Son reoccurring UTI

[cosietea]

My son had 2 UTI's last year and so was referred for an ultrasound as they are apparently uncommon in males

He had the US in January this year and his kidneys were fine but they noted lots of low level echoes and also his bladder didn't fully empty after he went to the toilet

I asked the radiologist if it's anything sinister and they said no, but we didn't come away with any explanation, just told to come back if further symptoms

Well last month he ended up with another UTI and another course of antibiotics. He took them religiously and today he has yet another symptom ( extremely foul smelling urine like before)

He is 16, not sexually active, very good at keeping hydrated and otherwise healthy

How much longer can this go on? What should I expect from the GP tomorrow? Could this be symptomatic of something else?

Thank you

Ask for referral to peadiatric urology. This can take time. Meanwhile ask GP to get advice for you to help minimise chances of UTI.

Our son has bladder issues (retaining urine but under and over active so complex). Drinking plenty - google how much for a boy of his age - it maybe more than you think.

Certainly he should be seen and treated UTI's are not fun. Our DS ended up with one a few months ago.

Can he go to the loo freely at school? He needs to be able to go when he needs to and not hang on.

ERIC are a great charity and have had good advice from them and there is a forum on health unlocked. .

Most GPs can also refer to a regional continence nurse team who often have local clinics.

Thank you

Yes, he can go to the toilet freely. He's finished school now so can go whenever and he does drink at least a litre of water, sometimes more

Perhaps join https://en-gb.facebook.com/groups/ChronicUTISupportGroup/ on Facebook there. Theres a wealth of information on there and hopefully someone can give advice. If the uti is coming back quicker it sounds like it may be becoming embedded or the antibiotic didn’t clear it and he needs a different one. If he’s not emptying properly then urine is sitting there allowing bacteria to attach to the wall and create more infection.

have you tried things like mannose d? Or urea uvi or other natural things?

ultimately though it would be best if he could completely empty and then hopefully this wouldn’t be happening any more. Any advice on why it’s happening and if there’s anything that can be done?
maybe ask Gemini Google’s AI?

He should be drinking 2 litres of water a day. No caffeine, no carbonated drinks, no citrus juices or citrus fruit, no chilli. You need the bladder lining to calm down and heal and that can take a few months
what antibiotic is he on?

Just had a google 14 to 18 boys 1.9 L per day recommended. Spread through the day.

We ended up on double strength anti biotics as it didn't clear and then an infection of the tubes (epidydimus?) and one testicle the size of a tennis ball.

I am sure this won't happen with your son OP, but it was alarming and we had 3 x trips to A and E in a week. That's it for the rest of the year now. We have had our compliment of A and E time in the waiting room! Glad he got treated though, NHS may creak and may have had us there til midnight and beyond but it did the job.

Think we were on amoxicillin high dose (double or triple normal strength for at least 1 week)

Saying this in the gentlest way possible, but has he been tested for sexually transmitted infections along with the urine tests? He may not be ‘sexually active’ as in having sex, but you can get an STI through oral sex. Unless you are certain he’s been tested for bacterial STIs, I would see if there is a way to discreetly suggest to the nurse or GP to approach him about doing an STI test along with everything else. It’s a sensible thing to rule out before going down the route of anything more invasive as easily treatable.

Trimethoprim for 7 days and the same last year

To another OP's question about STI's he definitely does not have any sexual partner and is quite a young 16 year old who mainly hangs out with us or his group of boys playing football Pretty confident on that one.

I suspect the infection has been there longer than we realised as the foul smell has been on/off for months and I did put it down to either food or dehydration but the test came back positive for infection ( originally E-Coli but not sure this time round)

That does sound worrying but glad he's ok now. Must have been scary

Did he have classic UTI symptoms?

My son doesn't seem to have much pain or urgency to urinate, it's the smell that's the giveaway

Dr commented there were lots of white blood cells in the urine

I'm sorry to hear of your son's woes. He doesn't need a continence nurse or continence service; he needs a urologist to check out his urinary tract from kidneys right through to exit.

He should be able to empty his bladder and if he can't, the reasons for that need exploring.

Ask for a referral; but it might not be to paeds urology, that will depend on the referral rules in your area. If there are any ongoing problems, then at age 16 it might be better to see adult urology as then he won't need to change over (and potentially get lost in the system!) when he's a little older!

In the meantime, impress on him that he might need to allow a bit longer at the toilet once he thinks he's finished peeing, in case there's a bit more still to come. The advice above about keeping fluid intake up (as long as it's not caffeine and fizzy drinks!) is sound. Has he tried peeing when he's sitting?

Thank you

I was just this moment thinking of telling him to try sitting down to wee and take his time. I have to catch him in the right mood though as sometimes he's quite open to talking to me about it and other times he shuts down

Is his dad around? Your son might be embarrassed talking to you about it so it might be better from his dad (if that's possible)?

Yes his dad has spoken to him too. He's quite open with us both, usually

He is a 16 year old boy though with a lot of free time in his room and I cringe saying this but would wanking cause this?! Although surely all boys that age would be in the same position?

if It’s ecoli then mannose d is well worth a try. It stops the E. coli sticking to the bladder wall. Just half a teaspoon three times a day in a glass of water half an hour before meals.

Otherwise you could try a different antibiotic but they wipe out your microbiome. Ask for a broth culture before further antibiotics go check sensitivity. Otherwise you’re just chucking stuff down you that might not work.

as PP said, you need to know why he’s not emptying properly. That needs investigating and getting to the bottom of the root cause.

Yes - pee when sitting and lean forward that gets the bladder in optimum position to empty.

UTI symptom was strong pain in one side we thought it could be appendix, went to walk in and they referred to children's A and E.

Agree with PP - go straight to urologist via GP. Best route to get action.

Just to follow up it's confirmed he has another infection ( or probably still the same one) a week after finishing antibiotics

He has more antibiotics and a referral to hospital.

E-coli as before

Only symptom is awful smelling urine, no pain or stinging

I really hope this round of medication does the trick

To continue with the saga he had this antibiotics in August into September ( amoxicillin) and this still hasn't cleared it

We saw consultant Monday but they didn't seem to worried as he's not 'sick' with it. No fever or pain etc so they sent us on our way ( although detected a heart murmur whilst there)

He now has been prescribed nitrofurantoin.

Anyone had any luck with this antibiotic? This will be his 3rd lot since July ( and 2 other occasions 12 months ago)

What did consultant say about bladder not emptying fully?

Have they done any more scans? Our son had a tilt table test done at urology ward of hospital so they could scan and see what was happening when he wees. In our case dysfunctional voiding - his bladder is overactive and under active at the same time. Hard to treat.

Did you give ERIC a call? They are helpful in suggesting what might be next steps. Or you could ask for a second opinion from another consultant if you feel like they are not being proactive to find and treat the source of infection.

He now has been prescribed nitrofurantoin.

This is the best ab for uti's imo

Take with d mannose (superdrug does a good one)

Also a 20 billion probiotic (cytoplan does a good one)

Course of Nitrofuritoin completed and a dip test today ( along cloudy smelly urine) is indicating infection so we'll be off the the GP once again

I'm not sure what else they can do. Antibiotics aren't working

When our son was in utero, they noticed an enlarged kidney, and after birth he was on low level antibiotics for a few years. He came off them, but we were always told when he starts drinking with mates, he may develop regular UTIs.

Fast forward 14 years, and they're here.

We're now going through the process of ultrasounds and a return to radioactive monitoring. More information here https://oxfordurologyassociates.uk/pelvi-ureteric-junction-obstruction-pujo

This is our experience of course; may be completely different for your son.

Investigate going to the Malone-Lee clinic. They are the experts at treating chronic uti.

Thanks

He had a scan in January and his kidneys were fine

They were talking about ciprofloxacin as a last resort but I've read some horror stories about side effects and permanent damage

The saga continues and he still has a UTI which apparently is sensitive to all the antibiotics he has tried

We now have cefalexin and I also have the D mannose powder

We have a paediatric appointment in December but I honestly don't know how much longer this can ( should) go on for. It's basically been all year and this is the 5th type of antibiotics

He also had a heart scare last week which saw him in A&E with raised troponin levels. Thankfully an ECH and ECHO showed no damage of inflammation to the heart but it's an added worry and I don't know if the 2 are connected? He has a cardiology appointment in December to follow up

A recent blood test also showed nothing concerning, white blood count fine, no indication of inflammation or infection and no diabetes

Where do we go from here? What should they be doing other than giving him more antibiotics?