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Dr. David
Dr. David, MD
Category: Urology
Satisfied Customers: 43430
Experience:  Experienced physican in Urology
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62 years female. diabetis mellitus type 2. blood sugar

Customer Question

62 years female. diabetis mellitus type 2. blood sugar presently under controll--within 120 fasting. recurrent uti since 2014. underwent cystoscopy with urethral dilation on augist 2016. uti came back by september 1st week. pain in the abdomen, low grade fever, nausea. resistant to most antibiotics except nitroflurontine. blood in stool presently.
Submitted: 3 months ago.
Category: Urology
Expert:  Dr. David replied 3 months ago.

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Customer: replied 3 months ago.
62 years female. diabetis mellitus type 2. blood sugar presently under controll--within 120 fasting. recurrent uti since 2014. underwent cystoscopy with urethral dilation on augist 2016. uti came back by september 1st week. pain in the abdomen, low grade fever, nausea. resistant to most antibioticsexcept nitroflurontine. blood in stool presently.
Expert:  Dr. David replied 3 months ago.

you need a proper urine culture to see what bacteria is growing in your urine causing your urinary tract infection.

sometimes bladder muscle spasms can give symptoms of UTI with there not being bacteria in your urine.

this is treated with overactive bladder muscle medications.

blood in your stool can be from hemorrhoid bleeding or other causes.

at your age, you should have a colonoscopy to look at the inside of your colon.

a cystoscopy would not tell if you have over active bladder muscles

a urodynamic study is needed for this.

Customer: replied 3 months ago.
urine culture done
bacterial colony count greater than 1 lakh
ous cell 3-4
Customer: replied 3 months ago.
r u there?
Customer: replied 3 months ago.
cystocopy reveals:
grossly trabelulated bladder ; no mucosal lesion; meatal stenosis; tonic bladder neck
Expert:  Dr. David replied 3 months ago.

I don't understand your urine culture.

what bacteria grew out of the urine? they should have done antibiotic sensitivity testing on the bacteria

is it e coli or klebsiella bacteria or pseudomonas ?

Customer: replied 3 months ago.
it is ecoli
Customer: replied 3 months ago.
sensitive to amycacin and nitroflurontine
Customer: replied 3 months ago.
sorry if i got the wrong spelling
Customer: replied 3 months ago.
whole abdomen usg done on august 2016 reveals:
both kidneys normal size; no calculus; hydronephrosis or SOL in wweither kidney. Rgt kidney measure 113X45 MM; left: 106X42 MM
Expert:  Dr. David replied 3 months ago.

then your doctor should treat you with amikacin and nitrofurantoin

and you should drink more water

and you have to be careful when you wipe after bowel movements

you need to wash your hands with soap after bowel movements to prevent spread of bacteria

Customer: replied 3 months ago.
Urinary bladder post void 50 cc. no significant intraluminal lesion seen; it is anteverted and small in size; normally distended with maintained contour and normal wall thickness
Customer: replied 3 months ago.
despite those tratementbeing done, the uti still remains; the colony count i sent you is POST the treatment. i dont understand
Expert:  Dr. David replied 3 months ago.

yes, those are all normal.

Customer: replied 3 months ago.
why low grade fever?
why maroon colored stool and nausea? for the past two months?
Expert:  Dr. David replied 3 months ago.

low grade fever can be from you fighting off the urinary tract infection

or from fighting off viral infections

maroon colored stools can be from your diet, what you are eating, spices in your food, or could be from blood from hemorrhoid bleeding.

nausea can be from excessive anxiety, excessive stomach acid in your stomach.

Customer: replied 3 months ago.
the UTI remains.
please tell me what is the logical cause behind this persistant UTI. my blood sugar is under controll. i have followed urethral relieving with cather once a week; done pelvic excerxises as advised. on nitroflurontine once a day for past two months. now it has been upgraded to thrice a day. what now?
Customer: replied 3 months ago.
releiving with catheter i meant
Customer: replied 3 months ago.
the doctor told, post dilation, the problem of uti wont recur for the next 5 years.
Customer: replied 3 months ago.
any examination or course of treatment u suggest? please help. i am panicking
Expert:  Dr. David replied 3 months ago.

you are most likely introducing bacteria into your urethra with the catheter.

that is most likely what is causing your UTI.

your catheter you are using is not clean.

Customer: replied 3 months ago.
doctor, r u there?
Customer: replied 3 months ago.
shall i go for a whole abdomen CT Scan?
Expert:  Dr. David replied 3 months ago.

no, you don't need it. it will be normal

it will not show the reason for your UTI

it is from your catheter introducing bacteria into your bladder.

Customer: replied 3 months ago.
the fever ranges between 98 degree to 100 degree farenheit every evening. have been taking P650 twice a day for 1 month
Expert:  Dr. David replied 3 months ago.

are you using new sterile urethra catheters weekly?

or are you re-using an old one and washing it before use?

Customer: replied 3 months ago.
sterile catheter every time
Customer: replied 3 months ago.
hands sanitized
Customer: replied 3 months ago.
as of now what do you suggest for examination or relief medication
Expert:  Dr. David replied 3 months ago.

you may still have bacteria on your skin of your vulva area which you are introducing into your bladder when you are doing this catheterization.

you should shower and wash the vulvar area with soap and water before catheterization.

why do you have urethral stricture? do you have excessive anxiety symptoms? this can cause you to tighten up your pelvic muscles.

usually women don't have problems with urination or blockage of their urethra because they don't have a prostate gland.

Customer: replied 3 months ago.
i do have excessive anxiety symptoms
Customer: replied 3 months ago.
do i need a biopsy? i have fatty liver symptoms as well. in fact i have multiple medical problems concerning heart, liver, stomach. i have hyperallergic symptoms as well
Expert:  Dr. David replied 3 months ago.

you should see a psychotherapist to teach you biofeedback therapy to help you relax your lower pelvic muscles.

Customer: replied 3 months ago.
ok
Customer: replied 3 months ago.
but what medication do i take now to control my fever (past one month continuing) and nausea?
Expert:  Dr. David replied 3 months ago.

let me know if you have other questions.

if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you today

we only get credit for helping clients after positive feedback

you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

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http://www.justanswer.com/medical/expert-dr-david/

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Expert:  Dr. David replied 3 months ago.

you should ask your doctor for medications to help decrease your anxiety symptoms.

you should use stomach acid reducing medications to help reduce nausea.