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Suggest Treatment For Recurring UTI In A 72 Year Old

Posted on Sat, 12 Sep 2015

Question: My mother 72 years has been diagnosed with frequent presence of E COLLI in urine culture test since last 6 years with severe paun , she may be suffering from UTI but inspite of many consultancy with doctors the problem still persists frequently. In recent treatment she has given mikastar injection course, ambikacine injection etc. after that frequent stool started. In USound TEst Report 150 ml urine remains in bladder after urination. Now dr. Is prescribing TROPAN 5 mg .
Kindly suggest for suitable treatment of my mother.

Answered by Dr. Dr. P. T. Patil (42 minutes later)

Brief Answer:
Her episodes of UTI are secondary to Post Menopausal Urethral Stenos

Detailed Answer:
Hello
Thanks for query ,Based on the facts that you have posted I would state that your mother gets repeated episodes of UTI due to what is called as Post Menopausal Urethral Stenosis,

After menopause in females there is generalized atrophy of genital organs which involved urethral passage too.This narrowing of the urethra results into incomplete emptying of the bladder during micturition causing some amount of urine to remain in bladder what is called as residual urine .This residual urine is the source of getting repeated episodes of urine .(This is being confirmed in your mother on Ultrasound Scan report).

In such cases taking multiple courses of antibiotics does not resolve the primary cause that is Urethral Stenosis .

I normally do endoscopic calibration of urethra followed by self catheterization at home for 3-4 months which has helped most of my patients .This widened urethral passage helps to empty bladder completely and prevent UTI.

Please discuss this modality of treatment with your Urologist . I am sure it will resolve her problem .

Hope I have answered your query .Please feel free if you have more questions I shall be happy to help you .

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

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

Sir, Further to my previous consultancy with you regarding my mother problem of reccurrent UTI ( E-COLLI presence) with severe pain creating so much of anxiety and scarring behaviour . One fact i want to mention that She underwent a apendecitis surgery in 1991. 2 years back she underwent Cystoscopy. 15 days back UTI found has been treated by doctors using Antibiotics. Some reporta i m enclosing for ur reference. But after that she is suffering from frequent stool( initially 8 times , now it is 3,4 times in a day), severe anxiety and scarring nature. She dnt have any heart problem , blood sugar. 1mnths back Urine retention in bladder was 18 ml, but in last 10 days two reports it is 90 ml and 140 ml respectively. Now she ia at home but stomach is upset. We are fully confused about the correct treatment.Is this frequent case of stool is result of long course of antibiotic ? Sir kindly give suitable suggestion please.

Answered by Dr. Dr. P. T. Patil (7 hours later)

Brief Answer:
It could be due to drug induced Gastro Enteritis0

Detailed Answer:
Hello
Thanks for follow up.Her problem of having loose motions could be due to drug induced Gastro Enteritis due to prolonged use of antibiotics.

As regards her UTI her recent USG scan shows significant residual urine of 220 ml .which is the basic cause of she getting UTI frequently .

You can discuss the modality of treatment with your Urologist which I have suggested in my reply earlier .

Thanks and Regards.
Dr.Patil.

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