Much More Than Chronic UTIs

Woman’s Perseverance Overcomes a Missed Diagnosis, Leading to Healthy Outcome

Having endured 15 years of pain and complications from what her doctors had perceived as chronic urinary tract infections (UTI), 46-year-old Marie knew there had to be more to her medical situation. Her symptoms had progressed far beyond the classic signs of a UTI and affected her professional, personal, sexual and social life.

Marie's Story

Through determination and an unwillingness to accept her diagnosis, Marie ultimately discovered the true cause of her medical problems and found surgical relief at the University of Colorado Department of Urogynecology.

“Yeah, so what, women get UTIs”

A UTI is a common infection that usually occurs when bacteria – most commonly E. coli from the gastrointestinal tract – enter the opening of the urethra and multiply in the urinary tract (the system that includes the kidneys, ureters, bladder and urethra).

While UTIs affect both men and women, the condition is much more prevalent in women, with nearly half experiencing one UTI in their lifetime.

Urinary catheterization and sexual intercourse can trigger a UTI, but other known sources, such as use of condoms with spermicidal foam and holding urine during an urge, may also serve as facilitators of infectious growth.

In 1999, Marie had all the classic symptoms of a UTI: strong urge to urinate, frequent urination in small amounts and sometimes a burning sensation with urination.

Assuming the issue would be simply resolved, Marie says she went to her general practitioner for an antibiotic prescription with the dismissive thought, “yeah, so what, women get UTIs.”

But Marie’s chronic UTIs became more painful and frequent with as many as six occurring in one year. She went to multiple practitioners, and they all insisted that she was simply prone to the infection.

She was prescribed a regimen of cranberry tablets, probiotics and antibiotics – all provided minor relief.

Over time, Marie developed more startling conditions such as kidney infections, painful intercourse, urination accompanied with dribbling and blood in her urine. In 2010, Marie went to a urologist, however he could not find anything wrong with her.

Frustrated, but not deterred, Marie visited women’s pelvic health specialist Dr. Karlotta Davis of the University of Colorado urogynecology department.

One doctor, one answer

After urodynamic testing and cystourethroscopy (a procedure that uses a thin tube equipped with a camera and light that enters through the urethra to view the bladder), Marie received a long-awaited answer.

Dr. Davis told Marie she had what is referred to as a suburethral diverticulum: a pouch, or “sac,” had formed in the lining of the mucous membrane of her urethra.

The cause of urethral diverticula (UD) is not clearly understood. What is known is that a herniation or an alternative pathological problem – obstruction of a gland or trauma caused by childbirth, catheterization or surgery – causes infection presenting a host of problems for the individual suffering from UD.

As was the case for Marie, many of the symptoms caused by UD are present in urination. Frequency, dribbling and painful urination affect patients early on. As inflammation around the pouch or sac develops, painful intercourse (dyspareunia) and pelvic pain can occur.

Due to the complexity and variability of the condition, incidence of UD varies from one to five percent of American women, however the number may be much higher as many cases are missed or misdiagnosed.

Prevalence rates of UD range from 16 to 40 percent in female patients with recurrent UTIs.

A surgical fix

Marie was told that her diverticula was about four to five centimeters in length and without removal of the mass her symptoms would persist.

Dr. Davis performed a transvaginal excision of the diverticula, completely removing the infected mass with minimal risk of recurrence.

“I experienced virtually no pain after the surgery. I was back to work in four days,” says Marie, an animal behavior counselor. “While I had to be on a catheter for two weeks, it was worth the relief.”

Marie says she is open about her condition because she hopes other women can learn from her experience and not simply tolerate their medical woe.

You don’t need to have an MD after your name to know that there is something seriously wrong. says Marie.

“When Dr. Davis discovered my problem, I felt like telling the other docs told you so. It was validating to have an answer and find a doctor that would listen to me.”