I was born with double collecting systems on both sides of…

You would need a urine culture and a CT scan for the evaluation. A urine culture will confirm the bacteria and also ascertain the best antibiotic for its eradication. A CT scan will tell whether your kidneys have some obstructive issue due to double collecting system and is not draining properly.

Following also may be helpful;

1) An estimation of residual urine. This is done by an ultrasound examination. An ultrasound is done with full bladder. Then you are asked to void and ultrasound is repeated. If there is a residual urine amount more than 50 ml; that is considered as significant amount. An high residual urine in bladder will not let the UTI eradicated. In a high residual urine following investigations would be done;

a) CMG (cystometrography); this tells about the bladder muscle and sphincter functions. A problem in these would not let the bladder empty properly and thus the recurrent UTI.

b) Pelvic floor EMG; tells about the pelvic muscle dysfunctions and help in above.

These will need medications to improve bladder emptying.

2) Medications which alter urinary pH helps in eradicating the recurrent or chronic UTI with the antibiotics.

3) Culture for the mycobacterium; this if grown will need different kind of medication regime specifically for the mycobacterium bacteria which do not respond to the antibiotics.

4) Gynecological examination; to see for the major cystocele (bladder prolapse). This also predisposes for the recurrent UTI.

5) If above do no help the other investigation contemplated are;

a) Cystoscopy; camera exam to look for bladder diverticulum or any other abnormality.

b) MR urography (magnetic resonance urography to look for infective nidus elsewhere in the urinary tract).

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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Yes you should see a urologist for assessing the cause of UTIs.

Macrobid is an antibiotic for chronic UTI. So it does not let the bacteria grow when it is continued. Since it has stopped, UTIs are occurring again.

In a double collecting system, there is a chance of urine flow to stagnate, to slow or to reflux. All these predispose for the infection. Also recurrence of UTIs may happen if there is not complete eradication.

I do not feel, you may need another surgery. But you would need a long course of antibiotic so recurrence may be prevented.

Unfortunately it is difficult to prevent the UTIs after sex, presently. You are doing very good measures. You may take Macrobid again which should help. But the best and permanent solution would be culture of urine to exactly know the best antibiotic.

It is privilege assisting you.