Hi, I'm a 27-year old male, and totally new to this board. I've had a condition from as long as I remember where I am not able to void completely the bladder voluntarily. According to my parents, this was noticed at around the age of 3, due to having recurrent urinary tract infections. Being a male, this isn't normally common, and this made the family doctor look into it further. Appartly, it was concluded that I have some impairment in the bladder which does not allow me to completely void my bladder. I can void bladder, but not completely till its empty. When I was younger and before this was discovered, due to this urinary retention, I was having urine reflux up, and as a side-problem, the kidneys enlarged (Kidney Hydronephrosis). Kidney size is currently roughly around 14 - 15cm in size, with the left kidney being bigger than the right. (as told by my ultrasound doctor). Based on ultrasounds, this enlargement has relatively stopped since I've been doing CISC. Due to not being able to void completely, I have to perform clean intermittent self catheterisation (CISC) 5 - 6 times a day. This was just to give an overview of my condition, my two main issues being below.
Everything was relatively OK apart from the cathethers, but for the past 3 - 4 years I've been having a LOT of urinary tract infections. I know that cathethers can be a cause for UTIs, but I don't think at this frequency. I've went to a hospital to monitor my technique, and they told me that it is very good. I use alcohol hand rub for my hands prior to performing the catheterisation, and use an individually wrapped chlorhexidine/alcohol swap to clean the tip of the penis / urethra. I also never touch the cathether with my hands anywhere which is going to be inserted, to make sure that I don't transfer any bacteria. I am currently using Lofric hydrophillic catheters, 14FR.
Last year, around Nov 2012 I undergone a rigid cystoscopy. After this was done I experienced almost 9 months of being infection-free. I was also on phropylaxis - Augmentin 250mg (x1) daily. No one could explain why I didn't experience any infection after the cystoscopy. Co-incidentally, I had also done 2 other 'soft' cystoscopies some years ago and both were followed by 6 - 9 months of being infection free. No link between them was ever found or even researched I think. Around June 2013, my first infection after the cystoscopy developed. To make it even worse I did a urine-test and the bacteria came out to be a multi-drug resistant form of 'Klebsiella Pneumonia', called 'Klebisella Pneumonia Carbapenemase-producer'. This was resistant to all forms of antibiotics available locally in pharmacies and by doctors, and I was told that I need to be admitted to hospital for a week to give me hospital-grade antibiotics. I have been admitted in hopsital in August 2013, and treated for it and urine was clear. A few days after I got discharged, I got once again the same infection. My consultant told me that until I have high bouts of fever, we should just leave it be. Around late Sep 2013 / Oct 2013, I was feeling quite bad with high fever, and was re-admitted back in hospital in Nov 2013 for IV antibiotics. The UTI was treated, and I got discharged. After about 2 weeks, I got re-infected with yet again the same bacteria. Strangely, this time round it was resistant to most antibiotics, but was sensitive to Septrin, a relatively common antibiotic. I was given a course of Septrin for 10 days, and again the UTI was treated. After 4 days, I got yet again the same bacteria, this time round resistant to most antibiotics, even Septrin and even the antibiotics I was given during my hospital stay. Again, I was told that until I feel very bad, I should leave it be because the antibiotics are very taxing on the body and are doing more harm than good.
My main issue is that the doctors that treated me never tried to discuss with me or look into WHY I am getting these infections. It is useless treating them, to just get another infection a few days later. I live in Malta, and where I live there are only a few Urologists. I feel that they are not trying to do their best, and have been left completely helpless in this situation.
I have tried doing some research on the internet on the topic, but I find loads of information and tried a lot of different things like cranberry supplements, uva ursi, herbs, probiotics, and nothing seems to help. I have a very active social life and love to go out and partying. I was never consulted on whether anything from my lifestyle could effect this. I feel completely lost in this, and would like any suggestions what I should try to maybe find out the root cause of these infections.