Suggest Remedy For Persistent UTI

Posted on Thu, 3 Dec 2015

Question: hi dr in 2012-2013 I underwent chemo for ewings sarcoma.During this period little episodes of uti underwent.But major UTI episode happened in july 2015 ith ecoli and I was hospitalized since in c/s all oral antibiotic was resistant. I was given injection ertapenem for 5 days by my gp.My condition but my uroflometry was poor 10 m/sec.After 2 week I was diagnosed with pseudomonas argenusia and was given moxifloacin and feropenem.Moreover Rgu was done and it showed bladder spasm and urethral stricture,After infection was controlled I underwent cystoscopy which revealed high bladder neck and stricture.Stricture was dilated and I was given flotral 10 mg and baclofen 10 mg.Urologist was saying that I have tight pelvic floor muscle.Moreover I am having early demylating poly neuropathy as a sideeffect of vincristine chemo.Nowadays I continuously feeling urge to urinate and I am going more than 6-7 times a day.Is it ok?is treatment ok?

Answered by Dr. Dr. P. T. Patil (5 hours later)

Brief Answer:
Frequency and urgency are due to multiple factors.

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have urgency and frequency for urination .

I shall be happy if you can post me few more details to help me in making comments on your problem .
1) What is the post void urine residue reported in your ultrasound scanning report ?.

After going through all the sequence of events and report I think the urgency and frequency that you have is due to multiple factors like
1) Bladder outlet obstruction due to high bladder neck
2) Stricture of the urethra
3) Poly neuropathy due to Vincristine.

You need to continue to take along with anti muscuranic drug like Darifenacin once daily and do revision Cystoscopy after six months to see the status of stricture urethra as stricture urethra has tendency to recur again .

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (2 hours later)

Post void residue is 20 ml.Moreover cystoscopy was done last month and stricture was dilated and high bladder neck was found.Only after cystoscopy I am feeling urgency and frequency.Moreover i am taking alfuzosin and beclofen along with tryptomer and pregablin.is these medicines ok?

Answered by Dr. Dr. P. T. Patil (2 hours later)

Brief Answer:
You need to take Anti Muscuranic drug like Darifenacin for urgency.

Detailed Answer:
Hello
Thanks for follow up .
Alfuzosin is a smooth muscle relaxant that relaxes smooth muscles in bladder neck which helps to improve urine flow .You need to take Darifenacin once daily which prevents involuntary contractions of bladder and there by help to control urgency and frequency of for urination .

Tryptomer is anti depressant .You may continue these drugs as they have been prescribed by your medical oncologist .

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar