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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17543
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Salam My mother is around 72 years old, shes type II diabetic

Customer Question

Salam
My mother is around 72 years old, she's type II diabetic & hypertensive but thank god control on oral tablets.
Since One year back she's suffering from burning in the urine specialy when she is sleeping & the urine is accumulated mostly at night which disturb her sleeping... once pass the urine will be more relax.
We checked with Gyne Doctors also they took specimen from her vagina & uterus Alhamdullelah all are normal.
We did urine culture test many times sometimes there is microbe like E_Coli so the Dr gave her sesitive Anti Biotic according to the microbe.
She had Herpis Simplex on left side of her face & neck two years back also & got full course treatment with dermatologist but still sometimes has itching although she's on Antihistamine tablet. Also one of her major problem costipation although she's on different laxative but no use.
We got very confused about her case coz she is suffering a lot.
Looking for your advice please.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. SH replied 2 years ago.

Dr. Shahzad MD :

Hi there. Thank you for your question. I will be helping you out with your queries

Dr. Shahzad MD :

Walaikum Asalaam.

Dr. Shahzad MD :

welcome

Dr. Shahzad MD :

Have you been to a urologist for this as yet?

Dr. Shahzad MD :

What kind of antibiotics has she been treated with?

Dr. Shahzad MD :

What is the symptom that is bothering her the most at the present moment?

Dr. Shahzad MD :

Please let me know.

Expert:  Dr. SH replied 2 years ago.

I tried the live chat session but I could not connect with you.
I would appreciate it if you could provide me more information on the questions that I have asked above.
Kindest Regards

Customer: replied 2 years ago.

 


1- yes we went to two different urologist. Even kidney scan been done and result was fine.


2- zinnat, Augmentin & Tavanic Tab for different courses.


3- Burning sensation down.

Expert:  Dr. SH replied 2 years ago.

I would personally give a course of antifungal treatment in the form of fluconazole (diflucan).

I say this because quite often diabetics have a fungal infection in the urinary tract and this will not response to antibiotics and will require antifungal drugs.

Fluconazole 150 mg be given at a dose of once daily for a period of five days.

If this does not work then I would recommend that she should have a cystoscopy done to have a look at the bladder from the inside and do a biopsy if required.

Let me know if you have any further questions.

Rate me for my services when you are done.

Regards

 

Customer: replied 2 years ago.

Salam Dr.


Thanks for caring.


I would like to inform you that one of Gynecologist prescribed Fluconazole 150mg &we gave her the full course but same problem is continuous with her.


Thanks

Expert:  Dr. D. Love replied 2 years ago.
The other expert has opted out.
Did they repeat the urine culture after the course of antibiotics?
If so, what was the result?
Did either Urologist perform a cystoscopy, a procedure to look inside the bladder?

Customer: replied 2 years ago.

What we have noticed whether there is microbe in her urine or not still she has burn.

Expert:  Dr. D. Love replied 2 years ago.
Does that mean that the last culture report was negative?
Did either Urologist perform a cystoscopy?

Customer: replied 2 years ago.

Honestly we haven't retest urine since anti biotic treatment had over 5 days ago but still she has burn.


With respect t.ko second question , no such test has been done


 


and

Expert:  Dr. D. Love replied 2 years ago.
Thank you for the additional information.

Well, the first issue would be to repeat the urine culture. The antibiotics that she was prescribed are good antibiotics, but there is no antibiotic that works 100% of the time. We typically do not recheck urine cultures when symptoms improve with antibiotics, but in someone with a positive culture and persistent symptoms despite antibiotics, it would be appropriate to recheck the culture. It is possible that the original germ has developed a new resistance to antibiotics, and this can only be detected by a repeat urine culture, which will also do sensitivities.

The reason tat I ask about the cystoscopy is because of two issues that can be addressed by this procedure. It is possible that there can be an anatomic condition that is contributing to either a persistent infection or symptoms in the absence of an infection. There also is another condition that can mimic a urine infection, called interstitial cystitis. Part of the evaluation for anatomic conditions would be the kidney scans that have been done, but the cystoscopy is better at detecting anatomic conditions of the bladder. The cystoscopy is also the usual test for assessment for interstitial cystitis.

If the repeat urine culture is positive and the sensitivities can guide selection of a different antibiotic that will eradicate symptoms, then there is less need for consideration of a cystoscopy. If the symptoms persist and there is no infection that can readily be treated, then it would be appropriate to consider a cystoscopy.

If you have any further questions, please let me know.

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