A Wonderful Urologist Near Fulton, Maryland

Ask me if a know a urologist near Fulton, Maryland and I’ll happily refer you to Dr. Lisa Hawes. Here is quick summary why I think you are lucky if you live nearby and looking for a female urologist (as much as you could be considered ‘lucky” when needing to see a doc, of course):

• Dr. Lisa Hawes is an experienced urologist near Fulton, Maryland who has been seeing patients since 2004. It’s fourteen years of practice (I’m writing this in 2018)! This is long enough to “see it all” but still be energetic and open to new solutions.
• Women want to talk to a woman urologist and therefore Dr. Hawes is in a unique position to work with a wide range of female patients complaining of chronic UTI-like symptoms, IC, pelvic pain, IBS, and stones.
• Dr. Hawes is a rare Western-trained physician who doesn’t shy away from successfully experimenting with homeopathic medicine in her practice.
• And lastly, she is down to earth and easy to talk to, she will be your partner in treatment and you can always rely on her paying attention to your story. In short, if you can make a trip to Chesapeake Urology in Fulton, Maryland, it would be worth your while.

According to Dr. Hawes, most of her patients come to her as referrals from local family practices. Family physicians learned to refer to Dr. Hawes as soon as a patient had as little as 2 UTIs in a year.

Usually, primary care physicians are quick to prescribe antibiotics and send patients away with “wipe front to back” advice. Unfortunately, family doctors rarely have time to get to the root of the problem and follow up. The longer you are treated by an OBGYN or primary care physician for your “chronic UTI”, the higher chances that you are treated for something you don’t have.

Dr. Hawes’ Chronic UTI Workup

Here is what I found out about Dr. Hawes’ approach to chronic UTI treatment.

First of all, per Dr. Hawes, many patients who complain about UTI-like symptoms and are treated with endless antibiotic rounds don’t even have a UTI. She explains that using a dipstick test to confirm an active infection (and this is a go-to strategy in most primary clinics) is a flawed practice and frequently leads to a wrong conclusion.

“These tests only look for red and white cells and nitrites”, explains Dr. Hawes, “The first two are very non-specific and may be present in lots of different situations (stones, UTI, bladder inflammation). Nitrites are a strong evidence of a UTI, but are only reliable as long as the patient not taking OTC medicines such as AZO that turn urine in bright orange color”.

Instead of a simple dipstick test, Dr. Hawes’ standard workup includes:

1. A culture test: “A culture is a 3-day test sent to the lab. There the urine is grown on an agar or food plate for 2 days. If anything grows, they identify the bug. Then they test what antibiotic will work which takes another 24 hours. After about three days the doctor gets a report showing what bug was present and what drugs will work to kill it”.
2. Imaging (ultrasound): Dr. Hawes checks kidneys and pelvis for blockages and stones.
3. Cystoscopy: a procedure involving placing a hollow tube (cystoscope) equipped with a lens in your urethra and into your bladder. Dr. Hawes uses it to examine the lining of the urethra and bladder for bacterial biofilms, inflammation, and any anatomic problems that might cause you to retain urine.
4. Post-void residual: The post–void residual (PVR) urine test measures the amount of urine left in the bladder after urination. It could be done with an ultrasound or with a catheter.
5. Medical history: Dr. Hawes will always discuss with women known UTI risk factors: hormonal changes, constipation, and other illnesses.

Q&A With Dr. Hawes

I also asked Dr. Hawes several questions that I keep seeing discussed on the blog, here is a quick summary of our Q&A session:

IC/UTI/IBS

AV: What are several main differences in symptoms between IC/UTI/IBS that you noticed in your practice?

Dr. Hawes: If there is blood in the urine or an odor in the urine, this is usually a UTI versus IC. Otherwise, the symptoms will be exactly the same. IBS will give more GI symptoms but may have some bladder irritation.

Misdiagnosed Nonbacterial Cystitis

AV: How often do you see patients that were misdiagnosed? What is most frequent wrong Dx?

Dr. Hawes: I am often seeing patients diagnosed with recurrent UTI who have chronic nonbacterial cystitis or IC, not real UTI. This is because culture tests are not done. I see this probably half the time.

Rarely someone may have bladder cancer, causing irritative voiding symptoms like frequency, urgency, and blood.

I have a lot of success with homeopathic remedies and dietary changes for those who have UTI-like symptoms but culture tests come back without bacterial growth.

AV: Can rUTI lead to IC?

Dr. Hawes: No

Vaginal Health And UTI

AV: Do you ask women about their vaginal health? Do you treat BV and yeast infection as a part of UTI treatment?

Dr. Hawes: I treat yeast infections. I do not regularly treat BV or do vaginal cultures. I do treat vaginal dryness, pain with sex, vaginal atrophy or thinning

Anti-inflammatories and UTI

AV: What role do anti-inflammatories play in your practice for UTI treatment?

Dr. Hawes: I use Pyridium (azo) and Uribel (another methenamine based medicine) but do not use ibuprofen at all typically for symptom relief.

UTI In Kids

AV: f a teenager presents with UTI-like symptoms, and primary care offers antibiotics as the only course of action, what recommendations would you give to a parent?

Dr. Hawes:   1) Send a culture before starting antibiotics. 2) If a young woman has >2 UTIs in one year, see a urologist.

Summary

• See a urologist if you have more than two UTIs in a year
• Ask for a culture test whenever your doctor wants to prescribe antibiotics
• Homeopathy could be a solution but first, confirm your diagnosis