Urethra pain, is there hope?

Patient

Q: 25 y/o female, I presented with symptoms of urinary urgency and pain in the urethra, sporadically, beginning early childhood. At age 18, I experienced my first painful flare-up. Now, have pain daily at 2 - 3 on a scale out of 10, and flare-ups at a 7 or 8 every few months. Have seen many pcp's, no UTI ever detected. Urologist suggested could possibly be interstitial cystitis, proposed using a scope to investigate. I refused, as I am in too much pain there already, and the discomfort during and afterward would be too much for me. Was diagnosed with pelvic floor disfunction, and even have muscle pain from tension due to anticipated urethra pain. Read that primary treatment for IC is bladder installation of solutions to protect the lining of the bladder, but 1. I have no bladder pain, only urethral pain, and 2. I have a strict no catheter policy. Is there any hope for alternate treatment aside from an invasive procedure if I opt for a scope to check things out? I currently treat with OTC Azo Standard, which I know has not been approved for long term use. I've been putting off the scope for years due to the anxiety.

Symptoms:  Pain in urethra, urinary urgency, pelvic floor disfunction, incontinence
Doctor

A:   The cause of your urethral pain and discomfort is still undiagnosed and until you avert steps to diagnose your disease, the chance of alleviation is poor. Cystoscopy may be an invaluable aid toward diagnosing your problem that may include an isolated urethral pathology or a bladder neck problem as well. Catheterization may be required, at your urologist's discretion, even for a prolonged period, if some urethral pathology is eventually diagnosed. Please let your doctor help you. If in doubt do seek a second opinion.

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