Hi my name is Nidhi Sharma.
I’m a women’s health physical therapist here at FuncPhysio physical therapy. Today I’m going to explain a possible connection between symptoms that seem like UTI symptoms that keep coming back and pelvic floor dysfunction.
I see a lot of women in my clinic that report they have had multiple UTI in past year or they have had UTI that have not resolved even after antibiotics. Or they have to go in two or three courses of antibiotics and still have symptoms.
So what’s going on. An important thing that a lot of women don’t know is that sometimes a pelvic floor dysfunction or a problem of tightness spasm cramping poor and function poor coordination of pelvic floor. It can mimic the symptoms that a UTI presents.
So to explain this why it can happen. Let’s go a little bit of anatomy. So basically an infection is an inflammation of the tissue around the urethra.
So if this is the bladder, which is sort of like a bag or a balloon filled with urine there is a tube coming out of it from the bottom which is the urethra and the tube ends and the unit opening.
Now. The usual UTI is usually infection along this tube. Some sort of microbial infection along this tube that irritates and inflamed the tissue and keeps you from either holding, passing, or retaining the urine.
it gives you that burning feeling of burning for that feeling of frequency and difficulty holding or passing urine.
Now if you think about pelvic floor, there are tiny little muscles off the pelvic floor that to wrap around the urethra as it comes down to become the urethra opening so close to the uterus opening.
There are few muscles that perform like a collar around the city through. Some of these muscles actually whole duty try and plays by inserting into the muscle into the bones on both sides. So basically there are these muscles that are forming collar or sometimes falling forming a sling around the urethra the tube.
When these muscles get too tight or they get to get in a spasm or in a cramp, they have the ability to squeeze this urethra. You usually squeeze this urethra to hold in place. you’re able to use these muscles to squeeze they try and hold your pee and when you relax these muscles you can pass the urine.
But when these muscles are tight and they lose their regular flexibility then instead of going through a cycle of relaxing and contracting they often stay contracted or tight and then they are contracted and tied around this tube of the urethra.
They do the same thing that a UTI tends to do that irritate the tissue they inflamed the tissue and they make it hard for the urine to pass.
So sometimes because these muscles are tight in squeezing the urethra you’ll have difficulty passing urine you’ll have burning and frequency and just this constant discomfort around the urethra without a UTI.
I often see this that women who have had couple of UTIs Still tend to have symptoms even though they don’t have UTI they don’t test positive for any infection and it’s these muscles that are holding tight and on the urethra are still have that you see dual sensitiveness from the UTI that happened before.
So what’s the takeaway. Whenever you have a UTI or you think you have a UTI, make sure to get a urine culture OK discuss with a doctor that even if you start the medication you want to get a culture to see if you really had. If an infection keep coming back and you are being given more antibiotic courses than think with a suspicion, it’s possible that it’s one of those deeply seeded hard to beat infections for which you are taking antibiotics.
But it’s also possible that the symptoms are coming from elsewhere.
So at that point discuss with a doctor have a little bit of suspicion about the symptoms and if the same if you test negative for UTI then definitely go see a pelvic floor physical therapist because we can work on these small muscles around your teeth to make sure they have good flexibility and good ability to relax and resolve your symptoms.
This happens all the time it’s common and you should seek physical therapy if that’s something you need to do.
Hope this helps
Dr. Nidhi Sharma, Board Certified Women’s Health Specialist