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Does Persistent Pain While Urinating Require A Medical Consultation Despite Taking Flomax?

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Posted on Wed, 20 Dec 2017
Question: I was seen approximately 10 days ago for difficulty in Urinating. I am a male 53 years old. The Doctor put me on Flomax and Sulfamethoxazole Trimethoprim. She did mention that there was blood in my urine. I seemed to respond to those drugs initially and the difficulty in urination went away. Both drugs were a 30 day supply. So I have continued to take them the whole time and still am. However, I am starting to have some difficulty and pain with urinating again. However, I am also weak , sweaty, and feel off, or not good. I have a follow up with the same doctor on Friday (3rd). Should I be seen before then?
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Answered by Dr. Bonnie Berger-Durnbaugh (34 minutes later)
Brief Answer:
Don't wait - go in now

Detailed Answer:
Hello XXXXXXX

Yes, I think you should be seen sooner. A kidney infection may not respond adequately to TMP/SMX and may need a different antibiotic. Symptoms of upper urinary tract infections (i.e. kidney infection, pyelonephritis) are aching or pain in the low back or flanks, nausea, sometimes fever.

I advise that you go to an urgent care clinic today and request to see a dr. (and don't accept seeing a PA or NP unless they absolutely have no MD on staff). The doctor should do an exam and do a dip urinalysis which can provide some immediate information about whether there is an infection in the urine. Then the urine should be sent to the lab for a full urinalysis as well as a culture + sensitivity. The sensitivity test shows which antibiotics a bacterial infection is most sensitive to. It can take a couple of days for this to result, and in the meantime, if the doctor thinks you have an infection, will give you an antibiotic anyway. Then when the culture and sensitivity results come back you and the doctor will know what you are dealing with and what to do (if it is an infection).

I do not recommend waiting.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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Does Persistent Pain While Urinating Require A Medical Consultation Despite Taking Flomax?

Brief Answer: Don't wait - go in now Detailed Answer: Hello XXXXXXX Yes, I think you should be seen sooner. A kidney infection may not respond adequately to TMP/SMX and may need a different antibiotic. Symptoms of upper urinary tract infections (i.e. kidney infection, pyelonephritis) are aching or pain in the low back or flanks, nausea, sometimes fever. I advise that you go to an urgent care clinic today and request to see a dr. (and don't accept seeing a PA or NP unless they absolutely have no MD on staff). The doctor should do an exam and do a dip urinalysis which can provide some immediate information about whether there is an infection in the urine. Then the urine should be sent to the lab for a full urinalysis as well as a culture + sensitivity. The sensitivity test shows which antibiotics a bacterial infection is most sensitive to. It can take a couple of days for this to result, and in the meantime, if the doctor thinks you have an infection, will give you an antibiotic anyway. Then when the culture and sensitivity results come back you and the doctor will know what you are dealing with and what to do (if it is an infection). I do not recommend waiting.