Q: I have suffered from burning urination for a year. Planned Parenthood said if I have an endometriosis test, they will give me something for my problem. I don’t want the test. Can they give me that ultimatum?
A: It might have helped if the physician or health care professional you saw gave you a reason for thinking you might have endometriosis and then explained just what the testing involved, unless you already knew. And no, if you don’t want the testing you don’t have to have it done. However, the facility may take a stand, as apparently they have implied, that they will not treat you without the testing, and for that I cannot fault them.
The causes for dysuria (burning on urination) are many and include a UTI (urinary tract infection), stones in the urinary tract, interstitial cystitis, STDs (sexually transmitted diseases), a side effect of medication taken, urethritis, (including endometriosis since 10% of endometriosis patients have disuria) and more. A UTI is the result of a bacterial infection that can occur in the bladder, kidneys, ureters or urethra. Stones are hard masses of crystallized calcium or other substances that originate in the kidneys but may pass through the urinary tract, causing possible pain, bleeding, and infection. Interstitial cystitis a/k/a painful bladder syndrome, is a chronic inflammatory condition within the layers of the bladder. STDs may present with pain on urination, itching, burning, a vaginal discharge, lower abdominal pain, and more. Urethritis is an infection of the urethra, the tube that carries urine from the bladder. Symptoms may include burning on urination, abdominal pain, and discharge.
In order to diagnose endometriosis, as well as other conditions that cause pelvic pain and burning on urination, a qualified professional will palpate areas in the pelvis for cysts or other abnormalities on your reproductive organs. The testing might be compared with having a Pap test. Your physician if a male, will likely have another female in the room while the brief test takes place and you can bring someone along with you, as well. With luck, this is all that may be required; however, an ultrasound may be ordered if cysts or some other uterine problems are suspected. And there is a chance you may be referred to a surgeon so a laparoscopy can be performed if there are abnormalities. This is a minor surgical procedure which will require general anesthesia which may be more than you are willing to consider at this juncture.
Now a brief coverage of endometriosis, a somewhat painful disorder in which tissue that lines the inside of the uterus (the endometrium) grows outside it. Because the tissue cannot leave the body, it is trapped and surrounding tissue may become irritated. Pain may be present – pain during your menstrual cycle, during and following intercourse, when attempting to have a bowel movement or when trying to urinate. There may be infertility issues, fatigue, diarrhea, and excessive bleeding. Do these signs and symptoms resemble what you are experiencing? If so, perhaps Planned Parenthood is on the right track. If not, you might consider other causes for your dysuria. .
The place to begin may be with a simple urine dipstick in a physician’s office which may indicate the presence of white blood cells and bacteria. Or, the physician may choose to request a clean catch mid stream urine which can also be accomplished in the office. This is a simple test performed by the patient without the presence of others. You will be instructed on the step by step process involved (which is brief). The urine collected is then cultured for analysis. If bacteria is found, the patient can then be treated with the best antibiotic based on the type of bacteria found.
Bottom line: don’t put endometriosis at the top of the list unless you have specific cause to do so. Start simple and progress from there. Good luck.
