Q. I have bad bladder spasms with burning. Is it due to UTI?

Answered by
Dr. Samer S J Altawil
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Jan 29, 2021

Hi doctor,

I am a 23 year old female diagnosed with UTI before six months back and took antibiotics. But I still have mild weird symptoms until today. I tested it again and did more than ten urine tests with culture during these six months. I felt that there is something wrong. But there is no sign of infection and the doctor told me that there is nothing wrong with me. I do not feel like peeing. But I used to pee with burning sometimes and I have abnormal symptoms. I am confused and do not know what to do. I drink around one liter of water and I will have a bottle of water wherever I go. I usually go to the bathroom when I wake up and I use to have four to six-bathroom trips throughout the day. But I have burning spasms whenever I pee. They really cause burning. I have a lot of burning spasms while going on the first trip.

The burning reduces after the second and third trips. When I rush to the bathroom after a burning spasm, I have concentrated urine and it burns a lot. When I finish passing the concentrated urine, my urethra seems to be inflamed and the irritation goes away after ten minutes. This happens once a day or twice and now it is frequent. Sometimes, the bladder spasm is normal and they do not cause burning. Rarely, I have normal spasms and my pee seems to be clear. I feel like my bladder is sending me signals with these burning spasms. I am dealing with this problem for six months and I tried chugging water. It worked for me and sometimes it did not help me. It makes me to have constant pee.

At that time, I stopped doing it and reduce my water intake. I feel normal for few hours and sometimes my urine becomes concentrated and it burns a lot. I do not have burning spasms while sleeping and it is present only when I wake up. I do not drink coffee and alcohol. I do not smoke and I take a reduced amount of salt in my food. I have tried everything. I do not know the reason for having this problem. I want to pee normally without any burning sensation as going to the bathroom became a nightmare for me.



Welcome to

There are two main issues and it can cause problems. The first one is interstitial cystitis. It causes chronic inflammation of the bladder with pain during filling of the bladder and pain goes away when the urine is passed. You can do cystoscopy and bladder biopsy. Then treatment can be taken if the biopsy is positive. The other cause is overactive bladder spasm and contraction of the bladder during filling and giving a sensation for a toilet. Often it can be diagnosed by doing a urodynamic study and treatment can be started after confirming the diagnosis.

The other causes can be bladder stone or tumor. You need to do an ultrasound KUB (renal ultrasound) to check your urinary system. Then you need to have a bladder diary for three days in which you need to mention the urine passed throughout the day and the time taken for it for three days. You can start taking tablet Tolterodine 10 mg once daily and it reduces the frequency. It relaxes bladder muscles to avoid spasms and increases bladder capacity. These issues have to be solved by step by step approach. Please have a follow up after doing an ultrasound and a bladder diary.

Thank you doctor,

I have done an ultrasound before a month and the doctor told me that everything is fine and there is nothing to worry. I will do a bladder diary and I will have a follow-up. I have some questions. Does Tolterodine help me? Is it for a short period of time or for a long period of time? Will it affect my body and cause long term effects? Will it fix my problem permanently? How to manage my water intake and when should I drink water exactly? Drinking water every ten minutes makes me urinate all the time but it helps for urination and the spasms are not annoying. My urine will appear clear all the time and it does not irritate the urethra. But it is not comfortable for me as I go out a lot and I cannot manage it.

But drinking water every two or three hours does not make me urinate. It makes me urinate less throughout the day like two times a day. It makes my urine concentrated and it irritates my bladder. If I forget to drink water for four hours, my urine becomes concentrated and I start to have burning spasms. Sometimes if do not drink water, I do not have urination. But when I drink water, my spasms are really bad with burning. Is this just a dehydration problem? I experience this issue before getting UTI. Because I will not drink water and used to drink energy drink a lot. My pee started to burn without drinking water for a couple of days. After that, I started to drink water, and then it has gone away completely.

The only problem I have now is after getting UTI, it happens for me constantly with or without drinking water every day even when I drink 1000 glasses of water. I stopped drinking energy drinks for six months now. Do urine tests show stones in the bladder? Or does it need other procedures? What causes problems with me? Is it due to interstitial cystitis or overactive bladder? Because I am struggling a lot and UTI was severe and it has damaged my bladder.



Welcome back to

Regarding the ultrasound done before a month, this is sufficient to say that you do not have stones in the bladder or in the kidneys. Tolterodine can be used for few months for now. After seeing the reduction of symptoms, you can stop it. If the symptoms come back, you need to take it regularly. Dry mouth and constipation are the side effects caused after taking it and it is tolerable. If you cannot tolerate it, then you can change the medication. Try to drink water of six to eight glasses per day.

Do not drink continuously. You can take a glass of water every two hours and go pee every two hours. This is a normal way and it avoids dehydration and will not cause concentrated urine with pain. Interstitial cystitis is a chronic inflammation that occurs without a specific cause. You should reduce the intake of tea, coffee, fizzy drinks, and spicy foods. Try to reduce the level of potassium present in food.

Overactive bladder can occur due to spinal compression caused by disc prolapse or trauma and neurological conditions like multiple sclerosis can also cause it. You can get an accurate diagnosis after doing a bladder biopsy and if the biopsy is negative, then you need to do a urodynamic study.

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