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What Causes Frequent Urination, Fever And Weakness?

Posted on Thu, 20 Aug 2015

Question: my grandfather is 90 yrs old. He urinates in every 30 to 15 minutes. Few days back all tests were done .
He got fever since 15 days and have become very week cant even stand on his knees plese guide .

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

Brief Answer:
Symptoms seem to be due to UTI secondary to Enlarged Prostate .

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that your grandfather has increased frequency for urination and severe weakness since couple of weeks.

All the symptoms that you have narrated are due to UTI secondary to Enlarged prostate which is common after the age of 65 years.

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Have you done his ultrasound scanning of abdomen and pelvis ?If yes what is the size of the prostate and what is the post void urine volume reported on scanning ?
2) Have you done urine culture please upload report so as to suggest proper antibiotics.
3) Have you done his renal function tests ?

Please consult qualified Urologist for clinical and digital rectal examination and get following basic
tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Serum PSA.

Please give him broad spectrum antibiotics like Cefixime along with urinary antiseptic like Nitrofurantoin twice daily and Tomsulosin once daily .Later on switch on to appropriate antibiotics as per culture report.

Get the prescription of medicines from your family Physician.

Ensure he drinks more water .To keep his urine dilute This will help to control dysuria.

Further treatment will depend upon result of these tests and final diagnosis.

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 (5 hours later)

PSA done 1.25 ng/ml
also our family physician has advised
1. Veltam plus
2. ceftas 200
3. multivitamine A to Z
4. serta
5. Alprax

But he is not able to sleep . Goes for toilet in every 15 - 20 minutes. Also he has become very week.

I m enclosing reports

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Get his ultrasound Scanning of abdomen done .

Detailed Answer:
hello
Thanks for follow up and feedback .

all the reports that you have posted are within normal limits
..
However I think you have not done his Ultrasound Scanning pf abdomen and pelvis. This will guide as regards size of the prostate and ,post void residue and whether he has chronic retention of the bladder with overflow .

Please get it done at earliest and revert back to me with report .

In the mean while continue taking medicines that he is atking now .
Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (1 hour later)

dear sir

Kindly see the report of ultrasound done

he has become very week has fever since many days please guide us

Answered by Dr. Dr. P. T. Patil (29 minutes later)

Brief Answer:
Please repeat his Ultrasound Scanning and get Urine culture done .

Detailed Answer:
Hello
Thanks for follow up .

The report of Ultrasound Scanning that you have posted was done in August 2014 which revealed Enlarged prostate .Since it is a progressive disease it is important to see the present status of Prostate size and more particular about the post void residual urine volume and back pressure changes in kidney which was revealed in his earlier report too..

The fever he has is due to infection of stagnated urine in bladder hence I suggest you to get urine culture done so as to take appropriate antibiotic as per sensitivity pattern.

Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (9 minutes later)

and what about the frequency of urination he urinates in every 30 minutes and not even sleeps at night

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

Brief Answer:
Frequency for urination is due to Enlarged Prostate and infection

Detailed Answer:
hello
Thanks for follow up .Frequency for urination is primarily due to enlarged prostate in addition to secondary infection infection.

Continue taking medications suggested earlier .

Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (24 hours later)

As i have recharged my acoount i have mailed you the report of ultrasound earlier he had prostrate of 40 gms now it is 30 gms.
kindly advice

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

Brief Answer:
He has retention of urine due to enlarged prostate .

Detailed Answer:
Hello
Thanks for uploading report of recent Ultrasound Scanning done Today which reveals Significant urine volume and he is unable to pass urine .This suggests that he has acute retention of urine due to Enlarged Prostate .

Please consult qualified Urologist at earliest and get him catheterized to drain his urine which will be left indwelling for a week . Normally we remove the catheter after a week and give the patient trial of voiding .If he fails to pass urine and develops retention of urine again he will need to be catheterized for a long time.

Looking at his age and his poor general condition he is not a fit candidate for endoscopic surgery ( TURP.)

Continue taking antibiotics and medicines prescribed by your Physician .

Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (45 minutes later)

thanks for replying..we have shown his reports to urologist. He has advised to wait for 2 days as he has advised
1) Uromax D (OD)
2) Zanocin 200
for 3 dyas
What do you say for this ?

Answered by Dr. Dr. P. T. Patil (6 hours later)

Brief Answer:
There is no harm in waiting for 2 days .

Detailed Answer:
hello
Thanks for follow up .You can certainly wait for 2 days however if condition remains same I would suggests him to get catheterized This will help him to relieve his retention and avoid his agony of going to toilet every 15 -30 minutes .

Let the catheter be indwelling for a week ..Remove the catheter after a week and give him trial of voiding .However in a worst scenario if he gets retention again hewill need to be catheterized again.

Consulting a qualified Urologist for further management will be of much help.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. P. T. Patil (33 hours later)

dear sir
after compeleting 3 days the things didnot changed.
so i went to the urlogist he prescribed cathedral to be used .
and medicines were
zanocin 200
pentanerv-nt
soliten -5

but the main problem we are facing is that after installing cathedral he again and again wants to urine in bathrum as he used to urinate. and has become very restless since we have installed what to do ?

one thing s that the urine which was stored in bladder has all come into the bag.
but he has become very rtestless and again and again he says i want to go toilet i want to goto toilet as old age i m worried

Answered by Dr. Dr. P. T. Patil (30 minutes later)

Brief Answer:
This is due to irritation of delicate Urethral Mucosa by catheter,

Detailed Answer:
Hello
Thanks for follow up.
The urge to pass urine is due to irritation of urethra due to foreign body (Catheter) and spasm of the bladder.

It takes few days to get accustomed to catheter .

.Please give him Oxybutinine (Cystran ) twice daily along with medicines that he has been prescribed ,if it does not work switch on to Darifenacin once daily keeping in mind that he may get constipation after taking Darifenacin.

Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (25 hours later)

Dear Sir
We installed cathedral but he became so restless and started saying i want to go to toilet and urinate i said there is cathedral but then also he became so restless that i had to remove it.
But urine approx 500 ml was there in that bag.
But still the urine is already came out then why he keep saying i want to urinate i want to urinate every 30 mins.
Also he didnt sleeep whole night and was very disturbed and restless and keep on going to the toilet but urine came only once or twice
Also today in the morning his bp was 100/60 and his hands are shivering since morning...please answer

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

Brief Answer:
Read detail answer below ..

Detailed Answer:
Hello
Thanks for follow up.
To empty the bladder is our prime objective .

Looking at his age I would suggest to put the catheter via supra pubic rout (SPC) where catheter is put directly into bladder from the abdominal wall just above the pubic bone.

This will avoid irritation of urethra that he has with catheter passed through penis.

This catheter can be kept for life long and helps to resolve all the symptoms like retention,infection etc

Consult your Urologist and discuss with him about putting SPC.

Thanks and Regards.
Dr.Patil.

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