Your doctor will want to look at your problem carefully; in first place to establish that the disorder is cystitis, and not something else producing similar symptoms. Infections of the cervix and vagina, for example, can mimic cystitis and urethritis, and cause pain on passing urine, but they also likely to produce irritation and soreness around the vaginal entrance, and a vaginal discharge.
It can be difficult, in fact, to tell just which part of you down below is actually hurting. But the pain of vaginitis and cervicitis is more external and a bit further back, and usually involves the outer vaginal lips. The pain you experience on passing urine in this case is due to the hot, acid urine running over the sore and inflamed labia.
The pain caused by emptying the bladder in cystitis and urethritis i a little higher up inside, and nearer to the front of your genital area, close to and behind your clitoris.
Sometimes vaginitis, cervicitis, urethritis and cystitis all occur together. If you are experiencing for the first time symptoms you believe add up to cystitis, or get recurrent bouts of cystitis that do not respond to self help measures, go and see your doctor and ask for a sample of your urine to be sent for bacteriological test. He or she may want you to take a cervical smear test, as well, to be on the safe side.
Even though all test in the past have proved negative, you must act promptly if you believe you may have an infection. Whether you decide to combine self help measures with your doctor’s treatment, or to consult an alternative practitioner in future, is entirely up to you. But an established infection, either in the bladder or uthera, or within the vagina and cervix, needs to be identified and treated without delay.
The second reason why recurrent cystitis needs to be investigated, particularly when infection is present yet unresponsive to treatment, is to rule out unusual predisposing causes for the attacks. These include:
– A source of infection above the bladder, for instance in the kidneys, associated with kidneys stones.
– Obstruction below the bladder, such as urethral narrowing in a woman, either this, or a tumour, benign or malignant
– A tumour or a foreign body in the bladder
– Spread of inflammation to the bladder from an nearby organ
– An anatomical defect, such as a pouch of tissues projecting from either the bladder or the urethra
Lastly, the bacteria causing recurrent infection may simply be resistant to the antibiotics chosen for treatment. Doctors are often criticized for the way they handle patients with recurrent urinary problems. Like thrush infection, cystitis can be highly frustrating to treat.
Resistant infections, and cystitis symptoms arising for no apparent cause, are difficult to advice about, unless an all around approach is adopted, which looks at the patients lifestyle for causes associated with stress, diet, exercise and contact with chemicals.