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This Message Is For Dr. Chobufo Ditah Hello Dr. Ditah,

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Posted on Tue, 2 Jul 2019
Question: This message is for Dr. Chobufo Ditah

Hello Dr. Ditah,
I had strep throat at the end of May and took Amoxicillin for 10 days. I finished them around XXXXXXX 2. On Tuesday XXXXXXX 4 I noticed that I had a frequent urge to urinate and that the area “down there” was constantly stinging. I cannot tell if the stinging is coming from the urethra, the vagina or both.

I went to the doctor. They used a dipstick to test my urine sample. She said I may have been starting a UTI. The sample showed a slight increase in neutrophils and small amount of blood. She prescribed me Fosfomycin which was one dose only. I was unable to take it until Wednesday evening. I don’t think the antibiotic worked because my symptoms have remained the same which are CONSTANT burning (it burns worse when I am sitting than standing) and frequent feeling that I need to urinate. My symptoms mostly feel more external than internal except for the urge to urinate.

I went back to see the doctor. She said that she was thinking it is possibly a yeast infection from having been on the Amoxicillin, which has happened to me in the past. I do recall having yeast infections that sting versus feeling itchy and getting the urge to urinate more often. She had a very quick look at the outer area of my vagina and prescribed me Taro-Terconazole vaginal cream to use for 7 days. She said if that doesn’t work she wants me to go for an ultrasound of my bladder and uterus.

I have only used the cream for 2 nights and am not noticing any difference in my symptoms. I don’t remember how long it has taken for my yeast infections to clear up in the past.

I have anxiety around my health. I am nervous that this is a UTI that is not being treated and may spread to my kidneys. I am not sure how many more days to give this before I see the doctor again.

Have you heard of yeast infections having the symptoms I am experiencing?
Can a yeast infection not only cause stinging in the vaginal area but the urethra as well?
How long can it take for a yeast infection to heal?
It would be difficult for me to see a doctor today but I could possibly go tomorrow. I just worry so much about getting a kidney infection from not having a UTI properly treated.

The medications I take are Micronor, Bisoprolol, Wellbutrin and Dexilant
Thank you for your help.
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Follow up: Dr. Chobufo Ditah (0 minute later)
This message is for Dr. Chobufo Ditah

Hello Dr. Ditah,
I had strep throat at the end of May and took Amoxicillin for 10 days. I finished them around XXXXXXX 2. On Tuesday XXXXXXX 4 I noticed that I had a frequent urge to urinate and that the area “down there” was constantly stinging. I cannot tell if the stinging is coming from the urethra, the vagina or both.

I went to the doctor. They used a dipstick to test my urine sample. She said I may have been starting a UTI. The sample showed a slight increase in neutrophils and small amount of blood. She prescribed me Fosfomycin which was one dose only. I was unable to take it until Wednesday evening. I don’t think the antibiotic worked because my symptoms have remained the same which are CONSTANT burning (it burns worse when I am sitting than standing) and frequent feeling that I need to urinate. My symptoms mostly feel more external than internal except for the urge to urinate.

I went back to see the doctor. She said that she was thinking it is possibly a yeast infection from having been on the Amoxicillin, which has happened to me in the past. I do recall having yeast infections that sting versus feeling itchy and getting the urge to urinate more often. She had a very quick look at the outer area of my vagina and prescribed me Taro-Terconazole vaginal cream to use for 7 days. She said if that doesn’t work she wants me to go for an ultrasound of my bladder and uterus.

I have only used the cream for 2 nights and am not noticing any difference in my symptoms. I don’t remember how long it has taken for my yeast infections to clear up in the past.

I have anxiety around my health. I am nervous that this is a UTI that is not being treated and may spread to my kidneys. I am not sure how many more days to give this before I see the doctor again.

Have you heard of yeast infections having the symptoms I am experiencing?
Can a yeast infection not only cause stinging in the vaginal area but the urethra as well?
How long can it take for a yeast infection to heal?
It would be difficult for me to see a doctor today but I could possibly go tomorrow. I just worry so much about getting a kidney infection from not having a UTI properly treated.

The medications I take are Micronor, Bisoprolol, Wellbutrin and Dexilant
Thank you for your help.
doctor
Answered by Dr. Chobufo Ditah (1 hour later)
Brief Answer:
Let me understand more about this!

Detailed Answer:
Hi and thanks for reaching out to me.

A few things i will like to get before narrowing down my options and making helpful recommendations.

1. Is the urge to urinate followed by actual urination? If yes, how much urine volume do you produce? Any pain when voiding? Can you tell me how many time you urinate in a day/night? It would be very unlikely that you developed a UTI after coming off 10days of Amoxicillin as this is equally a very good medication for treatment of UTI.

2. Am less inclined thinking there is a fungal infection though often more common after antibiotics use. With no itching and increased secretions, am a bit hesitant about this option. Also, do you have any burning sensation after urination?

3. I hope to hear back from you. There is no need to rush to a doctor at this time. You have been adequately treated and I will rather de-escalate most of these medications at this time. I will encourage you to finish the cream and accept no new medication unless something else comes up.

Waiting...
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Chobufo Ditah (0 minute later)
Brief Answer:
Let me understand more about this!

Detailed Answer:
Hi and thanks for reaching out to me.

A few things i will like to get before narrowing down my options and making helpful recommendations.

1. Is the urge to urinate followed by actual urination? If yes, how much urine volume do you produce? Any pain when voiding? Can you tell me how many time you urinate in a day/night? It would be very unlikely that you developed a UTI after coming off 10days of Amoxicillin as this is equally a very good medication for treatment of UTI.

2. Am less inclined thinking there is a fungal infection though often more common after antibiotics use. With no itching and increased secretions, am a bit hesitant about this option. Also, do you have any burning sensation after urination?

3. I hope to hear back from you. There is no need to rush to a doctor at this time. You have been adequately treated and I will rather de-escalate most of these medications at this time. I will encourage you to finish the cream and accept no new medication unless something else comes up.

Waiting...
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Chobufo Ditah (42 minutes later)
Hi Dr. Ditah,
Thank you for getting back to me.

To answer your questions:

1. I usually do urinate when I feel the urge. Basically, I have a urination with a normal amount. About a minute after I am finished and moving around or sitting down, I feel like I have to go again (it feels worse when I am sitting). Sometimes I just ignore it because I figure not much will come out. I would be sitting on the toilet all day because I pretty much always feel like I have to go.

Sometimes I will not ignore it for long and go again after about 10 minutes. I usually urinate but it is much less than a normal amount - proabably 1/4 cup or less. When done, I feel like I have to go again.

If I go again after having gone twice in 5 or 10 minutes, I will just have a few drops come out. I will still feel like I have to go again.

To be honest, I don’t feel like voiding causes the stinging. I would say it might sting a little at the end of urinating but it’s kind of difficult to tell. It just feels like that area is stinging constantly even when I am not going to the washroom.

Basically, I feel like I constantly have to urinate and I feel like the whole area stings constantly, especially when sitting down.

I have probably been urinating a little more than usual through the day, no difference at night. I find I am getting a fair amount of urine even though I am not drinking more than usual.

I hope this helps
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Follow up: Dr. Chobufo Ditah (0 minute later)
Hi Dr. Ditah,
Thank you for getting back to me.

To answer your questions:

1. I usually do urinate when I feel the urge. Basically, I have a urination with a normal amount. About a minute after I am finished and moving around or sitting down, I feel like I have to go again (it feels worse when I am sitting). Sometimes I just ignore it because I figure not much will come out. I would be sitting on the toilet all day because I pretty much always feel like I have to go.

Sometimes I will not ignore it for long and go again after about 10 minutes. I usually urinate but it is much less than a normal amount - proabably 1/4 cup or less. When done, I feel like I have to go again.

If I go again after having gone twice in 5 or 10 minutes, I will just have a few drops come out. I will still feel like I have to go again.

To be honest, I don’t feel like voiding causes the stinging. I would say it might sting a little at the end of urinating but it’s kind of difficult to tell. It just feels like that area is stinging constantly even when I am not going to the washroom.

Basically, I feel like I constantly have to urinate and I feel like the whole area stings constantly, especially when sitting down.

I have probably been urinating a little more than usual through the day, no difference at night. I find I am getting a fair amount of urine even though I am not drinking more than usual.

I hope this helps
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Follow up: Dr. Chobufo Ditah (6 hours later)
Hi Dr. Ditah,
My schedule for the week changed so I ended up going to the clinic today because I won’t be able to go for a few days.

They checked my urine with the dipstick today and said they found nothing. The doctor said that the one dose of Fosfomycin I took on Wednesday would be out of my system now so it’s likely not a UTI. They are going to send my sample off to the lab though anyway.

She said I should see my doctor and have an ultrasound done to look at my bladder and uterus.

She said to keep taking the yeast infection cream but she isn’t convinced that I have a yeast infection.

She said this could be hormonal because I am 42. I was on Marvelon for a long time and switched to Micronor a few months ago. My mom actually went through a similar thing when she was in menopause and had to be put on estrogen to help it.

I don’t want to sound silly or annoying, but with my health anxieties I am still concerned that this is a UTI that is not being treated and will spread to my kidney.

Would you agree with the doctor that the Fosfomycin is likely out of my system and if this was a UTI, the dipstick would have likely caught it? I need to understand this for my anxiety. Is it a low chance that I could get a kidney infection?

If it is hormonal, could this just happen overnight? I was fine on Monday and woke up with this on Tuesday.

Do you have any ideas of what this may be?

I will make an appointment to have an ultrasound and see my family doctor as soon as I can.

Thank you!
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Follow up: Dr. Chobufo Ditah (0 minute later)
Hi Dr. Ditah,
My schedule for the week changed so I ended up going to the clinic today because I won’t be able to go for a few days.

They checked my urine with the dipstick today and said they found nothing. The doctor said that the one dose of Fosfomycin I took on Wednesday would be out of my system now so it’s likely not a UTI. They are going to send my sample off to the lab though anyway.

She said I should see my doctor and have an ultrasound done to look at my bladder and uterus.

She said to keep taking the yeast infection cream but she isn’t convinced that I have a yeast infection.

She said this could be hormonal because I am 42. I was on Marvelon for a long time and switched to Micronor a few months ago. My mom actually went through a similar thing when she was in menopause and had to be put on estrogen to help it.

I don’t want to sound silly or annoying, but with my health anxieties I am still concerned that this is a UTI that is not being treated and will spread to my kidney.

Would you agree with the doctor that the Fosfomycin is likely out of my system and if this was a UTI, the dipstick would have likely caught it? I need to understand this for my anxiety. Is it a low chance that I could get a kidney infection?

If it is hormonal, could this just happen overnight? I was fine on Monday and woke up with this on Tuesday.

Do you have any ideas of what this may be?

I will make an appointment to have an ultrasound and see my family doctor as soon as I can.

Thank you!
doctor
Answered by Dr. Chobufo Ditah (6 hours later)
Brief Answer:
There is no infection!

Detailed Answer:
Hi,

There is no infection. I understand you are very particular about your health and this is the exact problem at this time. When you sleep at night, you don't have these urges and you don't wake up. The only difference is that your wakefulness and consciousness is are suppressed as well as your worrisome mindset. There is no infection and your kidneys are fine and would not suffer from any infection. Even if you had a kidney infection, you have been treated twice already: Amoxicillin and Fosfomycin.

My plan, talk yourself out of these intrusive and worrisome thoughts. They are not helping. Unless it has been a couple of hours after last urination, stay away from yielding to these rather unhelpful thoughts.

You may proceed with the ultrasound but am not keen about it. This is clearly not hormonal given its acuity at this time.

Keep me posted!
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Chobufo Ditah (0 minute later)
Brief Answer:
There is no infection!

Detailed Answer:
Hi,

There is no infection. I understand you are very particular about your health and this is the exact problem at this time. When you sleep at night, you don't have these urges and you don't wake up. The only difference is that your wakefulness and consciousness is are suppressed as well as your worrisome mindset. There is no infection and your kidneys are fine and would not suffer from any infection. Even if you had a kidney infection, you have been treated twice already: Amoxicillin and Fosfomycin.

My plan, talk yourself out of these intrusive and worrisome thoughts. They are not helping. Unless it has been a couple of hours after last urination, stay away from yielding to these rather unhelpful thoughts.

You may proceed with the ultrasound but am not keen about it. This is clearly not hormonal given its acuity at this time.

Keep me posted!
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Chobufo Ditah (31 hours later)
Hello Dr. Ditah,
Yesterday my doctor decided to treat me for a UTI based on my symptoms. He prescribed me Macrobid. A few hours later his office called to say that my lab results were in. It showed that I have a UTI (I’m not sure which bacteria I have). My doctor said he didn’t think Macrobid would work very well for the strain of bacteria I have so he switched me to Cefixime 400g. I am supposed to take 1 a day for 5 days. I have only had the one dose from yesterday. I was reading online that some people feel better within 24 hours on Cefixime but so far I am not noticing any difference.
I do hope that this medication will work and that the infection will heal soon and not spread to my kidney. I feel better that they know what is wrong with me now.
I am disappointed that my symptoms are still here but maybe I am expecting too much too quickly. It’s only been 17 hours since I took my first dose. My infection has been around for 7 days now as far as I know.
How long should I give this medication before I return to my doctor?
Thank you very much.
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Follow up: Dr. Chobufo Ditah (0 minute later)
Hello Dr. Ditah,
Yesterday my doctor decided to treat me for a UTI based on my symptoms. He prescribed me Macrobid. A few hours later his office called to say that my lab results were in. It showed that I have a UTI (I’m not sure which bacteria I have). My doctor said he didn’t think Macrobid would work very well for the strain of bacteria I have so he switched me to Cefixime 400g. I am supposed to take 1 a day for 5 days. I have only had the one dose from yesterday. I was reading online that some people feel better within 24 hours on Cefixime but so far I am not noticing any difference.
I do hope that this medication will work and that the infection will heal soon and not spread to my kidney. I feel better that they know what is wrong with me now.
I am disappointed that my symptoms are still here but maybe I am expecting too much too quickly. It’s only been 17 hours since I took my first dose. My infection has been around for 7 days now as far as I know.
How long should I give this medication before I return to my doctor?
Thank you very much.
doctor
Answered by Dr. Chobufo Ditah (18 minutes later)
Brief Answer:
I would love to review these results with you!

Detailed Answer:
Hi and thanks so much .

I am happy they are bringing up something definitive. I will like to get a copy of this result and go over with you. Cefixime is such a broad spectrum antibiotic and I am not worried what the exact germ maybe because this would certainly cover it. Most interestingly, I want to know what germ has been isolated and what antibiotic it is sensitive to. I also want to make sure we are making the right calls.

I often fail to rush, testing and treating without pausing to re-evaluate. Let's see what comes up with the last urine test.

Do you have any fever or flank pain at this time? What about the urinary frequency, about same?
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Chobufo Ditah (0 minute later)
Brief Answer:
I would love to review these results with you!

Detailed Answer:
Hi and thanks so much .

I am happy they are bringing up something definitive. I will like to get a copy of this result and go over with you. Cefixime is such a broad spectrum antibiotic and I am not worried what the exact germ maybe because this would certainly cover it. Most interestingly, I want to know what germ has been isolated and what antibiotic it is sensitive to. I also want to make sure we are making the right calls.

I often fail to rush, testing and treating without pausing to re-evaluate. Let's see what comes up with the last urine test.

Do you have any fever or flank pain at this time? What about the urinary frequency, about same?
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Chobufo Ditah (18 minutes later)
Hi Dr. Ditah,
I can try to get the copy of my results. Where I live, results are not usually given to us but we can request them.
I do not have a fever or flank pain. I am still experiencing the constant burning feeling and feeling the need to urinate even after I have gone. Basically my symptoms have remained the same and no new ones.
Thank you
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Follow up: Dr. Chobufo Ditah (0 minute later)
Hi Dr. Ditah,
I can try to get the copy of my results. Where I live, results are not usually given to us but we can request them.
I do not have a fever or flank pain. I am still experiencing the constant burning feeling and feeling the need to urinate even after I have gone. Basically my symptoms have remained the same and no new ones.
Thank you
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Follow up: Dr. Chobufo Ditah (2 minutes later)
The doctor said Macrobid may or may not have worked due to the sensitivity so he thought Cefixime was a better choice. My other results will hopefully be in by Friday
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Follow up: Dr. Chobufo Ditah (0 minute later)
The doctor said Macrobid may or may not have worked due to the sensitivity so he thought Cefixime was a better choice. My other results will hopefully be in by Friday
doctor
Answered by Dr. Chobufo Ditah (12 hours later)
Brief Answer:
Please request the results and update for review!

Detailed Answer:
Hi,

I will appreciate that you obtain a copy of this result and upload for me to review and discuss them in more details with you.

Waiting expectantly for this!
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Chobufo Ditah (0 minute later)
Brief Answer:
Please request the results and update for review!

Detailed Answer:
Hi,

I will appreciate that you obtain a copy of this result and upload for me to review and discuss them in more details with you.

Waiting expectantly for this!
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

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This Message Is For Dr. Chobufo Ditah Hello Dr. Ditah,

This message is for Dr. Chobufo Ditah Hello Dr. Ditah, I had strep throat at the end of May and took Amoxicillin for 10 days. I finished them around XXXXXXX 2. On Tuesday XXXXXXX 4 I noticed that I had a frequent urge to urinate and that the area “down there” was constantly stinging. I cannot tell if the stinging is coming from the urethra, the vagina or both. I went to the doctor. They used a dipstick to test my urine sample. She said I may have been starting a UTI. The sample showed a slight increase in neutrophils and small amount of blood. She prescribed me Fosfomycin which was one dose only. I was unable to take it until Wednesday evening. I don’t think the antibiotic worked because my symptoms have remained the same which are CONSTANT burning (it burns worse when I am sitting than standing) and frequent feeling that I need to urinate. My symptoms mostly feel more external than internal except for the urge to urinate. I went back to see the doctor. She said that she was thinking it is possibly a yeast infection from having been on the Amoxicillin, which has happened to me in the past. I do recall having yeast infections that sting versus feeling itchy and getting the urge to urinate more often. She had a very quick look at the outer area of my vagina and prescribed me Taro-Terconazole vaginal cream to use for 7 days. She said if that doesn’t work she wants me to go for an ultrasound of my bladder and uterus. I have only used the cream for 2 nights and am not noticing any difference in my symptoms. I don’t remember how long it has taken for my yeast infections to clear up in the past. I have anxiety around my health. I am nervous that this is a UTI that is not being treated and may spread to my kidneys. I am not sure how many more days to give this before I see the doctor again. Have you heard of yeast infections having the symptoms I am experiencing? Can a yeast infection not only cause stinging in the vaginal area but the urethra as well? How long can it take for a yeast infection to heal? It would be difficult for me to see a doctor today but I could possibly go tomorrow. I just worry so much about getting a kidney infection from not having a UTI properly treated. The medications I take are Micronor, Bisoprolol, Wellbutrin and Dexilant Thank you for your help.