Any doctors/urologists around? Constant UTIs!

[Hilltoptea]

Hi, I wonder if anybody can help me. I don't want to hassle the GP as this isn't the worst problem in the world, but it's something that is worrying me. I'm sorry, it became a much bigger post than I had planned!

I'm a 26 year old female, healthy body weight, I don't smoke and don't drink very much at all.

In mid 2016 I was admitted to hospital for acute pyelonephritis. I thought I had the flu, had a 39.9C fever and was feeling very ill. No symptoms of a UTI at all. I'd never had one before as far as I was aware, but didn't know the symptoms. Anyway, was in hospital for 5 days on IV antibiotics and sent home feeling much better (and grateful for the NHS!).

Since then I have been having almost constant UTIs. I don't get the most obvious symptoms of burning or blood in urine. It's when I wake up feeling exhausted, have a heavy feeling in my belly, and smelly urine that I know that it's back. I keep dipsticks now and test when I think I have another UTI. I'm almost always right and probably get one every couple of weeks to every month. Most resolve on their own after a week or two.

I only go to the doctors when my back starts aching because I don't want another kidney infection. I also don't want to be constantly taking antibiotics, because it feels unnecessary if the UTIs can fix themselves. I've been to the doctors twice this year about it. I was on antibiotics at the beginning of October for a UTI that was giving me a bad back ache. Followed the course correctly and felt much better afterwards.

Now it's less than two weeks later (9 days since end of course) and my dipsticks are testing positive for nitrites and leukocytes again. I shower daily, always shower after sex etc, and so does my partner. I think am doing everything right to try and prevent them, but it's still happening.

I just feel like it's constant, and don't know what I can do about it. I very rarely call the doctor because most of them resolve on their own, so there's not much on my medical record about my UTIs.

I've had a few blood tests in the past year due to a lump on my neck which turned out to just be an enlarged lymph node. But my kidney function results always seem to be at the end of normal. If the normal range is 1-60, mine are 60. If it's 1-80, it'll be 79 etc. One (eGFRcreat) was actually abnormal but they retested and it came back as 60, with a normal range of 60-99.

I just wonder if something bigger is going on, but I'm not a doctor and wonder if I'm thinking too much into it!

I would be very grateful for any (unofficial) advice!

Sympathies- I have struggled with recurrent UTI symptoms since I was a teenager. It is utterly miserable.

I have zero medical background but can share something that has helped me...

Over the years I have had a few cystoscopies which found nothing of note other than a very tight urethra- mine is so tight it spasms round the camera tube! The camera stretches the urethra so each time I had a cystoscopy I enjoyed a long period without symptoms afterwards. Indeed my doctor told me that cystoscopies themselves can act as treatment for people like me with tight tubes; some people have them every year or two.

Now, this might sound weird, but since then I have tried to make a habit of really blasting a big wee out occasionally, to attempt to really flush out my urethra! Especially if I'm feeling the symptoms start. I have not needed ABs in years now touch wood and I think my last cystoscopy was about 10 years ago.

Not a doctor but a nurse. Could you possibly have a full blood count? Are there any other infections going on like constant coughs or colds etc? Might be worth bloods to screen for possible underlying cause of repeated infections. Otherwise sorry to be graphic but do you wipe from front to back to prevent faecal contamination?
It may be that they need to keep you on a course of abx for longer day 10 days instead of 5-7. Or try a different one. Sometimes this is necessary to completely overcome the uti. The most frequently prescribed is trimethoprim but there are others.
Good luck

Get a referral to a urologist. I had constant UTIs when I was 19/20. When I presented at the GP for the 9th time in 6 months, he referred me to urology.

I was prescribed a 6 month course of trimethoprim. I'm now 33 and haven't had a UTI since. I know you don't want to be on antibiotics but UTIs are absolutely miserable.

I'd speak to the gp and see if you need a referal to urology and/or for an ultrasound of your kidneys to make sure there's no structural abnormalities that could be causing problems. Although that's prob more unlikely if you made it to adulthood without recurrent utis might be worth discussing. Don't feel you're wasting the GPS time, and if you have any suspicion of an infection get a sample handed in straight away.

I'd also get a urine sample sent off after you finish a course of antibiotics so they can check the infection is completely clear and there's not a small trace in bugs there's left which could redevelop.

This needs investigating. My SIL had this problem, she ended up losing a kidney.

Just some simple things to ask:

Do you shower before sex and use wet wipes after a poo? Most infections are ecoli from the bowel.

Do you actually wash your anus with soap rather than just standing under the shower?

Do you wear 'proper' big pants and not thongs? Thongs can transfer bacteria as they 'massage the area.

You need to pee within 5 minutes of having sex to flush out any bugs. Having a shower won't get inside your bladder where the bacteria might be ascending.

Stop wearing tight jeans (if you do), only wear cotton knickers.

If you are doing all of this, apologies but only trying to help.

But my kidney function results always seem to be at the end of normal. If the normal range is 1-60, mine are 60. If it's 1-80, it'll be 79 etc. One (eGFRcreat) was actually abnormal but they retested and it came back as 60, with a normal range of 60-99.

Some people just 'normally' have kidney function that is not 'perfect' on a score.

Are you sure you are reading the results carefully- has your dr been through them with you? I'm just checking because with kidney function a high score is usually better than a low score!

My elderly dad died not long ago and had kidney failure and spent years with his kidney function at level 4/ 5 ( level 5 is under 15% function left.)

Low scores meant- poor function, high scores= better.

good advice
in addition to personal hygiene, wash towels, bedding, pants, pj bottoms (anything that comes into contact with your nethers) on a hot wash at least 60 degrees.

good luck, I hope it will resolve quickly.

Nurse here with urology experience.
You need a referral to a urologist for evaluation.
As someone mentioned already you may have an anatomical abnormality that is pre disposing you to same.
Proper investigation is the way forward.
Good luck

Ask for a urology referral. I had constant UTIs and have had both my kidneys operated on. All fine now.

If these infections are going away, without treatment, I don't understand.

The dipstick you use- are they showing actual bacteria? When you went to the drs originally did they culture your urine ans say what the bacteria was?

You may not have infections- it could be a sensitive bladder that's not settled down. What are your symptoms when it happens? Have you seen any link to drinking alcohol or caffeine?

You need to send a sample in to your GP the minute you feel it coming on so they can give you the right AB if that's needed.

If you keep getting infections , it's something most likely you are doing.

You said you shower daily and after sex, but it's more important to shower before sex. I'm sorry to be graphic but poo has mucous in it- unless you wash your bum with plain, unscented soap, and rinse well, you could perhaps be infecting yourself. Carry small pkt wet wipes for bums during the day to use after a poo.

Likewise, after sex, you should wee within 5 minutes, because if you wait the bacteria will ascend - it's not romantic, I know, but just do it.

Hope this helps.

Thanks for all the replies, I am grateful for the advice!

I'll try to answer all the questions.

I always shower before bed (so before sex, not much adventure in this house) and use a zero percent hypoallergenic soap in the nethers.

Do wipe front to back with wet wipes.

My sheets are washed once a week at 60C. Recently just hot washed all my underwear and jeans at once too just in case.

I do have problems with oral thrush too. I don't use steroid inhalers anymore but still have the thrush that comes with it. I have a great oral hygiene routine so I don't know why that is.

I do wear thongs at least twice a week so will definitely stop that. And cotton underwear, I've just checked, some are cotton and some aren't. I'll stash the ones that aren't in the loft.

Pfingstrose - I will try the wee blast technique, thank you
I think it might be worth having a proper talk with my GP about it all. I didn't realise an abnormality could be the problem.

Should have put nurses in my title too, thank you for the advice. I wonder if I'm stashing bacteria and a longer course of antibiotics might work. Or an abnormality. When I get a bad UTI it feels like my kidneys are being squeezed/squashed.

Dr hasn't been through bloods with me and I've never had a blood count done on the basis of the UTIs. When my GFR was low I just got asked to retest and they removed my 'bad' result from my medical record and replaced it with the good one.

I had a culture sent off at the beginning of October but nobody called me about it. Checked online and it says culture- N/A?

Haven't noticed any link with food or alcohol at all.

I do do the post sex shower within a few minutes- it is not romantic

Those gins are supposed to be smiley faces

I had this and had to go on long term antibiotics. I was put on them by a urologist. I take one daily and up them to 3 daily if I feel an infection coming on. I’ve managed to avoid any full blown infections for about 15 years by doing this. (I take cefalexin).

Also - I have anaemia, Addison’s disease and thyroid problems. The anaemia often causes thrush (Oral thrush in particular) and can often cause issues with painful sex and utis due to changing the acidic nature and lubrication of the vagina. When I read your post I instantly thought “anaemia”. You need a full proper blood count and some intervention.

D mannose can help- it’s a sugar that your body excretes in urine, E Coli love it, bind to it and so the bugs are excreted also.
Also have a look here
www.chronicutiinfo.com
I am on long term Hiprex and nitrofuratonin for recurrent UTIs.

Make sure your boyfriend is washing just before sex too (I know, so unromantic). Never had one since.

If you get oral thrush frequently it could be an immunity issue...

I had this for years and years. An extended course of trimethoprim worked.

But then it came back again. I now take 1 cephalexen after sex, and that has kept it at bay for 15 years

The 'abnormality' people are talking about is very rare. I was checked for that years ago with a kidney X ray- they inject a dye in your arm first and I had to take a 'clearing medicine' for the bowel first (not nice.) It wasn't pleasant and things may have changed since then. I had it for the same reasons as you. Turns out I had IC. Managed with diet mainly but had years and years of misery and was housebound at times.

It's really quite rare- what they are looking for is a reflux of the ureters- the tubes from your kidneys. Very rarely, the urine flows backwards so you get a backlog and infection can set in. This is of course very rare.

You need to get your urine checked for bugs. As others have said you may need a longer course of ABs. Another simple thing- are you drinking enough ( plain water)? Over the day you need at least 1.5 lts fluid.

If you get thrush a lot, you need to tackle that and start by cutting out sugar and refined carbs.

Thanks for the replies.

Have just tested now with a dipstick- darkest leukocytes and second darkest blood levels, but no nitrites at all? At 11pm

Feeling tired and slight nausea but nothing too bad.

D Mannose. Recommended by DD’s urologist. She’s been infection free for 18 months.