### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello, My mother in law started having extreme pain and burning after she urinates and many times she feel like she has to urinate but nothing comes out or just a few drops. She has been like this since January 2014, she has has all gynocological tests nothing was found. She has been to many urologists and done ultrasounds, urine samples have been tested, cystoscopy done 2 times. At one point she was told she had a urinary tract infection and given antibiotic when checked again the infection was gone but she continued to have the same symptons. around the same time she started having symptoms she found out that her husband had aids which was a huge shock. Many of the doctors that she has been to see have told her kids that they should take her to a pshyciatrist as the tests come back clear nothing to justify the pain and burning feeling. Can her symptoms be all phycological? She say a urologist last week that told her that she might have urinary retention so she is going to have a test done next week to see if this is the case. she has gotten to the point that she fears going to the bathroom and many times holds off going. Do you have any idea what it could be? Could a biopsy see something more than all the other tests she has done?

### output:

HelloThanks for query. Based on the symptoms that you have narrated I would say that your mother-in-law has UTI secondary to what is called as Post Menopausal Urethral Stenosis. In post menopausal age all the Genitourinary organs get atrophied gradually. This also involves the urethral passage which gets narrowed. This narrowing of urethral passage causes incomplete emptying of bladder during every act of urination so that some amount of urine remains in the bladder what is termed as Residual Urine. This residual urine is the source of repeated episodes' infection (UTI). What she needs is to calibrate her urethra up to 35 French size which helps to empty the bladder completely. This calibrated urethra has to be maintained by doing Clean Self Intermittent Catheterization and dilatation at home by herself or any close female relative. This will definitely resolve your problem You can discuss this with your Urologist. For last 40 years I am following this modality in my patients with Post Menopausal Urethral Stenosis and getting encouraging results. Chat Doctor. 