Recurrent UTI for the past 1 year

27/F/India
Blood Group: B-ve
Sugar-Blood pressure: normal-80/120
Menstrual cycle normal
Husband's BG: O +ve

* Married:May 05, 05. No prior sexual activity and only 1 instance of UTI approx 2 yrs ago. Urine tested acidic; fluid intake increased;

* Post marriage - 1st UTI/Jul 8, 05  (a month after becoming sexually active)
Symptoms: Acute burning and pain while passing urine, severe pain toward the end of  urination, urinate frequently, headache, Weakness in the legs/lower abdomen.
Drug: Norflox 400mg (1-0-1 x 5 days) ; Candid cream

* No sex for 1 and half month. 2nd Instance - after I became sexually active with husband / 15 Sep
Urine Culture Report : Bacteria : Serratia Marcescens Colony Count : >100000.
Drugs:  Oflox 200mg (1-0-1 x 10 days); Citralka (1 bottle); Buscopan (SoS)

* 3rd UTI/15 Nov
Symptoms: Same as above, no headache but heaviness in the head.
Drugs: Norflox 400mg (1-0-1 x 5 days, that is 2 tabs for 5 days); Citralka; Pyridium (SoS)

* Nov 27 reported pregnant. Routine Pregnancy Tests normal.

* Spotting a couple of times in next 1 month.
Drug: Microgest 200mg (1-0-1 x 30 days); Folvite 5 (0-0-1 x 30 days)

* Early pregnancy ultrasound scan/16 Dec
Report : Subchorionic Haemorrhage seen in the upper part of uterine cavity
Tests: Platelet count, Lupus Anti Coagulent Test, Anti Cardiolipin IGA/IGM/IGG, Blood Urea, Urine routine/culture.
Report : All Normal

* Dec 27 little irritation in the urinary area.
Urine culture Report : No growth
Drugs: Proliser syrup

* Jan 6 bleeding leading to miscarriage. Ultrasound found that after the first scan there was no growth of the foetus. DNC performed.

* Next UTI close to becoming sexually active again/Jan 12
Urine Culture Report : Klebsiella pneumoniae 50000 orgs/ml.
Drugs: Bactrim Ds (1-0-1 x 14 days); Bactrim (0-0-1 x 21 days after BactrimDs course)

* Consulted Nephrologist
Test: Ultrasound of abdomen and pelvis and Urine cultures
Ultrasound Report : Normal except "Right KIDNEY NOT found and the Left Kidney appears bulky".
Urine Culture reports : No growth.

* Nephroligist suggested follow up Renal DTPA scan to rule out urine backflow.
Report: Left kidney - normal except mildly enlarged.
Right Kidney - not found.

* No sex for 1 month, resumed sex on 4th Apr and UTI on 6th.
Urine culture Report : No growth.
Medicine prescribed: Norflox 400mg (1-0-1 x 3 days); Candid cream

* UTI/May 6 Consulted another Urologist
Drugs: Betadine solution to be applied in the genital area, morning & night and before & after sex; Bactrim Ds (1-0-1 x 10 days)

* UTI/May 29
Urine culture: No growth.
Consultation: Ruled out bacteria as cause, Suspected fungal infection.
Drugs: Metrogyl Tampoons (5 days); Betadine solution; Liquid Zole (1-0-1 x 7 days) to be applied after cleaning with betadine.

* Today slight uneasiness in the genital area, heaviness in head and weakness. No pain/irritation. Drinking > 2000cc of water/day.

* The last 3 UTIs have been around the 8th day of menstrual cycle.
Cause/cure ?

[Kevin Pho, MD]

Recurrent UTIs can be frustrating and difficult to treat.  

One option would be prophylactic antibiotics - either on a long-term basis or after sexual activity.  

Another would be a cystoscopy to evaluate for any anatomical abnormalities that would predispose you to recurrent infections.  

I would obtain another urological opinion - or discuss these options with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

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