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Suggest Treatment For Fever And UTI

Posted on Wed, 19 Nov 2014

Question: Hello doctor..i am 24yrs old female..i had suffered from UTI with fever when i was 1 year and 4 years old. I was treated with amikacine. Three years hence i had complaints of frequent urination with smoky urine for the next 12 years. The urine would dribble in drops. This would also accompany burning sensation at times. I would simply pass urine drop by drop sometimes for 3-4 hrs at night trying hard to void the bladder which always disturbed my sleep. At the age of 19, i got my urine culture done which showed severe infection which got treated hence with antibiotics. But after 2 months, i started having complaints of frequent urination again which continues till today..the urine shows no pus cells, is not smoky anymore but has a characteristic pungent odour. My ultrasound abdomen is normal with residual urine of around 55ml, my uroflowmetry tests are normal too with normal mri spine. But till today i sleep 3 hrs later than i actually go to bed at night because of frequent urination. The urine never leaks. I have to strain really hard to empty my bladder. The 1st sream of urine is normal but then it is followed by breaks. I have urge to urinate 24 hrs just that i try to control for 2hrs during day time as i am busy but not at all at night. I go to urinate once before lying down but within 5 mins i start feeling heavy at my pubis and then i have to get up again and this process goes on for hours. Sometimes i sit for 15 minutes to clear my bladder and get a relief from the urge but i never acheive. I really dont know what is a beautiful sleep at night. Earlier flavoxate worked on me for few months but it dosent help me anymore neither does roliten. Some say it is in my mind but i know it is not just that. Please please help sir. Thankyou.

Answered by Dr. P. T. Patil (4 hours later)

Brief Answer:
You seem to have Over Active Bladder syndrome.

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have what is called as Over Active Bladder Syndrome.

I shall be happy if you can post me few more details to help me in making comments on your problem.
1)Have you done IVP( Intra Venous Pyelography) at any time during investigations to rule out any congenital anomaly in urinary system?
2) Have you done Urodynamic study of bladder? if so what were the results?

Normally signals from the brain are sent to bladder to evacuate ladder only when it gets filled up with 200 ml of urine ,But in this condition of OAB, bladder starts contracting involuntarily even there is little quantity of urine in bladder . These contractions are very weak and not powerful enough to empty the bladder completely but cause urge to pass urine resulting in to substantial volume of residual urine remaining in your bladder causing infection.

Please get your urine culture done and take appropriate antibiotics as per culture report.

Get your Urodynamic study for bladder done to confirm the diagnosis.

Start taking Darifenacin once daily .This will help to reduce the urge to pass urine.

Hope I have answered your query. Please feel free to ask if you have more questions ,I shall be happy to address the same and help you .

Thanking you with Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (3 hours later)

Thanku so much Sir. I havent yet done the IVP and Urodynamic study of bladder which i shall get dine soon. Apart from that what is the dosage of darifenacin that i have to take..?

Sir, also i have started taking urikind syrup at noon since yesterday feeling slightly better. Can i take darifenacin along with it?

Answered by Dr. P. T. Patil (1 hour later)

Brief Answer:
Take one tablet once daily.

Detailed Answer:
Hello
Thanks for follow up . Take one tablet once daily at the same time every day . Get the tests done and post me the reports I shall be able to make comments once I go through the reports. You may take Urikind syrup with Darifenacin Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar