I Am A 78 Yr Old Woman Who Is In

Posted on Thu, 23 Jun 2022

Question: I am a 78 yr old woman who is in pretty good health except for UTIs. Last year had 5 and this January 2 and now today another one. I had a cystoscopy by my urologist and bladder was normal. I take Cystex 1 tab at night, a probiotic Curelle and watch my diet. I was doing the cleaning system Theraworx too. Anyway, thinking about calling my urologist tomorrow. He said to have a catherized urine specimen today which I did - nurse said it is clear, no yellow. But bacteria was found. A lot of pain and chills when I pee. Do you have any idea which test I should have next? Am about to go nuts. Thank you for your opinion. I am put on cephalexin 500 mg twice a day again.

Answered by Dr. Dr. P. T. Patil (44 minutes later)

Brief Answer:
Repeated UTI that you get are mostly due to Senile Urethral Stenosis.

Detailed Answer:
Hello
Thanks for your query .
Based on the facts that you have posted the repetaed episodes of UTI that you get are mostly due to waht is called as " Senile Urethral Stenosis ".which is very common in elderly females.

During the age above 65 years theorgans of entire Urogenital System get atrophied which include narrowing of Urethral passage too.This narroewd urethral passage causes incomplete emptying of bladder dduring micturition which leads to large amount of urine to remain in bladder after urination what is called as Post Void Urine Residue (PVR).This PVR or stagnated urine is the source of bacterial infection causeing repeaded episodes of UTI.

This can be resolved by doing Urethral Calibration (Dilating Urethra.) which should be foillowed by Clean Self Intermittant Catheterization (CSIC) at home .I have been following this modality in most of my elderly female patients over last 45 years of my practice and getting very good results .This results in complete emptying of bladder and PVR to be 0 ml which is primary cause for UTI.

Consult your Urologist and discuss about this treatment regime .In the mean time continue taking antibiotics as prescribed by him.

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. Kampana

Follow up: Dr. Dr. P. T. Patil (11 hours later)

Do most urologists do this - can I mention this to my urologist? How often do you have to do the Clean Self Intermittant Catheterization (CSIC) at home and is it hard for me to do that? And do most urologists do the urethral calibration (dilating the urethra) and if so how often. Thank you for this information.

Answered by Dr. Dr. P. T. Patil (11 hours later)

Brief Answer:
I have no knowledge of Urologist practicing in U S

Detailed Answer:
Hello
Thanks for follow up .

We in XXXXXXX almost all Urologist are practicing this modality. Self catheterization or Dilation is a very simple and without any risk that can be done by patient herself. It has to be done daily for one month followed by twice a week for one month and later on once a week for third month .This helps to stabilize the calibration (Diameter) of urethra and helps to empty bladder completely .

Thanks and Regards.
Dr Patil

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Above answer was peer-reviewed by : Dr. Saisudha Kotla