Neobladder and urinalysis for UTI

13 years 11 months ago #31261 by Christine Springfield
Replied by Christine Springfield on topic Neobladder and urinalysis for UTI
Just wanted to thank you all for your input on this issue!

I had another UTI last Thursday, so I brought this whole thread in with the referenced article and got to share it with my doctor. He seemed to appreciate that I was doing what I could to educate him on the whole neobladder situation and he definitely has a clear understanding of what's going on in there physiologically. He still wants to do cultures when possible to make sure that there are not any "superbugs" causing the problems, which I am OK with now that I am back on insurance.

Concerning the UTI's, I have been trying to figure out what is triggering them. I think I have it narrowed down to spicy cajun food (not Mexican, for some reason). Seems like the last 3 UTI's have all occurred the day after a meal involving cajun food. My thought is that the neobladder (made from intestine) is freaking out from the spices and trying to combat them somehow. Am I totally grasping at straws, or has anyone else experienced anything like this? It would be nice to determine the trigger and just avoid it!

Also, MAN they seem to come on FAST these days! When I had my old "bad" bladder, I would get kind of warning twinges in the urethra area and I had about 3 days to get in to see a doctor for meds before it would get really uncomfortable. (Gee... wonder why it crapped out on me, right?) Now, if my back starts hurting at 10 a.m., I am in excruciating pain by 2 p.m. It took some real negotiating to get into the doctor's office right away this time and I knew it was going to have to be the ER if they could not see me. What gives?

What do y'all think?

Thanks,
Christine

T3/G3 - Squamous Cell/Transitional Cell Carcinomas
RC w/Studer Pouch 4/25/07

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14 years 1 month ago #30016 by harleygirl
Replied by harleygirl on topic Neobladder and urinalysis for UTI
All the uros that have been involved with my Dad's care since his RC and ileal conduit have basically said the same thing. Since the urine passes through bowel, bacteria is going to show up with infection or no infection. He has come to know the symptoms of UTI for him and at the first sign of infection, he calls his uro who calls in Cipro or something similar. The issue now is that he has ureteral stents in both ureters (and has had for about 2 years now) and some heavy-duty SUPERBUGS seem to colonize the stents. They culture the stents when he has them changed out every three months and those super-bacteria are always there. Thank goodness they have not migrated into his blood stream or caused any type of active infection.

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14 years 1 month ago #29978 by Patricia
Replied by Patricia on topic Neobladder and urinalysis for UTI
Well i've never had a UTI because, i think, i have never reused a catheter and i have an Indiana Pouch which has a valve to prevent backup into the kidneys.....however, every time i've had to go into an emergency room and give a urine sample they tell me i have a UTI and i tell them i don't and then hand them a paper which i downloaded from Pub/Med which explains why. They usually just scratch their heads but i'm slowly educating them....veeeeeeeeery slooooooowly! Here it is..copy it and take with you!!
www.ncbi.nlm.nih.gov/pubmed/18070190?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed
My uro knows the symptoms..flank pain and usually very odorous...
pat

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14 years 1 month ago #29974 by Christine Springfield
Neobladder and urinalysis for UTI was created by Christine Springfield
So I have had my Studer pouch neobladder for about 2 1/2 years. After the surgery, multiple urologists at M.D. Anderson emphasized that future urinalyses would be pointless because of the neobladder and the bacteria load associated with the intestinal wall construction.

Since my "installation", I have had a few UTI's. With the first one, it was a surprise. Basically I felt kind of crappy, then the flank pain set in. It felt like an elephant was kicking me in the kidneys continually. I called my urologist at M.D. Anderson and he had me come into the ER. At the ER, they did a very basic physical exam (vitals and tapped on my back to identify the areas that hurt, then palpated my abdomen). There was no urinalysis, which was weird, but expected. They told me that with neobladder UTI's, they basically confirm the symptoms and then prescribe an antibiotic, usually Leviquin. Same thing happened for the next one, too.

So, I decided that since this seemed so routine, my normal doctor could handle it and I would save the long drive and expense of using M.D. Anderson, which is pretty much always an ER visit.

I explained the process that M.D. Anderson used for UTI's when I visited my normal doctor, why they didn't do a urinalysis and he still REALLY wanted to do both a urinalysis and a urine culture. I figured, what the hell, insurance covers it and it'll make him more comfortable. No surprise that the UTI was confirmed by both tests.

Anyway, I got the flank pain again this afternoon. Being currently unemployed and uninsured until 3/1, I felt like doing those additional tests was just going to cost me more out-of-pocket money. Even after talking about it, he was still pretty uncomfortable just treating with Levaquin but he did agree to it and even gave me samples for the 10 day treatment (Leviquin is expensive!). I REALLY like this doctor, have a long history with him and can see why he has these concerns.

What protocol do your doctors follow when they suspect a UTI? It would be so nice to be able to present him with some documentation or a standard of care for this that we are both comfortable with.

By the way, strictures are not an issue... ruled out by all those other tests regularly done by M.D. Anderson at regular intervals.

Thanks for your help!
Christine

T3/G3 - Squamous Cell/Transitional Cell Carcinomas
RC w/Studer Pouch 4/25/07

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