How can I prevent recurrent UTIs as a 36-year-old male?

Question

Hello doctor,

I am a 36-year-old male experiencing urinary retention and recurrent urinary tract infections (UTIs). I am 6 feet tall, weigh 191 pounds, and am a father of two. For the past few months, I have also been dealing with mild constipation. My initial bowel movement is easy, but fully clearing the bowels often takes 15 to 20 minutes. Around the same time, I began noticing urinary retention and occasional rectal discomfort.

My symptoms began about five months ago with severe pain after urination. I was diagnosed with seminal vesiculitis, and the urologist explained that it is common in men. I was advised to take sitz baths during painful episodes and to maintain regular sexual activity. Although the sitz baths provided temporary relief, the pain returned every 20 to 30 days and continued for approximately 18 months.

About four months ago, after consuming alcohol for a few consecutive days (I rarely drink), the pain after urination worsened significantly. One episode was severe enough that I noticed blood in my urine, along with very frequent urination and fever. I consulted a urologist the next day and underwent several tests, including: Complete blood count, Random blood glucose and HbA1c, Serum creatinine, Urine routine and microscopy, Urine culture, Abdominal ultrasound with post-void residual assessment, Uroflowmetry

Diagnosis: UTI with cystitis

Key findings:– Pre-void bladder volume: 270 cc–, Post-void residual: 90 cc (significant), Bladder wall thickening with mucosal irregularity, Kidneys, prostate, liver, gallbladder, spleen, and pancreas all within normal limits, Urine culture: E. coli >100,000 CFU/mL, Blood tests indicated elevated WBC count and neutrophils, Urine analysis showed 1+ protein, numerous pus cells, and mild turbidity

My doctor prescribed Septra (Trimethoprim + Sulfamethoxazole) twice daily for seven days and Sildoo 8 (Silodosin) once daily for one month. I completed the Septra course but hesitated to start Sildoo due to concerns about side effects and long-term dependency. Meanwhile, I began Ayurvedic treatment, which resolved my urinary and rectal pain, although urinary retention persists.

I have also made lifestyle changes such as avoiding tea and coffee, limiting outside food, staying well-hydrated, and practicing yoga/exercise regularly.

I would appreciate your guidance on the following questions:

Is it advisable for me to start taking Sildoo 8?
Could it have any long-term negative effects?
After completing the prescribed course, can I safely discontinue it, or is there a risk of becoming dependent on it?
Can urinary retention be fully cured?
Is it possible to eliminate recurrent UTIs?
Although my prostate is normal in size, I was still prescribed Sildoo. Can it be taken even without prostate enlargement?
Will Sildoo affect my sexual function?
Are there ways to minimize or manage its side effects?

Thank you for your time and guidance.

Answer 1

Hi,

Welcome to icliniq.com.

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 the uroflowmetry with the date? I would like to do a fresh uroflowmetry with postvoid residue for you. Prostatic symptoms at times are not related to its size but rather to the alpha receptor overactivity.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.