Suggest treatment for UTI post urinary catheterization?

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Posted on Thu, 18 Jun 2015 in Urinary and Bladder Problems
Question: I was catheterized four days ago since I couldn't pass my urine. The pain was gone once the urine was released. I am still catheterized. Pain returned in my abodomen after 48 hours. I was then diagnosed two days ago with a UTI. My testicles are swollen. I am taking pain medication (Tramadol) 50 mg every six hours and a mild antibiotic( Ciprofloxacin) 500mg every 12 hours. Any suggestions as it is somewhat painful to walk.
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Answered by Dr. Saddiq Ulabidin 2 hours later
Brief Answer:
Nonrepsonding UTI with catheter infection or complication needs Urologist

Detailed Answer:
Hello,

Welcome to Health Care Magic.

Thanks for writing.

I am Dr.Saddiq ul Abidin. I have read your question completely, I understand your concern and will try to help you in best way possible.

The Kind of symptoms you have shared are suggesting a possibility of a condition called, Benign Prostatic Hyperplasia (BPH), which is common in men over 60 years of age, and it can lead to obstruction of urine outflow, and thus increases the incidence of Urinary tract infections, due to back flow of urine (vesico ureteral reflux) or filling of kidneys (pelvicocalyceal hydronephrosis).

Though the application of a Folleys catheter has caused resumption of outflow of urine, but still chances of already present Urinary Tract Infection got super imposed due to bacterial colonization on a foreign body (urinary catheter).

Now since you are already put on Antibiotics, so the likelihood is, that they must have sent the urine sample for culture and sensitivity test, before starting antibiotics. Its report would be expected sooner or later, so it would be most appropriate to reconfirm the kind of bug causing infection in your case, and whether it is sensitive to ciprofloxacin, which you are using, or do you need to switch the antibiotic?

As the increased intensity of abdominal pain, and swelling of testicles is indicating, increase or spread of infection, so you need to trace culture report promptly. Also that, if i were your doctor, i would have recommended you to get an appointment for ultasound KUB and pelvis, and if possible you might need to reschedule the appointment with the urologist preemptively, to rule out any complication of per-urethral catherization, which can spread in you testicle and pelvis too.

Your urologist might also like to see your renal function test,s as any long standing obstruction can cause acute tubular necrosis or other damages to fine kidney contours. Complete blood picture might be required to see the degree of leucocytosis (increase in WBC count with infections), as age groups above 60 can develop urosepsis and spread of infection systemically, for which the use of early inject-able antibiotics has shown to be more effective.

He might also want to order PSA (prostate specific antigen), if your ultrasound is suggesting increased prostatic size and weight, along with significant post-void volumes left in bladder, even after emptying, which in your case is unlikely as you are already catheterized and bladder emptying is dependent on that.

At the moment along with use of antibiotic, tramadol is already a potent pain killer, so instead of increasing quantity of pain killer medications or anti-inflammatory drugs,as long as pain is tolerable, i would suggest you to avoid those as the chances of kidney damage increases with their use . Try taking rest, and restrict mobility, until you get scheduled, for a revised early visit with the urologist.

I hope this answered your question.If you have more queries I am happy to answer. Otherwise rate before closing the discussion

Regrads.

Dr.Saddiq ul Abidin
M.B.B.S(Licensed Family Physician)
Resident Medicine.


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Saddiq Ulabidin

General & Family Physician

Practicing since :2011

Answered : 3030 Questions

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