Urinary Tract Infections

[Chris__0__0]

    
      Re: Urinary Tract Infections
    


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Posted by HFHS-M.D. MS on February 04, 1998 at 18:02:52:

In Reply to: Urinary Tract Infections posted by Chris on February 02, 1998 at 20:41:10:
  I am a 22 year old female and I have had urinary tract/bladder infections since age 11. When I got my first UTI I was prescribed Gantrisn. Since then I have had them very frequently, as often as twice a week, which is not uncommon for me. I have seen a doctor about six different times and was denied a request to see a urologist until a couple of months ago. The doctors had told me that they knew what was wrong and prescribed me different antibiotics: Macrodantin and Sulfer-something. Both did not work. About a couple of months ago I saw a Urologist who performed a cystoscopy and found nothing wrong. He then prescribed me Macrodantin. I'm still getting UTIs all of the time. My symptoms are painful urination, a sharp pain and pressure against my bladder during sex, chills, occasional lower back pains, painful urination, and the urgency to urinate. My Urologist did a urinalysis a few times and it came back positive for a UTI, so it ruled out the possibility of being something that has the same symptoms as a UTI. I am desparate to find out what is wrong with me. I can't take it anymore. Having two UTIs a week is driving me crazy. No medication has helped.
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Dear Chris
I am very sorry you are  having such a difficult time !

  Since  your urine has grown a significant amount of bacteria in culture, I will address your problem as if you  truly suffer from UTIs (urinary tract infection).  There are other diseases which you alluded to which masquerade as a UTI.  This means you have had at least one positive urinalysis and culture obtained from a sterile catheterized urine sample.
Have you  had any xray test looking at the kidneys and bladder?  An Ultrasound or Voiding CystoUrethroGram (VCUG) or better yet an excretory urogram commonly called an IVP?  The IVP  looks  for  kidney or ureteral stones  which maybe infected and seeding your urinary tract when antibiotics are stopped.  This would be very suspicious if the very same bacteria type  kept growing out in your urine culture.  
Have you had any other abdominal surgeries or Crohn’s disease?  A small connection between the bowel and bladder or ureter can also occur and seed the bacteria to the urine.  The urine culture would probably grow  different bacteria each time. The connection can be missed easily on cystoscopy especially if there is a connection between the bowel and ureter.   A CT scan is the most sensitive test for this.
Have you been checked recently for tuberculosis , TB or ever tested positive?     If your urinalysis showed an “infection”, ( lots of white blood cells or pus)  your culture may or may not have grown bacteria if you have a rare tuberculosis urinary tract infection.  This is tested for by doing a urine culture for TB.   TB is a very slow growing organism and is  negative on routine urine culture. A TB urinary tract infection can be the first sign of TB infection of the lung  and antibiotics do not relieve the symptoms .
When you say the antibiotics “did not work”  do you mean they worked temporarily but did not you from having another UTI when you finished taking them or they never worked at all?  The antibiotics can be tested against the bacteria which grow in the urine culture to make sure the bacteria is not resistant to the prescribed antibiotic.
If your  antibiotics worked temporally, the repeat urine cultures can tell if you have been re-infected or the UTI never cleared adequately with treatment. The repeat culture between infection will be negative if you have re-infections and positive if you have recurrent UTIs.
      Some bladders take a long time to rebuild their lining to a point that it is strong enough to resist future UTIs.  The makes a point for long-term ( usually 6 months) prophylactic antibiotics once the urine is clear of infection documented by a normal urinalysis and negative urine culture.  Many women can get away if a prophylactic antibiotic taken only around the time of intercourse.  This is usually the only the time when seeding of bacteria to their urinary tract occurs and thus the antibiotic kills the bacteria  before they start an infection.    
You will always be at risk for UTIs. Remember, the goals for treating UTIs are to irradicate the infection , find and treat the source of  recurrent infections and prevent re-infection or increase the time intervals between  UTIs. Increasing your fluid intake, emptying the bladder frequently, emptying the bladder after intercourse, wiping away from the urethra (from front to back) after urine or bowel movements can all also help prevent UTIs. Good luck and hope this has helped.  
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).

Sincerely,
HFHS-M.D.  MS
*Keyword:  Urinary Tract Infections