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Urology (Expert Forum)
Urethral Syndrome
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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Urethral Syndrome
by DJH, Apr 16, 2003 12:00AM
Dr.,
Please reference my intial question of 4-2-03.
What organisms or type, would not be sensitive to cipro,doxy, or zithro and would be sensitive to flagyl/metro; and why would that organism not be evident on a urinalysis and urine culture?
Infect by G or C is not a possibility; is there another type of generic culture/test, other than urine which could be done to identify the offending organism and its antibiotic sensitivity?
Might Bactrim be effective?
Could a GI problem be causing the symptoms I complain of?
Could anything over the counter help; if not, I am becoming frustrated with repeated fruitless Drs visits, which country near the US allows purchase of Flagyl w/o an rx? How long should one allow between antibiotic therapies.
Thank you very much for your help.
Please reference my intial question of 4-2-03.
What organisms or type, would not be sensitive to cipro,doxy, or zithro and would be sensitive to flagyl/metro; and why would that organism not be evident on a urinalysis and urine culture?
Infect by G or C is not a possibility; is there another type of generic culture/test, other than urine which could be done to identify the offending organism and its antibiotic sensitivity?
Might Bactrim be effective?
Could a GI problem be causing the symptoms I complain of?
Could anything over the counter help; if not, I am becoming frustrated with repeated fruitless Drs visits, which country near the US allows purchase of Flagyl w/o an rx? How long should one allow between antibiotic therapies.
Thank you very much for your help.
Doctor's Answer
by Kevin Pho, MD, Apr 17, 2003 12:00AM
, Apr 17, 2003 12:00AM
Hello - thanks for asking your question.
To answer your questions:
1) This is not a clear-cut answer. The same bacteria that is sensitive to some antibiotics, may not be to others. Broadly speaking, anaerobic bacteria (bacteroides, clostridium) are more senstive to flagyl, but less so to cipro/doxy/azithro. In some cases there is not enough of the bacteria present in the culture sample to grow, which results in a negative test.
2) A urethral swab test (direct culture of the urethra) can also be performed to identify if bacteria is causing your symptoms.
3) If the bacteria is resistant to other antibiotics, Bactrim may be effective.
4) I am not aware of GI causes cauing urethral symptoms. However, other causes may include a neurological cause (i.e. nerve irritation), or a prostate infection. You may want to consider a neurological evaluation if your physician agrees.
5) If nothing prescription works, I am not aware of anything over the counter that could help. I am also not aware of a country where you can obtain Flagyl without a prescription.
You may want to consider that your symptoms are not caused by an infection. I would consider a cystoscopy to evaluate for urethral strictures or polyps. As I mentioned before, a referral to a neurologist may help.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
To answer your questions:
1) This is not a clear-cut answer. The same bacteria that is sensitive to some antibiotics, may not be to others. Broadly speaking, anaerobic bacteria (bacteroides, clostridium) are more senstive to flagyl, but less so to cipro/doxy/azithro. In some cases there is not enough of the bacteria present in the culture sample to grow, which results in a negative test.
2) A urethral swab test (direct culture of the urethra) can also be performed to identify if bacteria is causing your symptoms.
3) If the bacteria is resistant to other antibiotics, Bactrim may be effective.
4) I am not aware of GI causes cauing urethral symptoms. However, other causes may include a neurological cause (i.e. nerve irritation), or a prostate infection. You may want to consider a neurological evaluation if your physician agrees.
5) If nothing prescription works, I am not aware of anything over the counter that could help. I am also not aware of a country where you can obtain Flagyl without a prescription.
You may want to consider that your symptoms are not caused by an infection. I would consider a cystoscopy to evaluate for urethral strictures or polyps. As I mentioned before, a referral to a neurologist may help.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments (2)
by DJH, Apr 17, 2003 12:00AM
To: Urinary Tract Infections
0
by susfubb, Apr 20, 2003 12:00AM
To: Urinary Tract Infections
0
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