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What causes progressive fatigue and frequent urination?

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Posted on Mon, 1 Jun 2015
Question: I am a 62 year old female having had chills off and on starting about 4 wks ago. They have gotten progressively worse with some fatigue and frequent/urgent urination. I saw my general practitioner about a week ago thinking I had a UTI. Upon checking my urine, he indicated it was negative and said that yeast infection can cause feelings to have to urinate and was willing to give me a pill for this. Since my symptoms did not seem to coincide with yeast infection, I called my ob/gyn. She thought it sounded more like a urinary infection also and we decided to try an antibiotic, the generic for Macrobid (100MG Caps). I took for 7 days just finishing the last one this morning. However, I am still having the symptoms at different times. My temperature usually runs low. This morning was 97.5 and tonight is 99.3. I do believe I am running a slight temp at times. I am out of state visiting my daughter and don't know what to do at this point. I won't be back home until this coming Friday night, so won't be able to see my doctor until next week. Is this something I should be concerned about enough to see a doctor out here in New Jersey? I am from Nebraska. I also saw my ENT before I left town thinking I might have a sinus infection, but he indicated not that he could see. I don't know if the Macrobid would address a sinus infection if there would happen to be one up higher? I did have a cold in January and took an antibiotic, then had a cold again in March but did not take anything. Both times I was coughing up yellow/green mucus. I have allergies and colds seem to go right to my chest. When I saw my g.p. last week, my white blood cell count was normal. What advise can you give me at this point? Thank you,
doctor
Answered by Dr. P. T. Patil (2 hours later)
Brief Answer:
Your symptoms could be due to Either UTI or Over Active Bladder syndrome.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have urgency,frequency for urination off and on since couple of weeks .

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Are you diabetic?
2) Do you have burning urination?
3) Have you done urine culture ?

Frequency ,urgency for urination at this age are mostly due to UTI secondary to what is called as Post Menopausal Urethral Stenosis.

After menopause there is generalized atrophy of the genital organs which involves urethral passage too.This narrowed urine passage results into incomplete emptying of the bladder causing significant quantity of urine to remain in bladder .This stagnated residual urine is the source of chronic infection giving ride to symptoms like frequency urgency etc.

In absence of any positive evidence of infection on routine urine test these symptoms could be due to what is called as Over Active Bladder syndrome.

Consult qualified Urologist and get following basic tests done to confirm the diagnosis.
1) Routine urine test and Urine culture.
2) Urodynaemic study
3) Endoscopic examination of bladder (Cystoscopy) .

In the mean while take take broad spectrum antibiotics like Cefexime along with urinary antiseptic like Nitrofurantoin twice daily and anti muscuranic drug like Darifenacin once daily.Later on switch on to appropriate antibiotics as per culture report.

Get the prescription of medicines from your family Physician.

Ensure to drink more water.To keep your urine dilute This will help to control dysuria.

Further treatment will be decided by concerned Urologist based on results of these test and final diagnosis.He may do endoscopic calibration of urethra to widen the urethral passage while doing Cystoscopic Examination .

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. Yogesh D
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Follow up: Dr. P. T. Patil (15 hours later)
In answer to your questions:

1. No, I am not diabetic; however, last A1C was slightly elevated. We are retesting in 6 months.
2. No burning with urination
3. I believe they just did a general urine test but did not culture. Gave them my urine at about 11:00 am and they called me with results late in the afternoon.

Did take Nitrofurantoin for 7 days. Just finished yesterday morning.

As far as overactive bladder, I wouldn't have chills and low temp accompanied by fatigue would I?

Will probably go to urgent care today since I am not at my home until next Monday to contact my regular doctor. Don't want to wait that long. I will ask for culture to be done and go from there.

Look forward to hearing back from you. Thanks.
doctor
Answered by Dr. P. T. Patil (9 hours later)
Brief Answer:
Fever witth chills suggests UTI.

Detailed Answer:
Hello
Thanks for follow up and feedback.
Please get urine culture done and start taking appropriate antibiotic as per culture report.
Do write if you need any help from me.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10425 Questions

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What causes progressive fatigue and frequent urination?

Brief Answer: Your symptoms could be due to Either UTI or Over Active Bladder syndrome. Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have urgency,frequency for urination off and on since couple of weeks . I shall be happy if you can post me few more details to help me in making comments on your problem. 1) Are you diabetic? 2) Do you have burning urination? 3) Have you done urine culture ? Frequency ,urgency for urination at this age are mostly due to UTI secondary to what is called as Post Menopausal Urethral Stenosis. After menopause there is generalized atrophy of the genital organs which involves urethral passage too.This narrowed urine passage results into incomplete emptying of the bladder causing significant quantity of urine to remain in bladder .This stagnated residual urine is the source of chronic infection giving ride to symptoms like frequency urgency etc. In absence of any positive evidence of infection on routine urine test these symptoms could be due to what is called as Over Active Bladder syndrome. Consult qualified Urologist and get following basic tests done to confirm the diagnosis. 1) Routine urine test and Urine culture. 2) Urodynaemic study 3) Endoscopic examination of bladder (Cystoscopy) . In the mean while take take broad spectrum antibiotics like Cefexime along with urinary antiseptic like Nitrofurantoin twice daily and anti muscuranic drug like Darifenacin once daily.Later on switch on to appropriate antibiotics as per culture report. Get the prescription of medicines from your family Physician. Ensure to drink more water.To keep your urine dilute This will help to control dysuria. Further treatment will be decided by concerned Urologist based on results of these test and final diagnosis.He may do endoscopic calibration of urethra to widen the urethral passage while doing Cystoscopic Examination . 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.