Smoking and dysplasia
You are correct that smoking is associated with dysplasia. Stopping smoking will help your body's immune system heal over the dysplasia cells.
There are several things associated with pain in the entrance area of the vagina. Vulvar vestibulitis is one of them. It has a characteristic area of pain distribution and should be easy to diagnose but it is extremely difficult to treat.
Retin-A has been used but I'm not aware that it is very sucessful. Sometimes it is treated with surgical excision.
Urethral versus vaginal discharge
How would one be tested to see whether or not a discharge was vaginal or from the urethra?
On vaginal exam a speculum is used to look into the vagina to see a cervical discharge or a vaginal discharge. After the speculum exam, a finger is used to press on the anterior vaginal wall under the urethra and "milk out" a discharge or secretions.
Can an gynecologist test for it or does a urologist have to test for it?
What color is a urethral discharge? Is it clear, white or yellow?
Normally there is no discharge present from the urethra. If there is discharge expressed from the urethra, it can be clear, white, bloody or brown (indicates small amount of blood).
What causes a urethral discharge?
Infection of the Skene's glands of the urethra, a urethritis or bladder infection, gonorrhea or chlamydia infection, polyps, just over active Skene's glands, a urethral diverticulum, urethral prolapse, and cancer of the urethra come immediately to mind.
I do not have burning or itching. The fluid is sometimes clear and sometimes rarely yellow. I have been tested for STD's the last 3 years and they always come up negative. Because I have no burning or itching pain I usually don't seek medical care. Can birth control pills cause a urethral discharge?
Yes. Sometimes they can cause the Skene's urethral glands to just over produce mucous.
There is no blood with the discharge. Sometimes rarely, I get a brownish discharge.
If the brownish discharge is from the urethra, it implies a small amount of old blood.
Would you know the cost of a test for urethral discharge? There is no foul odor with this discharge. Please advise on what doctor I should seek a test from.
It sounds as if you have already had a exam in which the discharge can be expressed from the urethra. Once that is done and cultures of the discharge are taken, the next step is to rule out any mechanical causes such as polyps or diverticula in the urethra.
This needs to be looked at by urethrocystoscopy, an office procedure in which a scope is placed in the urethra and bladder. It is usually performed by a urologist or urogynecologist. Cost is in the $200-300 range plus office visit for initial assessment. Usually covered by insurance.
Have they yet made a home test to test for yeast/urethral discharge?
No. I know there is a strip test out on the market which you can get over the counter for urinary tract infection.