Do You Always Feel Like You Have a UTI?- Episode 43

This episode of the Marrón Pelvic Health Podcast, hosted by Dr. Kari Roberts, focuses on the frustrating experience of always feeling like you have a UTI— even when tests show no infection. While many assume urinary symptoms must come from a bacterial infection, sensations like urgency, burning, or bladder pressure can also be linked to pelvic floor muscle tension, bladder irritation, or nerve sensitivity. The podcast highlights the importance of understanding why these symptoms happen and what may be contributing to them. Dr. Roberts explains that pelvic physical therapy can help through personalized assessments and exercises designed to reduce discomfort and improve pelvic floor function. Awareness and proper care are essential for managing persistent urinary symptoms effectively.

Book a call with Dr. Kari Roberts today.

• Episode Transcript

  Dr. Kari: Have you ever been diagnosed with recurrent UTIs, but the test comes back negative, but your symptoms still are lingering? If so, this episode is for you.

  Dr. Kari: Welcome to the Marron Pelvic Health Podcast. Hi, I'm your host, Dr. Carrie Roberts. On this show, we will be discussing a variety of things regarding your pelvic health. These conversations will be a mix of education, personal experiences, and a blend of tips you can apply to have a healthier pelvis.

  Dr. Kari: And the goal of this show is

  Dr. Kari: to normalize conversations around pelvic health and help women stop suffering in silence.

  Dr. Kari: And today I wanted to talk about the symptom of when people have UTIs or chronic UTIs. I've noticed a little bit of an uptick lately. You know, everything comes in cycles. And lately I've noticed that. I've had patients come to me and they're like, oh, I have uti, but the. The test is negative. And it's like, do you really have a UTI or is something else going on? So this episode is for you. If you said, I feel like I always have a uti, my test is negative, but I still have the symptoms. Antibiotics help, but then the symptoms come right back. And if you're shaking your head, yes, this is me, or this has been me, then this episode is for you. And we're going to dive in a little bit deeper into what could be going on. Now, what is a uti? UTI stands for urinary tract infection. And it's usually something that's in the ureter or the urethra, basically below the bladder. And you can have all sorts of discomforts with that. A lot of times it comes on quick. There is a sudden onset, and you have a burning with urination, and you have usually a foul smell when it. When that happens. And you can also have frequen. So you'll notice you're going to urinate a lot, and there's not a lot in there. And there's a pretty significant burning sensation with it. The urine, if you look in the toilet, is usually cloudy. And like I said, it usually does have a little bit of a strong foul odor. Sometimes if it's really bad, you can feel unwell, kind of like you have the flu. You can develop a fever. And these are short term. You know, there's an active infection. So it's a short. A sudden onset. The symptoms are short term. You get the antibiotic, the infection goes away and it's cleared up. So what could it be? If you are having some of these symptoms, the Frequency peeing a little bit, feeling burned, feeling discomfort with sex, feeling pressure in your pelvic floor area, and the test comes back negative. So what are signs that this UTI that you think you have may not actually be a uti? Well, as I just described, a UTI is an infection. So if the test comes back negative, then with the urine test, then it's not a uti. Something else to consider is that if it leaves and comes right back multiple times, it possibly isn't a uti. If you have flare ups with stress during or after sex, if he's been sitting too long or during exercise, those are not symptoms of a uti because generally speaking, you feel that burning when you're actually urinating and emptying your bladder. And even if you take the antibiotics and it feels like it helps a little bit, but it doesn't knock it all the way out, chances are it might not be a uti. Now what are some common things that happen that can mimic UTI symptoms but that are 100% not UTIs? Well, the first one is pelvic floor dysfunction. When you've got muscles that are too tight or they're overworking, they're not coordinated with, you know, they're turning on and off when they're not supposed to. Then a lot of times urinary. Excuse me, a lot of times pelvic floor dysfunction has those classic urinary symptoms with the burning when you urinate, burning with sex, sometimes burning with pressure, sometimes there's, it's an itch. It's really interesting. Sometimes the area down there, it doesn't really perceive pain, but our bodies perceive it as an it or burning, something like that, or just generalized discomfort. If you have interstitial cystitis or bladder pain syndrome, go ahead and go way back to my beginning episodes. I think it's two or three where I kind of go into interstitial cystitis and my journey with it. But generally speaking, some of those symptoms are pressure in the, in the pelvic area, urinary frequency, urinary urgency. And usually when you pee, the pressure or the discomfort gets better, which is the opposite of a uti. Cause usually when you pee is when you have the symptoms. Something else that we have to think about is our good old friends, the hormones. And you can have sensitivity changes when you're postpartum, when you're breastfeeding, or when you're menopausal, perimenopausal. And then if we have just generalized nervous system sensitivities, then we can have a heightened response to those normal sensations. And our body can perceive that as pain or, you know, sometimes that heightened response increases our urge, increases our frequency. So why does knowing what a UTI is in some pelvic floor concerns or conditions that could mimic UTIs that aren't? Why is it so important? Because when you're treating a non ut urinary tract infection with antibiotics, it disrupts your natural bacteria in your body that increases irritation and it can delay proper care. So most people do not want to be on medication when they don't need to be. Most people don't want to be on antibiotics when they don't need to be. And you don't want to create a problem by taking antibiotics that you don't need while you're still not addressing the main problem. So what actually helps with these UTIs that seem like they're never going away? Well, what mostly helps is getting the proper assessment. You want to get a full total body assessment, not just a urine urine test. You want to be able to explain your symptoms, how long it's been going on for, have a pelvic exam, possibly have your pelvic floor muscles evaluated to make sure that it isn't what we think it is. With that being said, you might benefit from a pelvic physical therapist assessment because we're going to do a head to toe assessment. We're going to look at what impacts the pelvis, what's going on inside the pelvis, what's going on outside of the pelvis. We're going to do a sexual activity screen, a bowel screen, a bladder screen, a low back screen, a leg screen, a shoulder screen. We're going to look at all of those things. We're not just going to look just at the urine test. And then third, while we're doing that, we're going to look at those muscles and see how those muscles are performing. We're going to look at that nervous system and see if that nervous, your nervous system is impacting what's going on in your pelvic area. And then, you know, we are not experts in hormones, but we're aware of them and we know what some of those hormonal changes look like when we're doing our assessment. And that's something that we'll be able to help you with as well. So just as a review, what is a urinary tract infection? A urinary tract infection is a short term infection that usually has a sudden onset and its symptoms are frequency and urgency with urination. And you feel a discomfort or burning while you're urinating, the urine is usually cloudy with a foul odor. What are some common causes that can mimic a UTI that aren't really a uti? Pelvic floor dysfunction if we have tight overactive muscles, those muscles can present with burning discomfort, itching, increase bladder habits, increased frequency, increased urgency. Also, if you have bladder pain syndrome or interstitial cystitis, then you can have pain in your pelvic area that's reduced when you urinate. It also can cause pressure in your pelvic area and you can also have pain during and after sex. But with bladder pain syndrome or interstitial cystitis, hormonal changes can impact the area as well as the increased nervous system and what we want to do if you feel like you're having this UTI and it's always there, you want to make sure you're getting a full assessment and having a full conversation with your physician and not just doing the urine test. You might want to consider having a pelvic floor assessment with a skilled pelvic floor physical therapist. And you want to make sure that you're receiving the the assessment of your muscles, your neuromuscular system with your nerves, your musculoskeletal system with your muscles, as well as your hormones. So hopefully this helps. Hopefully this gives you things to think about and questions to ask your provider. If you're in the Atlanta area and you want to maybe come in for an assessment, then please reach out to me. I would love to help you overcome your symptoms that fail feel like a uti. A UTI that may not be okay. I'll be back next week with another episode. Thank you for listening to this episode

  Dr. Kari: of the Maroon Pelvic Health Podcast.

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