uti

You need to have a urine sample taken and passed to the lab to work out what bacteria it is, and which antibiotics will hit it, rather than those it's resistant to. This takes about 3 days, and then you go and get one of the relevant antibiotics from your GP.

If you got the antibiotic prescription when you went into the GP, it's a guess, and may not work.

Around 70% of male urinary infections are caused by outflow obstructions (something slowing your pee rate), causing incomplete voiding (not fully emptying your bladder). If you are getting recurrent UTIs, you should ask to be referred to urology so they can check peak flow rate and perform a cystoscopy if necessary.

Edited by member 11 Apr 2020 at 18:17  | Reason: Not specified

Bill

I probably have taken tamsulosin in the early days of my stricture but cannot recall it being effective, hence the reason for trying all sorts of other medications. Good points from Andy on how tamsulosin works.

You say your max flow of 3mls/sec quickly slows to a dribble, do you mean at each visit to the toilet or over a period of time.

Post dilation I could sometimes  do an average of  between  20 and 10mls/sec and it usually took three or four months to get back down to 0.5mls/sec. Scar tissue continues to grow which is why I needed numerous dilations.

Thanks Chris

I'll suggest an alternative strategy to try. Don't try fighting it when the stream stops. Just wait 30 seconds, and then go for a pee again (by relaxing like normal, not by forcing). This is called double voiding. Keep doing this until you reach the point there is nothing more left in the bladder other than the few cc's your kidneys will have generated in the last 30 seconds wait. I can't promise it will work, but it's probably worth a try.

The smooth muscle of the sphincter doesn't relax until your bladder is empty - it relaxes for a length of time which is normally ample to empty your bladder at a reasonable flow rate. For a slow flow rate, it will contract and close the sphincter before your bladder is empty (which is why slow flow causes incomplete voiding). So the suggestion above is to accept that will happen, but then go for a pee again to repeat the process as necessary until you do empty your bladder. Trying to force pee out by tensing can be counter productive by also tensing muscles that restrict flow, and might do some other damage in your abdomen/bowel.

Going for a pee should be a relaxing task. If you find yourself all tensed up worrying if it will work or not, try taking in something to distract you like a book or a smartphone, sit on the loo, and use those between pees to take your mind off it. (Don't sit on the loo for hours - it's not great for circulation in the legs.)

Maybe urine running past an open scar. You probably restrict your fluid intake in the light of the difficulty voiding, and that may make your urine more concentrated and acidic. If you get more confident that you can empty your bladder, increase your fluid intake to make your urine more dilute. It should look no more concentrated than pale straw coloured. If it looks more like orange juice, that might be part of the explanation for the pain.

I've given some quite detailed suggestions here, but note that I am not a clinician, and you may have some condition I have failed to recognise. You might want to run them past your own clinicians first. At a flow rate of 3ml/s, you are at risk of going in to retention.

Edited by member 13 Apr 2020 at 08:33  | Reason: Not specified