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Dr. Andrew Rynne

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What do these following lab reports indicate?

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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 9889 Questions

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Posted on Mon, 27 Mar 2017 in Urinary and Bladder Problems
Question: This question is related to the question asked in the below link:

https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=317983

Dear Sir, Recently, I have conducted my test after taking levorun 500 mg for 4 days as doctor asked to stop the levolve Z 500 mg after taking 5 weeks. My results after taking levolve Z 500 mg, my PSA was 1.89 ng/ml and my pus cells were 4-5 and there was no blood cells coming. But recent medical test advised as attached my PSA has been increased to 3.05 ng/ml. In the urine report, it is blood cells and also 4-5 blood cells. Can you please advise, what should I do, it looks like no medical helping me and i am more worried now.
doctor
Answered by Dr. P. T. Patil 1 hour later
Brief Answer:
You have UTI .

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have UTI.

Get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.

Take broad spectrum antibiotics like Cefixime along with urinary antiseptic like
Nitrofurantoin twice daily and urine alkaliser thrice 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.

Though your PSA has raised from 1.89 to 3.05 it is within normal range and this happens whenever there is UTI or more specifically Prostatitis .But there is nothing to be worried about it .

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
doctor
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Follow up: Dr. P. T. Patil 47 minutes later
Thanks sir for your response. I have also checked with the urologist who is seeing me currently and he has advised me to take amikacin 500 mg iv twice daily for 3 days and also suggested to conduct the urine culture and meet him after 3 days with the report. Please advise, whether i should see him with your advise or take what he has prescribed.

My urologist seems to be qualified as well and as per his qualifications he has done MBBS, MS and MCH.

Earlier he also advising me to conduct the trus ultrasound but as i suspected to have some more infections due to this so he advised to conduct the prostate MRI which is not available at my location so may be i will complete my test once i go to different city which is far away from my location. Can you please advise, if i need to complete the prostate MRI as its not invasive.
doctor
Answered by Dr. P. T. Patil 6 minutes later
Brief Answer:
I personally feel no need to do MRI for Prostate

Detailed Answer:
Hello
Thanks for follow up .

Since your PSA is reasonably normal I personally do not find any logic for doing MRI
for Prostate .

You can repeat urine culture and take appropriate antibiotic as per culture report .

Give urine sample for culture and then start taking Amikacin twice daily for 3 days and take a call for further treatment (After getting the culture report).

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil 9 minutes later
Thanks so much Sir for your quick response. So what do you feel that after having of this UTI or prostratitis since more than 2 months as still its not gone away and its keep coming back on the following medicines since i am taking, please see the history.

I took:
1. Feropenum
2. Liprufox
3. Tobramycin injections for 1 week.
4. Levolve Z for 5 weeks.
5. Levo Run 500 mg.

I am really frustrated on my condition and on top of it, my medical test supposed to happen in the next week on 17th of march for the visa of other country. I am more worried whats going to impact of this on my visa medical test as they do the urine test.

I also need your advised on the trus ulrasound what he has suggested, is it neccessary to conduct that as I am suspecting, it may cause some other issues with me as this is invasive.

Thanks for your patience with me so far. Do you feel that Amikacin 500 mg IV is going to improve my condition or is it really a reactive antibiotic? Should i conduct the test first to see, if it reacts? Should i ask to conduct the reactive test first with me to see, if its going to react with my body, sorry to keep asking idiotic questions but as you can see, i am really disappointment of my treatment and diagnosis so far.
doctor
Answered by Dr. P. T. Patil 3 hours later
Brief Answer:
It is a routine that we come across such case quite often

Detailed Answer:
Hello
Y\Thanks for follow up .
It is a routine in our practice to treat such chronic prostatitis cases very often.

You can get TRUS scan done .It is not that painful more over it will help to pin point diagnosis .

Repeat your urine culture and then take a decision regarding further treatment and Amikacin.You are not going to loose anything by waiting for 3 more days.

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil 4 hours later
thank you sir for your response. Now, another thing which i wanted to tell you and surely will tell to my urologist as well. I had an accident and due to which i had fluid collection on my hip and back. Please see the reports attached in the below link:
https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=314133

The concern here is since i had this accident my prostate problem or UTI problem started occurring and not going away, I am trying to think and as per my search on the various medical forums, many people started to have prostate problem since they had some disc bulge and back injury. Is this could be the reason for my prostate problem as well which may infected or inflammed my prostate? or the reason of having a enlargement of the prostate as last year, I have done my ultrasound and my prostate was very small to see by the radiologist.

Sorry Sir, i am bothering you with so many questions but I am trying to get the root cause of this issue so that find the right treatment as so far no treatment has given me relief. i also noticed that i had shooting pain in my back and my anus on yesterday and it could be the cause of the compression of the nerves or somwhere related to the prostate. Can you please clarify my position so that i can just move forward with the right treatment and the properly diagnosed.

I have started on Amikacine 500 mg since today evening and will complete this course in 3 days by taking injections twice daily. Another question, is it really neccessary to have injections at the intervals of 12 hours or it can vary by 1 or 2 hours? would it cause any issue to my problem or is this fine to have injections in the interval of 13 or 14 hours? thanks so much for your help and time on this so far and more importantly your guidance to make me feel better.
doctor
Answered by Dr. P. T. Patil 4 hours later
Brief Answer:
Accident that you met can not be a cause for Prostatitis .

Detailed Answer:
Hello
Thanks for follow up .
The chronic prostate infection is very notorious disease where both patent and treating Dr gets frustrated and keeps on lingering for long time even after taking various antibiotic .The basic problem here is it does not reflect the precise cause for this inspite of carrying out many tests.

The accident that you met can not be cause for your symptoms .

The action of Amikacin lasts for 12 hours hence it has to be taken at 12 hour intervals with minor variation of an hour or two is acceptable.

You are under care of an qualified Urologist follow up im regularly and get investigated as per his suggestions .

Thanks and Regards.
Dr.Patil.

Thanks and Regards.
Dr.Patil.

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