Brief Answer:
Nothing to worry, however routine and timely follow-up to continue..

Detailed Answer:
Hello XXXX , Welcome to HCM,

I've gone through your query and understand your concern..

Yes, I've reviewed all of your reports and good news is they are essentially within normal limits..

Occasional epithelial cells are normal findings in urine analysis .. Same goes for occasional Gram Negative Bacilli in urine culture(gram negative bacilli is a commensal of our urinary tract )..

Now if these commensal become active and their colony count increases to a certain level (varies from organism to organism) , then that becomes a cause for concern..

Once again , no pus cells are the way it's supposed to be, so you can relax, there's no urinary tract infection..

Can you please tell me why all of these reports were done (is it routinely basis or due to any particular reason) ?

Take Care
Regards

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Brief Answer:
Follow the Advises as below..

Detailed Answer:
Dear Thiru, Welcome Back,

Thanks for following up with all those details.. Now I can understand that 3 years must be really stressful and frustrating time period for both of you , so I won't take any longer duration and get straight to the point here..

I've reviewed all those details you had previously last year with the fellow Gynecologist and it seems that after a while you lost follow-up with her(June'15)..

So I'd like to know have you done all those tests as already mentioned as they are really important to narrow down your problem..

Secondly, "Frequent urination, abdominal pain, pain while urination, Semen early discharge while Intercourse" - in absence of urinary infection and since you've checked your STD panel also, it can even be prostatitis , for which there is a need to get the Prostatic secretions checked (routine microscopy as well as Culture & Sensitivity )..

At the same time you need to get to a Urologist/Andrologist to get yourself thoroughly checked and physically evaluated for any element of Premature Ejaculation as well as residual infection any where in the urogenital tract (at the same time there may be a need for USG-KUB+Prostate) to look for any residual abnormalities inside..

Since you've already mentioned that your Semen analysis was within normal range then there's nothing to panic.. But at the same time your wife is also needed to get tested for any residual vaginal infection - for which you need to take her to a Gynecologist to get a thorough physical check-up along with Colposcopy and USG of her Uro-genital tract also followed by Laparoscopy to look for any undetected structural abnormality .. Once again a follicular monitoring may be be needed if the gynecologist feels so after the clinical evaluation..

You did a good job by getting yourself tested for those STD panels as they are the primary culprit in lot of cases.. Also congratulation on stopping alcohol as it's another offending agent..

Also discuss with the Urologist and the Gynecologist (Only when you'll visit them physically), if there's any chance of Tuberculosis of any part of the urogenital tract, which usually gets detected after a laparoscopy and histopathological examination of the urogenital tract..

So the first point is to focus on finding the exact cause which is creating all these trouble and then to treat it accordingly and only after that goes successfully, there comes the part for baby planning..

Both of you are still pretty young (I believe your wife must be under 35 yr too), so chances are pretty good..

But don't delay any more and get diagnosed at first that what is the culprit here..

If everything comes back within normal range , then you can even discuss with the Urologist and / Gynecologist to get a proper referral to Infertility specialist also (to decide upon any IUI or several other procedures available now a days to conceive)..

Time is the key here, I hope I've clarified your concern in a simpler way, now just get on to it..

Let me know how everything goes and don't loose hope and don't jump steps, you'll be fine..

My Best Wishes..
Kind Regards

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