Urethral stricture decsion Part 2

Thats interesting on the CRP...i always have to ask my internist to do that test as its not routine with him. I know it indicates inflammation ..just doesn't tell you where especially if you're asymptomatic.
My poor husband had a kidney stone once and his comment was that he totally appreciated women and childbirth ......OUCH.
Feel better soon........Pat

Hey Pat,
All of the post procedure workup was done by me through my office. My urologist won't even know what's happened until I get to speak with him on Monday. Since most docs would report a less than 10,000 colony count to the patient as a negative culture, the patient would be non the wiser. I just couldn't dismiss it with my fever and symptoms, and since I ordered the culture, I could be the one to request further analysis.
I've had kidney stones 4 times. The first trouble was 8 years ago during the Mitomycin C treatment for my bladder cancer. The remaining 3 times were within the past 2 years, always while I was suffering from stricture or procedure related symptoms. It would appear that my lower urinary tract issues like upper urinary tract company.
BTW, my organism was senstive to Bactrim and Cipro, but I opted for Levaquin because it only has to be taken once a day.
I am glad I opted to start the antibiotic rather than waiting for the confirmatory culture because I just can't consider the Serratia a contaminant. By the time I started the antibiotic I was afebrile and my systemic symptoms were improving. My CBC was unremarkable but my CRP was a whopping 158. We'll never know for sure what I had, but with the kidney stone thrown in for good measure at the end, I just can't be sure what's causing what, and I'm glad I'm on a full course of Levaquin.
-Warren

Wow...you're right Warren.....how many would insist on a breakdown of their urinalysis.........This wasn't the new doctor was it?
Ninety percent of patients with Serratia urinary tract infection have a history of recent surgery or instrumentation of the urinary tract.
Makes you wonder how long that bottle of sterile solution was open huh?
Well at least you're on the right antibiotic for it...Cipro works also.
Have you had kidney stones in the past?
So sorry for your pain......Pat

First, a quick recap. I saw my urologist last Friday for him to evaluate my stricture and make a decision about treatment. The question was, "Is the opening of the stricture large enough for me to attempt self catheterization again?" My uro placed the cystoscope in only as far as the stricture to look at it. He did not pass through the stricture or enter the bladder. I had no pain during the procedure. Now, considering the aftermath of this uncomplicated procedure I am quite certain that self catheterization would be a disaster.
Let's start by taking the mystery out of the events that followed. There are three possible interpretations:
1. I developed lots of inflammation from just passing the scope to the stricture plus I waws unfortunate enough to develop some other miserable illness while suffering with post procedural pain.
2. I developed lots of inflammation from just passing the scope to the stricture complicated by a UTI
3. I have a UTI (unlikley as the only explanation)
I had mild dysuria and frequency after the procedure which continued for a while. This is not an unusual reaction to instrumentation for me. Sunday night I had difficulty sleeping and was urinating frequently. Monday I did a urinalysis which showed moderate blood but now white cells, nitrite, or bacteria. Monday afternoon I developed shaking chills, fever to 102.5, and worsening urinary symptoms. Repeat urinalysis was the same and I sent s specimen for culture. I spoke to the covering urologist who felt that the story and urinalysis were not consistent with a UTI.
The fever continued until Friday night, a total of 5 days. Let me add that I was also miserable aside from the urine symptoms. In the meanwhile the culture came back showing less than 10,000 colonies/ml of bacteria. A UTI usually causes at least 50-100,000 col/ml, so the result was considered insignificant; however, I've had many urine cultures in the past, all of which showed no growth. I asked the lab to identify the organism and get antibiotic sensitivities. It turned out to be 3,000 col/ml of Serratia marcesens. I did a little research, and while the organism may be found in the intestines, it's not a skin organism and strikes me as a highly unlikely contaminant of a midstream urine. It can also bea contaminant in supposedly sterile solutions including the solution used to sterilize the cystoscope.
Today (Saturday) I have had no fever and feel much better, but still have annoying urinary symptoms. In addition, yesterday I started intermittently passing fingernail clipping sized and shaped clots. I did a repeat urinalysis which now showed large blood, and still nothing else. I sent a reapeat culture and drew some blood from myself. I started treatment with Levaquin.
For those of you thinking clots=cancer I had my last clean scope 2 months ago and have never had a recurrence. The clots are likely from the stricture or a UTI. Based on their consistent shape, I think they're from the stricture.*
Anyway, I am now certain that self catheterization would have been a disaster. I also wonder how any of you who are not physicians would have managed if the same thing had happened to you after a scope.
-Warren
*Addendum: Based on the fact that there have been way too many clots to come frm an irritated stricture and other symptoms I had during and right after posting this, I may now have passed or be passing a kidney stone on top of everything else