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Suggest Treatment For Persistent UTI While On Flotral, Thyronorm And Stamlo

Posted on Tue, 30 Aug 2016

Question: Sir, I was suffering from recurring UTI with bleeding since 2012. In the year 2014 I had UTI twice. In the month of May 2014 PSA report was 49. after taking antibiotic PSA became normal. In November 2014 again I suffered from UTI.Then I was undergone flexible cystoscopy. Investigation report reveals my prostrate is normal my bladder neck was diliated for better urine flow. Since then no major UTI with bleeding. I am taking
Cranberry tablets(Cranbe)
Flotral 10mg
thyronorm and
Stamlo 5mg
regularly.
My thyroid, BP normal
HbA1c test report reveals 5.7 in the month of March 2016.
Recently I am facing some problem.
During deep sleep in the night time by mistake I have urinated in the bed. This happend twice in last one month.
During day time my urine pressure, urgency, flow are normal. Please advice me How to recover from this situation.

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

Brief Answer:
Needs to investigate .

Detailed Answer:
Hello
Thanks for query and gone through our previous thread of discussion that we had few months back regarding your problem of repeated UTI .

The problem of secondary Enuresis that you have twice in last month could be due to
what is called as Over Active Bladder (OAB)
1) Do you take any alcohol beverage or Coffee before going to bed ?
2) Do you drink more water after evening ?
3) How is your urine flow now?
4) Are you able to hold on urination if required due to lack of availability of toilet ?

The occasional incidence of Enuresis has no significance and it is very difficult to find the cause for the same or pinpoint the diagnosis .

Following general measures may help you to get this issue resolved .
1) Avoid drinking coffee and water after afternoon .
2) Avoid taking alcohol before going to bed .
3) Make a routine habit to empty your bladder before going to sleep .
4) Make a habit to wake up once in night and empty your bladder .

Take Darifenacin once daily .This will help to relax the bladder and thereby prevent unvoluntary contractions of bladder during sleep .

If problem persistent even after following this routine for 2 months consult qualified Urologist for evaluation to establish the diagnosis and further treatment .

Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (31 minutes later)

Sir,
I do not take coffee or alcohol before going to bed
I try to empty my bladder before going to bed.
Sometimes I take 750ml to 800 ml water after dinner.
After dinner I go to bed atleast after two hours.
Urgency of urination reduced gradually after cystoscopy.
Urine flow is fair enough
I can hold urine if I do not find a toilet nearby when I am conscious.
I used to take 4-5 litres of water every day.
These informations may help you to find the problem.
Thanks,
xxxxxxxxxxxxxxxx

Answered by Dr. Dr. P. T. Patil (16 minutes later)

Brief Answer:
Reduce water intake after evening .

Detailed Answer:
Hello
Thanks for follow up and feedback.

Secondary Enuresis that you have is occasional hence has no significance.

Get your blood test to detect serum ADH (Anti Diuretic Hormone ) done .
This hormone reduces production of urine by Kidneys in the night if the level of this hormone is low results in to increased urine production in night and may cause Enuresis.

Reduce your water intake after evening .Have a trial of Darifenacin once daily for a month and observe for any improvement .

Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (38 minutes later)

Sir,
Thanks for your advice. I will try to follow as per as possible.
Thanks,
xxxxxxxxxxxxx

Answered by Dr. Dr. P. T. Patil (47 minutes later)

Brief Answer:
Go ahead .

Detailed Answer:
Hello
Thanks for follow up .

Please go ahead and do write in future if you need my help I shall be happy to address your concern,

Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (15 days later)

Sir I was experincing burning sensation during urination since last 5days. I have given my urine sample for test. Please advice me after going through my test reports.
Thanks,
xxxxxxxxxxxxxx

Answered by Dr. Dr. P. T. Patil (9 minutes later)

Brief Answer:
You can take Tetracycline twice daily

Detailed Answer:
Hello
Thanks for follow up .

You can take Tetracycline ans Nitrofurantoin twice daily for a week with urine alkalizer like Citralka thrice daily .

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. P. T. Patil (28 minutes later)

I have Martfur MR 100mg in stock. Shall I start taking Martifur. Please advice doses.

Answered by Dr. Dr. P. T. Patil (23 minutes later)

Brief Answer:
You can take Martfur 100 along with Tetracycline twice daily.

Detailed Answer:
Hello
Thanks for follow up .

Martfur 100 mg is Nitrofurantoin .Yo can take along it with Tetracycline twice daily .

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. P. T. Patil (12 days later)

Sir refer to previous illness I followed your advice. I was gradually becoming normal. But on 5th Aug late night I had high fever(103.4 Deg F). I took Calpol and the fever reduced a bit. I was experiencing burning during urination with frequency and weak flow. On 6th Morning I have given urine sample for test. RE report reveals pass cell 3-5.
Culture report detected organism Pseudomonas Aeruginosa. Report attached for your reference and advice.
I have consulted local doctor , he advised me to take Alevo 750mg with Murtifur 100mg to continue.
I have acute acidity
I used to take purgative to clear bowel.
Urine is acidic with PH 5.
Please advice me.

Answered by Dr. Dr. P. T. Patil (13 hours later)

Brief Answer:
Take Bactrim D.S twice daily.

Detailed Answer:
hello
Thanks for uploading culture report .

Please take Bactrim D.S (combination of Trimethoprim and Sulfamethoxazole ) twice daily along with Citralka thrice daily .

Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (13 hours later)

Sir, as there was delay in response I had contacted Fortis Hospital XXXXXXX As per their advice I have already started taking Alevo 750 once daily, Martifur 100 mg twice daily with Alkasol. rest other medicines continued as before.Thanks and
Regards,
Bibhash XXXXXXX

Answered by Dr. Dr. P. T. Patil (18 minutes later)

Brief Answer:
Continue taking medicines as suggested

Detailed Answer:
Hello
Thanks for follow up .

Sorry I could not communicate as I was travelling ( long air journey to U.S.)

Continue taking medicines suggested and repeat urine culture if symptoms persists .

Thanks and Regards.
Dr.Patil.

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