Burning with urination? Localized irritation? Pelvic pressure with or without a sense of urinary urgency? Does this sound like a urinary tract infection? Many times, yes, a urinary tract infection (UTI) is exactly what it is. A simple course of antibiotics may be the answer. However, diagnosing a UTI based on those symptoms may not always be the correct diagnosis, and antibiotics may not always be the proper treatment.

All too frequently, women self-diagnosis or are misdiagnosed by their health care provider for a UTI when there are other possibilities that may be causing similar symptoms to a UTI, particularly if painful urination and vaginal irritation are present.

A UTI is often diagnosed based on a woman’s classic symptoms of burning with urination and urinary frequency, but this practice may also result in a misdiagnosis. Frustrated women return to their medical provider for another course of a different antibiotic that, again, will not fix the problem but will put a woman at risk of antibiotic side effects and antibiotic resistance. Discussed below are four alternate diagnoses to a UTI that can present in a similar fashion.

1. Yeast infection

The classic symptom of a vaginal yeast infection is thick, off-white, clumpy discharge. However, early on in the infection vaginal irritation may start before the clumpy discharge is present. This irritation can cause an increased burning sensation when urinating, as acidic urine touches the sensitive skin.

What can result is a woman misinterpreting the painful urination for a UTI when it is, in fact, a yeast infection. A yeast infection requires a completely different type of treatment using an anti-fungal product.

Mistakenly treating a yeast infection with an oral antibiotic can further increase the risk and symptoms of a yeast infection. It is not uncommon for a woman to experience a yeast infection while or shortly after having taken a course of antibiotics.

2. Vaginal atrophy

Vaginal atrophy occurs as the vaginal tissue becomes thin and dry, which is most often associated with age and a drop in estrogen levels.  Signs of vaginal atrophy often include brighter pink or red tissue that has lost the appearance of any natural lubrication.

Women with vaginal atrophy may experience vaginal irritation and itchiness from the dryness. Burning with urination may occur because the thin skin is vulnerable and can crack, or there may be break down in the skin from itching.

Treatment options include over the counter, water-based lubricants to prescription only estrogen creams. In severe cases or in cases where women are coping with other bothersome symptoms of menopause, a health care provider and the woman may decide an oral hormone replacement is the best answer, after carefully weighing the risks and benefits.



3. Bladder, bowel or uterine prolapse

While this may freak some women out, it is quite common for either the bladder, bowel or uterus to drop down to varying degrees. Risks of this occurring include childbearing history, age, hysterectomy, and loss of vaginal muscle tone.

What results can be a sense of pelvic or vaginal pressure, often confused with a symptom of a UTI. As antibiotics will not manage this condition, women requesting treatment for a UTI will not experience any relief from antibiotics.

Management options for a prolapsed condition include vaginal toning exercises, often supported by a physiotherapist specializing in vaginal strengthening. In severe cases or particularly bothersome cases where the prolapse causes the dropped tissue to bulge externally outside of the vagina, surgery with a mesh support may be considered.

Interestingly, as the anatomical changes that occur with a prolapse often result in a change in position of the bladder, women may become prone to incomplete urinary emptying putting them at risks for UTIs. Further assessment by a gynecologist is often warranted.

4. Sexually transmitted infections (STI’s)

STIs, may occur withoutsymptoms and sometimes the person is unaware of having the infection. At other times, STIs may cause burning with urination and/or abnormal discharge for both women and men. Affected individuals may visit their health care provider requesting treatment for a UTI. While STIs are treated with antibiotics, the antibiotic required is different that what a typical UTI would require. Accurate diagnosis through either urine sampling or a cervical swab (for women) or a urethral swab (for men) is required.

Consistent condom use and limiting sexual partners is the best way to minimize risk of developing an STI.

The next time you, or someone you know, experiences symptoms of an everyday UTI, consider asking your health care provider about other possible causes, especially if the symptoms do not clear up with the first course of antibiotics. With a proper diagnosis you can receive the best treatment to alleviate and control symptoms of a non-UTI. Avoiding over use and unnecessary use of antibiotics protects your health and helps to prevent community wide antibiotic resistance patterns.



Leave a Reply