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Urology (Expert Forum)
Recurrent UTI for the past 1 year
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Recurrent UTI for the past 1 year
by tinks30, Jun 04, 2006 12:00AM
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 ?
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 ?
Doctor's Answer
by Kevin Pho, MD, Jun 05, 2006 12:00AM
, Jun 05, 2006 12:00AM
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_
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_
Member Comments (3)
by Thuney, Jun 07, 2006 12:00AM
To: Urinary Tract Infections
0
by jakesma, Jun 14, 2006 12:00AM
To: Urinary Tract Infections
0
by Thuney, Jun 14, 2006 12:00AM
To: Urinary Tract Infections
0
by jakesma, Jun 15, 2006 12:00AM
To: Urinary Tract Infections
0
by runaround, Jun 19, 2006 12:00AM
To: Urinary Tract Infections
0