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Repeated UTI - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Urinary and Bladder Problems
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3560 Questions

User :   Hi, I've had nearly back to back uti's since treated for chlamydia in sept
User :   I just went to the gyno and waiting on results and i have an appt with a urologist in 2 weeks, but i feel another one coming on and i've done everything!
Doctor :   Hi
Doctor :  
Let me read it
User :   i cut out alcohol, spicy foods, abstained from sexual activity, vitamins and herbs such as vitamin c, cranberry extracts, acidophilus, garlic tablets
Doctor :  
Repeated the UTI is something to be evaluated thoroughly
Doctor :  
Good that you are on top of all the measures to cut the next infection
Doctor :  
What is your age?
User :   27
Doctor :  
How many episodes yet?
User :   i've NEVER had any issues until chlamydia, i've had 5
Doctor :  
When did you start the above measures?
User :   a few weeks ago
User :   2 weeks
Doctor :   Was all the episodes confirmed to be UTI by Urine test by doctor
User :   a few yes, but some i went to a clinic and they just do the dips
Doctor :   You have to be on prolonged course of antibiotic with low dose too.

Doctor :  
Are you taking enough water?
User :   i have read that, so should i bring this up with the urologist?
Doctor :  
which is very important
User :   yes! i drink water all day, it's all i drink anymore bc i'm too scared to drink anything else
Doctor :  
You can start on other alternative measures like Cranberry juice
User :   i take the extracts
Doctor :   Yes you have to bring the prophylactic dose of antibiotic with the Urologist

Doctor :  
and you should also need a review of the genital tract
Doctor :  
with Ultrasound
User :   i've had an ultrasound
Doctor :  
Some UT abnormalities should be checked

User :   they detected a cyst on my ovary and when i went to the gyno he did a pap smear and also prescribed me azithromycin? and cipro just one dose of each on seperate days
Doctor :   Ok
Doctor :  
Fine
User :   he prescribed the azithro bc he said that typically they treat gonnorhea along with chlamydia and i was only treated with the doxycycline for 14 days
User :   but this was wed and i felt better for a few days and now the dull ache in my ut is back
Doctor :  
Do you have back pain also?
User :   i just feel like i've taken every precaution to no avail, and i still have another 2 weeks until i see the uro
User :   some yes, i also workout, but it just feels sore sometimes but it's not an aching pain
Doctor :  
The low dose antibiotic course I was mentioning can be given by any Doctor for that matter even a Family practitioner if you get an appnt with him / her soon. You may ask about it
Doctor :  
When you see the Urologist he may ask for CT Scan / IVP first
Doctor :  
Then if needed Cystoscopy
User :   for how long? i've read it can be taken for up to 6 months
Doctor :  
I cannot say exact duration, it depends on individual to individual
User :   what are the typical antibiotics
Doctor :  
Make sure those antibiotics you were taking are not nullified ( no effect) because of other medicines that you might be taking.
User :   well i've taken cipro and bactrim and have went back for another urinalysis on both after treatment and i was negative, but it comes back
Doctor :   Yes
Doctor :  
I understood that point
Doctor :  
About one out of every five women who get a UTI will get another one. Some women get three or more UTIs a year.
Doctor :   High Blood sugar levels are to be tested.
User :   i just don't understand why, i never had any issues like this until after i had chlamydia
Doctor :  
Urinary tract problems are to be tested with IVP or CT Scan
User :   okay
Doctor :   Let me help you in other important things
User :   is this common after an std like chlamydia? i have been on some health forums and i do see others with the same issue
User :   okay
Doctor :  
Urinate frequently and go when you first feel the urge. Bacteria can grow when urine stays in the bladder too long.

Doctor :   Urinate shortly after sex. This can flush away bacteria that might have entered your urethra during sex. Drinking a glass of water will also help.
Doctor :   After using the toilet, always wipe from front to back, especially after a bowel movement.
Doctor :   Wear cotton underwear and loose-fitting clothes so that air can keep the area dry.
Doctor :   Avoid tight fitting jeans and nylon underwear, which trap moisture and can help bacteria grow.
Doctor :   Do you use Birth control methods?
User :   condoms, but i haven't had sex in a few weeks
Doctor :  
ok
Doctor :  
Take Vitamin C supplements
User :   i do, i have for a few weeks
Doctor :  
Ok
User :   what do you know about d-mannose? that has popped up as an alternative treatments and in the forums it seems to work for some people
Doctor :  
Did you understand the intructions I gave you?
User :   yes i did, i follow all those
Doctor :   Ok
Doctor :   Since you have used Cipro and Bactrim which are common drugs for UTI

Doctor :  
you may now need a Urine culture to determine the most sensitive antibiotic
Doctor :  
urine is cultured for 3 days, and the bugs are identified, and the drug sensitivities are listed so your doctor can treat you aith an appropriate antibiotic.
Doctor :   The low dose antibiotic is put for long term
User :   so would i be treated with the strong dose of antibiotic first and then the low dose?
Doctor :   For the current episode the strong dose ( after culture ) and low dose to prevent the future episodes.

Doctor :  
Some doctors give patients who get frequent UTIs a supply of antibiotics to be taken at the first sign of infection.
User :   okay, and is it a good idea to try and gather all my medical records of treatment to the urologist?
Doctor :   Make sure you understand and follow the instructions your doctor gives you.
Doctor :   That is brilliant idea too
Doctor :  
In fact one should so that he does not put the same treatment
Doctor :   *do that

User :   okay, i have been pretty good about keeping track of everything but i want to make sure that he listens to me and doesn't try to rattle off some treatment
Doctor :   The best way is to note down all the points in a paper and all the questions too and ask him / her all about
Doctor :  
This is helpful as you do not miss any of them
Doctor :  
and same time you can note the answers against
User :   i have kept note of my symtoms, and i also have a book that has a list of questions and symptoms to fill out
Doctor :   Wonderful

Doctor :  
Do you have frequency and urgency
User :   i am prepared but the issue is getting through all these uti's until then,
User :   yes
Doctor :  
of the urine?
Doctor :  
Do you have frequency and urgency of the urine?
User :   yes i do
Doctor :   Did you have a pregnancy ever?
User :   no
Doctor :  
ok
Doctor :  
I was wondering if you have pelvic floor muscle weakness too that is causing the repeat infection
Doctor :  
It is also possible that you are having UTI symptoms related to musculoskeletal issues
User :   what would that be?
Doctor :  
Urgency and frequency point towards that but there is no risk factor pointing towards pelvic floor muscle weakness as you never had a pregnancy and vaginal deliver
User :   okay
Doctor :  
moreover it needs physical examination of the area to say if you really have a weak pelvic floor
User :   i had only had one uti which was 3 or 4 years ago, this all started when i was infected with chlamydia
Doctor :   Chlamydia is not a serious bacteria to cause major problems it can be easily treated

Doctor :   I was thinking in other perspective why is there repeated infection
User :   okay, my family doctor suspected maybe my immune system had been weakened by the infection and antibiotics
Doctor :  
Ok
Doctor :   Then did he not give you a long course of antibiotic to help you in overcoming the current problem

Doctor :  
Please give me a minute
User :   okay
Doctor :   I suggest you to get an evaluation by Urologist, if he feels tests to determine some Urinary tract abnormality
User :   okay
Doctor :  
Till then you have to take symptomatic treatment and the measures that I hve told you
User :   so i should go ahead and see a doctor before then
Doctor :  
As far as your FP opinion is concerned, we cannot rule that out but still the treatment remains the same
User :   okay
Doctor :  
Is there anything else I can help you with?
User :   no, you seemed to answer most of my questions
Doctor :  
If some left you can get back to me
Doctor :  
anytime 24/7
Doctor :  
Please fill the feedback form say done when done.
Doctor :   Thanks for consulting me. Hope you get well soon.
User :   thank you
User :   done
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