Hello doctor,
I am 36 years old suffering from UTI and urine retention. I am a father of two, height is six feet and weighing 191 pounds. I was suffering from mild constipation (first poop is easy but clearing remaining used to take some time from past few months. I used to spend at least 15-20 minutes in loo. This is when I observed urine retention and mild constipation). From past few months, even my rectum was paining. History of UTI includes, it all started with severe pain after the passage of urine five months back. It was diagnosed as seminal vesiculitis and urologist said that it is common among men and advised sitz bath whenever it pains and advised me to have sex regularly. Though sitting in hot water tub helped me and it relieved me from pain, but the pain was recurring every 20 to 30 days. This continued for almost 18 months. Four months back, I had few drinks (I never consumed alcohol earlier) continuously for a few days, and that triggered severe pain after urination. One day it was so severe that I noticed blood in urine (hematuria) and urination was very frequent on that day. I suffered from fever also that day. The very next day I went to a urologist and got it diagnosed. This time my doctor advised for the following lab test: Hemogram (automated), glucose – random, glycated hemoglobin (HbA1c), creatinine – serum, urine routine, microscopy (qualitative method), urine culture, imaging – ultrasound abdomen (including post void residue) and uroflowmetry.
It was diagnosed as UTI infection with below observations (latest report): Major impressions: Cystitis. Pre void/post void – 270 cc/90 cc (significant). Liver – Normal. Gallbladder: Distended. Wall of the gallbladder is within normal limits. No calculi seen. Spleen: Normal in size and show normal echo pattern. No focal lesion. Aorta: Normal in course and caliber. Pancreas: Normal in size and shows normal echo pattern. Kidneys: Both kidneys are normal in size and shows normal corticomedullary echogenicity. No calculi or hydronephrosis seen. Urinary bladder: Distended. Increased wall thickening noted measuring 5 mm with mucosal irregularity and multiple floating internal echoes notes. Pre void: 270 cc and post void: 90 cc. Prostrate: Normal in size. Normal in shape and shows normal echotexture. No focal lesion. No paraaortic nodes or free fluid in the abdomen. Culture report - Organism isolate: E coli with colony count: >1,00,000 cfu/ml. Serum creatinine: 0.90 (within biological reference range). Serum glucose (Random) : 121 mg/dl. Glycated Hb (whole blood) : 4.90 %. WBC count: 17300/cu.mm. RBC count: 4.95 million cells/cubic mm. Hemoglobin: 14.90 mg/dl. Hematocrit: 43.10 %. MCV: 87.20 fl. MCH: 30 pg. MCHCV: 34.40 g/dl. Platelet count : 297000 / cu mm. Differential count. Neutrophils: 83.00# above range (40.00 – 75:00). Lymphocytes: 12.00# less than range (20.00 – 45.00). Monocytes: 4.00 % (2 -10). Eosinophils: 1.0 (0.00 -7.00). ESR: 32.00/1st hour (0.00 -10). Peripheral Smear examination: RBCs are normocytic normochromic with an increase in rouleaux formation. WBCs show neutrophilic leucocytosis. Platelets are adequate. Routine urine analysis, microscopic description includes, colour: Pale yellow. Appearance: Slightly turbid. Reaction (PH)- 6.5. Specific gravity: 1.01. Chemical examination: Protein/albumin – Present 1+. Glucose – NIL. Ketone bodies – NIL. Urobilinogen – Normal. Bile salts – Negative. Bile Pigments - NIL. Microscopic Examination: WBC/pus cells: Numerous/hpf. RBC – Nil. Epithelial cells – 10-15 hpf.
The doctor prescribed Septra (Trimethoprim and Sulfamethoxazole) (2-0-2) for seven days & Sildoo 8 (Silodosin) once daily for one month – I took Septra course for seven days but did not take Sildoo considering its side effects and dependency. Meanwhile, I started taking ayurvedic medicine, and my urinary pain (during and post-urination pain) and rectal pain are no more, but urine retention persists. Current lifestyle changes that I have made. Not having coffee or tea. Only occasional outside food. Having plenty of water and fluids. Yoga or exercising regularly. My questions are, can I take Sildoo 8? Will this harm me in future? Can I discontinue Sildoo 8 after this courseor will I be dependent on Sildoo for lifetime? Can urine retention be cured completely? Can recurring UTI be completely cured? My prostate is normal in size, but I am prescribed Sildoo. Can I take Sildoo even without prostate enlargement? Will Sildoo effect my sex life? How to overcome its side effects?
Hi,
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With your elaborate history what I could make out is that you had a severe episode of acute prostatitis which was undertreated and now it is chronic prostatitis syndrome. Also, you have severe constipation. Sildoo is silodosin which is a highly potent alpha-blocker. I would like to place you on an alpha-blocker like Alfuzosin which will not produce any retrograde ejaculation in young males. Consult your specialist doctor, discuss with him or her and take medications with their consent. Also, you have to correct your constipation. Could you send a picture of uroflowmetry with the date? I would like to do a fresh uroflowmetry with post void residue for you. Prostatic symptoms at times are not related to its size rather to the alpha receptor overactivity.
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