How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. David Your Own Question
Dr. David
Dr. David, MD
Category: Urology
Satisfied Customers: 46943
Experience:  Experienced physican in Urology
41363181
Type Your Urology Question Here...
Dr. David is online now
A new question is answered every 9 seconds

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: 1 year ago.
Category: Urology
Expert:  Dr. David replied 1 year ago.

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

Customer: replied 1 year 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 1 year 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 1 year ago.
urine culture done
bacterial colony count greater than 1 lakh
ous cell 3-4
Customer: replied 1 year ago.
r u there?
Customer: replied 1 year ago.
cystocopy reveals:
grossly trabelulated bladder ; no mucosal lesion; meatal stenosis; tonic bladder neck
Expert:  Dr. David replied 1 year 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 1 year ago.
it is ecoli
Customer: replied 1 year ago.
sensitive to amycacin and nitroflurontine
Customer: replied 1 year ago.
sorry if i got the wrong spelling
Customer: replied 1 year 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 1 year 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 1 year 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 1 year 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 1 year ago.

yes, those are all normal.

Customer: replied 1 year ago.
why low grade fever?
why maroon colored stool and nausea? for the past two months?
Expert:  Dr. David replied 1 year 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 1 year 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 1 year ago.
releiving with catheter i meant
Customer: replied 1 year ago.
the doctor told, post dilation, the problem of uti wont recur for the next 5 years.
Customer: replied 1 year ago.
any examination or course of treatment u suggest? please help. i am panicking
Expert:  Dr. David replied 1 year 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 1 year ago.
doctor, r u there?
Customer: replied 1 year ago.
shall i go for a whole abdomen CT Scan?
Expert:  Dr. David replied 1 year 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 1 year 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 1 year ago.

are you using new sterile urethra catheters weekly?

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

Customer: replied 1 year ago.
sterile catheter every time
Customer: replied 1 year ago.
hands sanitized
Customer: replied 1 year ago.
as of now what do you suggest for examination or relief medication
Expert:  Dr. David replied 1 year 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 1 year ago.
i do have excessive anxiety symptoms
Customer: replied 1 year 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 1 year ago.

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

Customer: replied 1 year ago.
ok
Customer: replied 1 year ago.
but what medication do i take now to control my fever (past one month continuing) and nausea?
Expert:  Dr. David replied 1 year 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

here is my website if you need to reach me:

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

Thanks for using JustAnswers.com

Expert:  Dr. David replied 1 year 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.