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I have a fairly complicated case. Dark yellow, urinating…

I have a fairly...

I have a fairly complicated case

Doctor's Assistant: Any pain or burning sensation while urinating? What color is your urine?

Dark yellow, urinating frequently

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

A lot

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Answered in 1 minute by:
1/17/2018
Dr. Arun Phophalia
Category: Urology
Satisfied Customers: 39,130
Experience: MBBS MS (Surgery) Vast experience and routinely perform all urology procedures including endoscopy.
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Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Could you please give detail?

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Customer reply replied 7 months ago
My wife has had a UTI for the past year. She has been on numerous antibiotics without any improvement. She also has blood in her urine. It is cataloged as microscopic (moderate). She has had a cystoscopy and CT scan of the kindeys, both came back negative / normal.
Customer reply replied 7 months ago
Latest appointment, urine dipstick test shows nitrite as negative, but when sent out for culture comes back positive for bacteria infection. Also, latest test showed no WBC in urine.

Thanks for the additional information. I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

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Customer reply replied 7 months ago
In all tests, she continues to show blood in urine...just fyi

This is likely to be chronic or recurrent UTI.

Following approach for the chronic / recurrent urinary tract infection 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).

Was this information helpful to you? I would be glad to answer any further questions.

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Customer reply replied 7 months ago
Thank you, ***** ***** helpful

You are very welcome.

It is privilege assisting you.

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Wishing a speedy resolution for your wife.

Dr. Arun Phophalia
Category: Urology
Satisfied Customers: 39,130
Experience: MBBS MS (Surgery) Vast experience and routinely perform all urology procedures including endoscopy.
Verified
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Category: Urology
Satisfied Customers: 39,130
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Experience: MBBS MS (Surgery) Vast experience and routinely perform all urology procedures including endoscopy.

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