pain in the anus, occasional stomach cramps; the symptoms vary and may be one, some, or all depending on the severity of the case) with CPPS only causes confusion on the patient's part, and that confusion can often times turn into worry, stress, and anxiety, all of which only further contribute to CPPS.

CPPS is still relatively new in terms of being diagnosed and recognized in the medical community. It isn't a completely understood problem, and a lot of urologists aren't even aware of it as a term. Most urologists still treat this kind of thing--again, often diagnosed as non-bacterial prostatitis--with long courses of antibiotics, despite the fact that there isn't an actual infection present. This has mixed results with patients, with most CPPS experts explaining success stories of extended courses of antibiotics on the anti-inflammatory properties most antibiotics contain, coupled with the placebo affect that they have on a CPPS sufferer: "I'm on antibiotics, so I'll get better eventually. I just have to keep taking them, and I'll be fine soon." However, as someone who was on two months worth of 500mg of ciprofloxacin twice daily, along with an additional month of 100mg of doxycycline twice daily, I can tell you that they did very little to nothing for me.

As far as other medications go, I also took VESIcare for a time early on in my treatment, as well as Toviaz later on. Both did nothing. Oxybutinen (sp?) was another one I took for the smooth muscle around my bladder, as well as supposedly having anti-depressant effect, and I can tell you, as someone who was depressed about this, that medication was ineffective for both issues. Flomax, which is an alpha-blocker, was also prescribed for me early on, but I was taken off of it shortly thereafter due to sexual side-effects. There are probably others that I'm forgetting, and throughout all of these I was on either one or the other of the antibiotics listed above. Currently, the only thing I'm on is 0.5mg of Xanax, just one pill before I go to bed at night to help me sleep, and I honestly did notice my symptoms begin to subside a bit when I first started taking it, which at the time further convinced me that anxiety was playing a big role in my suffering.

Concerning said suffering, it absolutely is a physical problem. By no means did I mean to imply that it's strictly a mental condition. In fact, don't let any doctor ever tell you that it's all in your head, because it's not, and if they do, I'd encourage you to walk right out of there office and never look back. While the problem may originate from stress or an unhealthy obsession with one's private region (in my searches, I've come across people suffering from symptoms after they had a risky sexual encounter, despite the fact that they'd tested negative for every STD under the sun), the symptoms are a result of muscle tension, usually from an unconscious, instinctual overreaction of the body attempting to protect that area. The muscles contract, shorten, and eventually cause the frequent urge to urinate, in addition to a whole slew of other stuff you wouldn't believe could be caused just by muscle tension. But then, muscle tension caused by stress can bring about headaches and stomachaches, as well, so I suppose it shouldn't be too surprising that something like CPPS exists, too.

Not to frighten you, but in addition to the constant urge to urinate, my symptoms also included a burning in the urethra following urination and ejaculation (which has since improved), an occasional feeling of drops still in the urethra following urination, a weakened stream, bouts of feeling as if something hot were in my anus, and random cramps in my lower abdomen, around my pubic bone. At the onset, however, I was just like you: Merely a frequent need to urinate, regardless of how much I drank or how often I voided. I wouldn't worry, though, as I believe my symptoms only became worse because I panicked and stressed myself out for so long, so if you just stay calm, you'll hopefully begin to only improve in time.

Nevertheless, you can see why the problem is so often misdiagnosed. It's hard for a lot of people to accept that muscle tension and anxiety can cause so many problems in an area that's somewhat removed from the source of the problem. The thing is, though, what we're experiencing is basically referred pain. As opposed to the pelvic muscles themselves saying to us, "Ow, stop doing that!" those signals are instead transmitted in other ways, as either a pain in the penis itself, the anus, or an unusual sensation to urinate. I say "unusual" because I don't know about you, but these days I call the constant urge a false-positive, as though subtle, anymore I can nevertheless tell the difference between actually having to urinate and merely the "symptom" of having to urinate. What you said about the feeling of something pushing on your bladder is more or less what's actually going on; it's just that it's your own muscles that are doing the pushing.

What I can recommend to you is that you find a good urologist who you trust and who's open to the possibility of CPPS, perhaps knows of a good physical therapist who does pelvic floor therapy, and, once again, remain as stress-free about the condition as possible in the meantime. I've done a lot of searching on the Internet over the past six months despite myself, and I've found quite a few positive experiences of people suffering exactly as you are who beat the condition in time with nothing more than patience and confidence that they would. A physical therapist is not a necessity, in my opinion, though they do perhaps speed up the healing process considerably.

Another thing you can consider doing is read the book A Headache in the Pelvis, but I would recommend reading it as a necessity-based endeavor. There's a lot of good information in that book, but a lot of it is somewhat frightening, too, and much of it is nothing more than a sales pitch for the author's clinic out in California. You don't need to go to all that trouble, as far as I'm concerned, but there are some inspirational stories in there, some helpful exercises you can do at home that might be of some help, and, perhaps most importantly of all, it really sheds more light on the CPPS phenomenon than any other resource I've managed to track down yet.

One final word: Please remember that I'm not a doctor, merely someone like you who's been dealing with a similar experience and am now confident that all of the above applies to me. From what relatively little you've told me of your own troubles, I believe this information could be of use to you, but if there's any other possibility that you wish for your doctor(s) to explore, then by all means I encourage you to have him do so. Lord knows I've been through just about everything short of a pychic reading at this point, so I'm confident in my own diagnoses, but your body is your own, and you owe it to yourself to be equally confident in your own treatment.

Again, good luck, Laoks. I wish you all the best in getting past this hard time in your life, and I sincerely hope you begin to improve soon. Be sure to let us all know how you're situation changes in the weeks and months ahead. And please don't hesitate to hit me up with another question if you've got one. I'd be happy to answer it if I can.

Old 03-24-2011, 09:02 PM   #5
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Re: Frequent Urination, all tests negative, any ideas?

Laoks9999, how are you doing now?

Ropes End, thank-you for your detailed posts here. As someone who has just been diagnosed with Prostatitus it's really invaluable to learn from your experience and knowledge. Like both of you, I have been trolling the internet for as much info as possible. Ropes end, I've ordered the book you recommended. I have some questions for you - well many, actually - but let's start with some:

I have the same symptoms as you except my prostate is inflamed. Yesterday when they did a DRE on me I jumped a foot while screaming. So would that indicate CPPS for me? It feels as though, and I may have this wrong, but it's the prostate which is enlarged/inflamed and pushing against the bladder. So does CPPS say that the prostate is inflamed due to referred pain and causing bladder to feel full even when it isn't?

Although there's considerable pain at times up in my perineum (where the prostate is), I don't think my pelvic floor/"kegel" muscles are tight. It feels to me as though it's the prostate inside, just up above that spot which is inflamed & causing the pain as well as perhaps crowding up the bladder. The pain down there is so bad that I need to sit on a medical doughnut.

Also, if it's CPPS, should I keep drinking lots of water to flush out the "bacteria" (which is non-exsistent)? Or is it better to just drink normal amounts of water so I don't have to pee every frickin' 30-60 mins? Has cranberry juice helped you at all?

Have you been able to get to the gym to exercise over the past 6-8 months? I read in one of your other posts that, like me, you are a bit of an exercise addict. I already miss the endorphins from it. Are you able to lift weights or just do cardio? Does lifting weights hurt the pelvic floor and exacerbate that?

That's all for now. Hope you both are better.

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