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Suggest remedies for recurring UTI

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Posted on Sat, 7 May 2016
Question: Hi, I've taked to you on a few other occasions, Dr. Magnat You were very helpful. Since I last talked to you, I had yet another bladder infection, treated with ampicillin. I have been off the ampicillin for two weeks. The doctor said to do a repeat urinalysis at the lab which I just got back. This is the forth infection since XXXXXXX This XXXXXXX came back with very small amount of white cells which my doctor said was meaningless. He didn't think it needed to be cultured even though the lab would have, I assume, for any white cells. They said it was protocol but that it was very few and I should trust my doctor. So they're not culturing it. But I'm still worried. I really hope it's not still there. I also don't want to keep taking antibiotics. I still always have some irritation the vaginal /urethral area which I'm told is due to post menopause. I'm using estriol cream. I've seen a gynecologist who agreed with that treatment. I've also had complete blood work. All was fine. Kidneys good. Fasting blood sugar was 100 but I was super stressed. A1c is only 4.0. Doctor thinks that's terrific. Hemoglobin 15.6 which he also loves. I'm just worried that there is still infection. Do I trust my doctor and just relax? I'mso confused. Thanks for hyour help. I hope you have access to the other questions you answered so this all makes sense. Thankyou
doctor
Answered by Dr. Matthew J. Mangat (1 hour later)
Brief Answer:
Pink of health.

Detailed Answer:
Hi XXXXXXX and welcome to HCM,
Hope you're relaxed now.

Your reports show, you're in the pink of health.
Excellent. Try to maintain this level of health forever.

You must be following my few directions like :
1. Drink 8-10 glasses fluids daily.
2. Exercise 20-30 minutes daily.
3. Engage in meditation,yoga or music therapy.
Some even join laughter clubs and find great relief.
It's up to you really.
Always start antibiotics,only after an urine culture sample is given.

Good to know you're fine. God bless and take care.

Dr.Matthew J. Mangat.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat (1 hour later)
So do you agree with my doctor about no need for culture and that just a few wbc's are insignificant? His nurse said he said there was nothing on the urinalysis (including microscopic) that warrants culture. He said no bacteria to culture.But I have had alot of infections and I don't want to keep taking antibiotics. I am drinking alot of water and taking cranberry tabs and D-mannose powder in water. I also take good probiotic and use estriol bio identical estriol vaginally as well as bio identical tried estrogen and progesterone topical cream.
However, I still have irritation around the vaginal and urethra area and feel as if my urethra kind of cramps and tingles when I have to urinate. Does this sound abnormal? I do exercise almost every day and try and do 10000 steps as well. So I'm trying to do what I need to. Anyway.... Thanks for the input.

Also, I seem to urinate a little more often and usually have to go once, sometimes twice, at night. Before these infections I could go all night. It doesn't wake me but if I wake-up, I may need to go atleast one time. However, I am hyper focused on it so that probably contributes atleast somewhat.
doctor
Answered by Dr. Matthew J. Mangat (5 hours later)
Brief Answer:
No need for urine culture.

Detailed Answer:
Hi XXXXXXX

Your urinalysis report, doesn't indicate need for urine culture.

Keep up your habit of drinking about 10 glasses fluids daily.
Exercising with 1000 steps daily is strenuous at your age.
Just do them for 20-30 minutes daily.

Applying estrogen cream at bedtime, is sufficient in majority, with your symptoms.

Once you've taken a course of antibiotics,try not to think about UTI.

Wish you good health.

Dr.Matthew J. Mangat.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat (17 minutes later)
So few wbc is normal? And what of the other symptoms I mentioned, is that all normal as well?
doctor
Answered by Dr. Matthew J. Mangat (15 minutes later)
Brief Answer:
Few wbc's are normal in urine. Other symptoms aren't significant.

Detailed Answer:
Hi XXXXXXX
XXXXXXX just relax and listen to some soothing music.
You're in good health at present.

Few wbc's don't mean infection in urine.

Your other symptoms aren't significant at all.
The other symptoms're common in women your age,and don't require medication.

You should try meditation for 20 minutes daily.
It really helps in majority of patients.

Wish you good health.

Dr.Matthew J. Mangat.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat (5 hours later)
I guess I'm just confused that the lab thought there was reason to send it out but the doctor said no so they didn't. Are labs just required to send out things that don't really need to be? That's what worries me.
doctor
Answered by Dr. Matthew J. Mangat (13 minutes later)
Brief Answer:
Forget the labs.

Detailed Answer:
Hi XXXXXXX XXXXXXX forget the labs.
You're in good health.

Maintain the routine, you're following at present.
You should remain in good health.
Don't exercise more than half hour daily.

Take time to walk in the garden,or pursue some other hobby.
If you're a member of some women's club,keep engaged there.

It'll be a good distraction.
Hope you keep away from doctors,as long as possible.
You're welcome to share your anxiety with me anytime.

Dr.Matthew J. Mangat.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat (19 minutes later)
Clarification on exercise, I exercise about 35 min then stretch. The 10000 steps are just including the exercise and adding enough movement throughout the day to register 10000 on my fitbit monitor. Since doing that my cholesterol is 179, hdl 71 ldl 97. Hdl was much lower before. Ratios improved rather significantly
doctor
Answered by Dr. Matthew J. Mangat (43 minutes later)
Brief Answer:
Excellent lipid profile.

Detailed Answer:
Hi XXXXXXX
XXXXXXX your lipid profile is excellent.
HDL is the good cholesterol,which should be above 50.
LDL and TGL(triglycerides) and VLDL, are the bad cholesterol.
LDL should be below 100.
So, available reports show a good control.
Total cholesterol, also is normally done,but some reports of a profile, are missing.
Anyway, you don't need to bother.

You're exercising more than needed.
20-30 minutes daily is excellent routine.
You must be taking some Atorvastatin tablets.

Maintain your routine.
Dr.Matthew J. Mangat.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat (40 minutes later)
Do you mean statin drugs? No I'm not taking anything like that. Don't think I would either. Diet and exercise. My lipids were never bad just not as good as now.


I just went to the doctor and he explained the actual report to me. The wbc's were 6-10. The ref range is 0-10
No bacteria, no rbc's, no nitrates. Color was clear, straw. Specific gravity was at the low end of normal so urine was fairly diluted. Would that dilution mean the wbc's were higher if it hadn't been so diluted? My doctor thinks it's just the inflammation and no infection. He said we could repeatin a week or two and of it doesn't get worse then forget it. I do have irritation around the urethra and outer vaginal area which the gyn confirmed. Would that cause some wbc's from that irritation locally to get in the urine. My doctor said that makes sense but he wasn't sure, that only a urologist could answer that for sure. Also there was a small amount of yeast. He didn't care about that either. What do you think of all that?

Excuse me, the ref range on wbc is 0-5 so I was over.
doctor
Answered by Dr. Matthew J. Mangat (9 hours later)
Brief Answer:
No rigid protocol in treatment.

Detailed Answer:
Hi XXXXXXX

As clinicians,we do interpret the reports with some flexibility.
As long as you're not having any other significant symptoms,you don't need to worry.

Enjoy life and relax.

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

Urologist

Practicing since :1981

Answered : 1898 Questions

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Suggest remedies for recurring UTI

Brief Answer: Pink of health. Detailed Answer: Hi XXXXXXX and welcome to HCM, Hope you're relaxed now. Your reports show, you're in the pink of health. Excellent. Try to maintain this level of health forever. You must be following my few directions like : 1. Drink 8-10 glasses fluids daily. 2. Exercise 20-30 minutes daily. 3. Engage in meditation,yoga or music therapy. Some even join laughter clubs and find great relief. It's up to you really. Always start antibiotics,only after an urine culture sample is given. Good to know you're fine. God bless and take care. Dr.Matthew J. Mangat.