Question Title: Chronic Urinary Tract Infections

Samantha who is 7 years old has suffered with repeated UTI's for three years. For the last three months she has begun to have blood in her urine. Recently she has begun to have incontinent problems.
In the last year they have become more severe and painful. She has under gone repeated test which always come up negitive. .
Tests include, renal sonogram, voiding cystourethrogram, ultrasound of kidney and bladder and a cystogram.
Medications she has taken include: bactrum, keflex, Ditropan, Nitrofurantion, Oxybutyin, phenazopyridine and macrodantin.
Recently her urologist told us that for some reason her bladder was not formed right and that she would have to stay on the macrodantin at least until she reached puberty and possibly the rest of her life.
Some of the medication seems to help for a day or so and then she begins to complain again. At times she has gone a week without discomfort but then begins to have problems again even when she is still on the medication.

Do you think the urologist is missing something? This is an everyday problem and we donot know what to do for our daughter at this point. Any suggestions you have would be a great help to us.
Thank-you cheryl

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Dear Cheryl
Thanks for your questions.
It sounds like your urologist has things pretty much covered with the appropriate test , antibiotics, anticholinergics etc. If her urine cultures had always come back negative for infection a consideration of interstitial cystitis diagnosis maybe not too far fetched . Interstitial cystitis is a poorly understood inflammatory disease of the bladder which is almost unheard of in the pediatric population.
With regards to her bowel movements, constipation can exacerbate UTI’s and incontinence. It is important for her to have a bowel movement daily. This can be difficult to accomplish because Ditropan is constipating. Diet high in fiber can help if this is a problem as well as fluids. Once the cycle of incontinence, UTIs and constipation is broken , patients can usually be managed with prophylactic antibiotics.
This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. The Henry Ford Hospital Department of Urology has experience in the evaluation and treatment of problems such as you describe. We would be most interested in helping you. You can reach us through our toll-free number (1-800-653-6568). We can also arrange local accommodations through this number if this is your need. Please bring any x-rays (not just the reports) as well as any physicians’ notes and lab test results that you may be able to obtain. These will help us greatly.
Sincerely;
HFHS-M.D. MS
* Keyword: recurrent UTIs

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