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Suggest Treatment For UTI After TURP

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Posted on Mon, 21 Sep 2015
Question: Question to urologist or infection diseases specialist.
I am 74 yrs old male. Couple of weeks ago had TURP surgery. Had Foley catheter in and out. Had renal retention. Developed a lot of blood clots. Then catheter was out. Developed severe UTI. Was in ER few times. Urologist was out of town. Was proscribed Levofloxacin for few days, then cephalexin, then amoxicillin, then, finally nitrofurantoin (today). Urine tests always show great number of bacteria. Progressively feel worse. Pain, burning, flank pain, sweating, dizziness, frequent painful urination. Suspect it is Candida infection. Primary care physician and urologist, ER doctors (in two months was there 8 times) have no expertize in this. Had candida some time ago. Started to take fluconazole concomitant with antibiotics. Do not know weather it will work. Have to stay in bed. Desperate
doctor
Answered by Dr. Manuel C See IV (41 minutes later)
Brief Answer:
Culture both for fungal and bacteria.

Detailed Answer:
Good Day and thank you for being with Healthcare Magic!

I am very sorry to hear that you are currently suffering from pain. Since you had multiple antibiotics already I would recommend a urine culture and sensitivity and a urine gram stain to check for bacteria and fungal elements in your urine. There is a very high likelihood of UTI occurrence after TURP and this should be treated accordingly with culture guided antibiotics.

I would suggest doing a KUB ultrasound to check for possible urinary retention and incomplete emptying of the bladder. Also after TURP some patients would complain of pain on urination and urinary urgency which is severe in some cases. An alpha blocker like tamsulosin would also help you while there is still swelling in the prostate.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manuel C See IV (9 minutes later)
Four antibiotics did not help, neither tamsulosin. Frequent urination, bad flank pain. Still, can it be fungal infection, for I had it before - thrush in mouth, bad rash in genitals, etc. I will follow yiour advice. Can fluconazole work concomitantly with antibiotics? Pain in flanks is so bad, that I need to go to ER, but tomorrow finally I have appointment with urologist. Afraid that I damaged kidneys for good.
Thank you
doctor
Answered by Dr. Manuel C See IV (11 minutes later)
Brief Answer:
Yes fluconazole can work together with antibacterial.

Detailed Answer:
Thank you for your follow up question. Yes anti fungals can be given together with antibiotics to treat fungal and bacterial infection respectively.

Pls keep hydrated and make sure that you are voiding adequate amounts of urine. If not better go to the emergency room.

Regards, Manuel C. See IV, M.D. DPBU FPUA
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Manuel C See IV

Urologist

Practicing since :2005

Answered : 909 Questions

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Suggest Treatment For UTI After TURP

Brief Answer: Culture both for fungal and bacteria. Detailed Answer: Good Day and thank you for being with Healthcare Magic! I am very sorry to hear that you are currently suffering from pain. Since you had multiple antibiotics already I would recommend a urine culture and sensitivity and a urine gram stain to check for bacteria and fungal elements in your urine. There is a very high likelihood of UTI occurrence after TURP and this should be treated accordingly with culture guided antibiotics. I would suggest doing a KUB ultrasound to check for possible urinary retention and incomplete emptying of the bladder. Also after TURP some patients would complain of pain on urination and urinary urgency which is severe in some cases. An alpha blocker like tamsulosin would also help you while there is still swelling in the prostate. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes