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Posted: 3/16/2006 4:15:44 PM EDT
I go to the doc today over some serious pain, more serious than any other UTI I have ever had, but far less painful then any kidney stone attack I've ever had (Believe me, I've had my fair share of both) and he tells me I have a UTI. I really don't think that's my problem...but whatever, he's the doctor right? He doesn't do any kind of examination, and hasn't got my urine culture back yet, but is going to go ahead and treat me like it is an UTI. He calls me back to let me know that since I do have such a history of stones that I need to be aware that UTI's are generally the beginning of an attack So I sit there like WTF? I just sit here and wait to wither in pain? I mean REALLY!
Link Posted: 3/16/2006 4:23:36 PM EDT

Originally Posted By MSKOOTER:
I go to the doc today over some serious pain, more serious than any other UTI I have ever had, but far less painful then any kidney stone attack I've ever had (Believe me, I've had my fair share of both) and he tells me I have a UTI. I really don't think that's my problem...but whatever, he's the doctor right? He doesn't do any kind of examination, and hasn't got my urine culture back yet, but is going to go ahead and treat me like it is an UTI. He calls me back to let me know that since I do have such a history of stones that I need to be aware that UTI's are generally the beginning of an attack So I sit there like WTF? I just sit here and wait to wither in pain? I mean REALLY!



You don't say much about your symptoms but the irritation caused by ureterolithiais can lead to a UTI.

That said, I suspect that maybe he has reconsidered his diagnosis.
However, there is no reason to wait on a culture to treat a UTI. Would you rather you became much more ill while waiting for the culture?

I didn't see you, nor did I see your U/A so I haven't much to go on.
If you are not pregnant, a KUB film may pick up a stone but not always. CT is much more definitive but as always, expensive tests are really not all that necessary to make a proper diagnosis provided an adequate history and exam are performed.

Link Posted: 3/16/2006 4:29:13 PM EDT

Originally Posted By drjarhead:

Originally Posted By MSKOOTER:
I go to the doc today over some serious pain, more serious than any other UTI I have ever had, but far less painful then any kidney stone attack I've ever had (Believe me, I've had my fair share of both) and he tells me I have a UTI. I really don't think that's my problem...but whatever, he's the doctor right? He doesn't do any kind of examination, and hasn't got my urine culture back yet, but is going to go ahead and treat me like it is an UTI. He calls me back to let me know that since I do have such a history of stones that I need to be aware that UTI's are generally the beginning of an attack So I sit there like WTF? I just sit here and wait to wither in pain? I mean REALLY!



You don't say much about your symptoms but the irritation caused by ureterolithiais can lead to a UTI.

That said, I suspect that maybe he has reconsidered his diagnosis.
However, there is no reason to wait on a culture to treat a UTI. Would you rather you became much more ill while waiting for the culture?

I didn't see you, nor did I see your U/A so I haven't much to go on.
If you are not pregnant, a KUB film may pick up a stone but not always. CT is much more definitive but as always, expensive tests are really not all that necessary to make a proper diagnosis provided an adequate history and exam are performed.




The U/A has not yet come back, I also get to see my test results online. I've had an ultra sound done on my kidneys about 3 years ago or so and they found a lot of stones, I average a kidney stone attack a year or so

My problem is that there is a TON of pressure in my pelvic area, my lower back is hurting, there is blood in my urine and when I void it's extremely painful near the end of the process, to the point that my whole body quivers. Nothing burns/stings...just pressure and pain. I know I'm not pregnant, and I know it's not my cycle. I just know that I've never had an UTI that hurt THIS bad. The reason I don't really want to take the Trimeth-sulfa tablets is because they give me killer headaches.
Link Posted: 3/16/2006 4:44:51 PM EDT

Originally Posted By MSKOOTER:

Originally Posted By drjarhead:

Originally Posted By MSKOOTER:
I go to the doc today over some serious pain, more serious than any other UTI I have ever had, but far less painful then any kidney stone attack I've ever had (Believe me, I've had my fair share of both) and he tells me I have a UTI. I really don't think that's my problem...but whatever, he's the doctor right? He doesn't do any kind of examination, and hasn't got my urine culture back yet, but is going to go ahead and treat me like it is an UTI. He calls me back to let me know that since I do have such a history of stones that I need to be aware that UTI's are generally the beginning of an attack So I sit there like WTF? I just sit here and wait to wither in pain? I mean REALLY!



You don't say much about your symptoms but the irritation caused by ureterolithiais can lead to a UTI.

That said, I suspect that maybe he has reconsidered his diagnosis.
However, there is no reason to wait on a culture to treat a UTI. Would you rather you became much more ill while waiting for the culture?

I didn't see you, nor did I see your U/A so I haven't much to go on.
If you are not pregnant, a KUB film may pick up a stone but not always. CT is much more definitive but as always, expensive tests are really not all that necessary to make a proper diagnosis provided an adequate history and exam are performed.




The U/A has not yet come back, I also get to see my test results online. I've had an ultra sound done on my kidneys about 3 years ago or so and they found a lot of stones, I average a kidney stone attack a year or so



A U/A takes 1 minute on the dip and a little more on the spin and micro. 30minutes tops.
I ALWAYS had pts wait while we ran. Typically, I would have them start running before I even went in the room if their symptoms indicated the test be done.


My problem is that there is a TON of pressure in my pelvic area, my lower back is hurting, there is blood in my urine and when I void it's extremely painful near the end of the process, to the point that my whole body quivers. Nothing burns/stings...just pressure and pain.


Could definitely be a UTI or a stone(they can hang up in different places-3 places typically where they get stuck). It could also be something else. You need to take your antibiotics or it is going to get worse if it is a UTI.



I know I'm not pregnant, and I know it's not my cycle.


Gotcha. But I would never do Xrays or a CT on a child bearing age woman without verifying first. Some get mad about that, I don't care.


I just know that I've never had an UTI that hurt THIS bad.


That doesn't mean it isn't one, but it could be something else also. Your history would lead me to cover the bases as to other potential diagnoses.


The reason I don't really want to take the Trimeth-sulfa tablets is because they give me killer headaches.



Did you tell your doc that???
Maybe you should call and see if you can get on something else tonight yet.

Pyridium can be obtained OTC and will help with bladder spasm.

You should also list TMP/SMX(Bactrim or Septra) as an adverse reaction on your chart.
FWIW, I have found it to be mediocre at clearing UTIs due to all of the problems with antibiotic resistance.

The other alternative is to go into the ER and be seen again. It might not be a bad idea but maybe you should just call your doc first. If they are not availabel there should be someone on call for them and they may be able to help. Deal with it before the pharmacies close.
Link Posted: 3/16/2006 4:51:19 PM EDT
i had a uti a couple years back. told me it was rare for guys to get them, guess i'm just lucky like that...

all i can say is it hurt worse than anything in the world to take a piss. never wanna experience that again. EVER.
Link Posted: 3/16/2006 4:53:43 PM EDT
Additionally, based on your one stone/year history:

Did they ever do an analysis on one?

You are probably not drinking enough water.

Treatment is clearly intended to help you pass the stone if that is what is going on.
Pain pills and fluids.

Sometimes they have to remove the stone and place a stent to keep the ureter open.

In all honesty, based solely on your limited history, I'd say you have a stone at the UVJ(ureterovesicular junction) Where the tube from the kidney dumps into the bladder. There is a valve there. And yeah it hurts like hell....

Typically a stone is more one sided, pain typically radiates into the flank and groin region given location I am assuming. Tenderness above the ovary a little ways up on the affected side.


Know that there is always the chance it is some oddball thing that would require a further workup. I could name a bunch but the odds are on a UTI or stone given your history.
Link Posted: 3/16/2006 4:55:05 PM EDT

Originally Posted By jerrmy:
i had a uti a couple years back. told me it was rare for guys to get them, guess i'm just lucky like that...

all i can say is it hurt worse than anything in the world to take a piss. never wanna experience that again. EVER.



Very unusual for guys.
When it occurs I start looking for other pathology, ie what caused it?
Or is the diagnosis correct?

My 2 cents.
Link Posted: 3/16/2006 5:11:52 PM EDT

Originally Posted By drjarhead:
Additionally, based on your one stone/year history:

Did they ever do an analysis on one?

You are probably not drinking enough water.

Treatment is clearly intended to help you pass the stone if that is what is going on.
Pain pills and fluids.

Sometimes they have to remove the stone and place a stent to keep the ureter open.

In all honesty, based solely on your limited history, I'd say you have a stone at the UVJ(ureterovesicular junction) Where the tube from the kidney dumps into the bladder. There is a valve there. And yeah it hurts like hell....

Typically a stone is more one sided, pain typically radiates into the flank and groin region given location I am assuming. Tenderness above the ovary a little ways up on the affected side.


Know that there is always the chance it is some oddball thing that would require a further workup. I could name a bunch but the odds are on a UTI or stone given your history.



Thanks for the input, I have started the sulfa pills, they didn't give me the Pyridium since there is no burning. They did run tests on one of the stones that I caught in the strainer while pregnant and in the hospital and best I can remember it was a calcium based stone? I know I don't drink enough water I showed up an hour before my appoint to leave a "sample" so I don't know WHY it has taken so long to get the results, I still haven't got the email that says my results are in. I don't want to go back to the urgent care because Kooter doesn't get off until super late and I don't want to take both kids with me. I told him the pills give me a headache, but he said it's because I'm not taking enough water with them. He said if I take 2 full glasses of water with them that should eliminate the headache. The pain in my pelvic area is right about where you said the tenderness would be. But every other stone I've had has left me withering in pain bad enough that I couldn't stand/sit/lay flat/hunch over or anything comfortably. It's not that bad.....yet. Hopefully this will all go away soon enough as he gave me just a 3 day prescription of sulfa tabs.
Link Posted: 3/16/2006 6:14:41 PM EDT
Doesn't drinking cranberry juice help?
Link Posted: 3/16/2006 6:17:14 PM EDT

Originally Posted By GunLvrPHD:
Doesn't drinking cranberry juice help?



Or lite beer
Link Posted: 3/16/2006 6:25:30 PM EDT
[Last Edit: 3/16/2006 6:26:22 PM EDT by The_Reaper]
My ex-wife used to get UTIs all the time.

Doc told me the stick test only looked for blood.

If you have a stone, it will produce blood.
So the stick test, if described accurately, will yield a false positive for UTI.

Stones and UTIs are totally unrelated.

A stone will not cause a UTI, because urine is sterile.

And a UTI will not cause a stone.

Link Posted: 3/16/2006 6:25:36 PM EDT

Originally Posted By GunLvrPHD:
Doesn't drinking cranberry juice help?



The hippuric acid in cranberry juice make it more difficult for bacteria to attach to the bladder wall. Cranberry juice + antibiotics + pushing fluids hard help clear the infection.

Contrary to popular belief, urine is far from sterile. But if you drink enough fluids, bacteria never get very concentrated.
Link Posted: 3/16/2006 6:27:42 PM EDT
[Last Edit: 3/16/2006 6:31:04 PM EDT by The_Reaper]

Originally Posted By C-4:
Contrary to popular belief, urine is far from sterile. But if you drink enough fluids, bacteria never get very concentrated.



National Institute of Health claims urine is sterile.

kidney.niddk.nih.gov/kudiseases/pubs/utiadult/
Link Posted: 3/16/2006 6:31:48 PM EDT

Originally Posted By The_Reaper:
My ex-wife used to get UTIs all the time.

Doc told me the stick test only looked for blood.
False. It also looks for leukocyte esterase (from white blood cells) and nitrites (nitrates get reduced to nitrites by bacteria).

If you have a stone, it will produce blood.
Yes. A small rock scraping against the ureter will cause it to bleed.

So the stick test, if described accurately, will yield a false positive.
False.

Stones and UTIs are totally unrelated.
False. It depends on the type of stones. Magnesium Ammonium Sulfate stones are caused by UTI's.

A stone will not cause a UTI, because urine is sterile.
Urine is not sterile. That is a very common misconception.

And a UTI will not cause a stone.
The vast majority of UTI's do not cause stones, but they can and do.




Link Posted: 3/16/2006 6:42:25 PM EDT

Originally Posted By The_Reaper:

Originally Posted By C-4:
Contrary to popular belief, urine is far from sterile. But if you drink enough fluids, bacteria never get very concentrated.



National Institute of Health claims urine is sterile.

kidney.niddk.nih.gov/kudiseases/pubs/utiadult/



Actually, they don't quite say that:


Normally, urine is sterile. It is usually free of bacteria, viruses, and fungi but does contain fluids, salts, and waste products. An infection occurs when tiny organisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. The urethra is the tube that carries urine from the bladder to outside the body. Most infections arise from one type of bacteria, Escherichia coli (E. coli), which normally lives in the colon.


Bacteria often reside in the bladder. It is the overgrowth of bacteria that is the problem. If you drink a normal amount of fluid then you don't have to worry about UTI's unless there is some other underlying problem. Women are much more prone to UTI's because their urethra (tube from bladder to skin) is very short compared to men. A more pathogenic strain of E. Coli, for example, can travel the short distance (vigorous intercourse) and, if the conditions are right, cause an infection.

INormally, urine is sterile. It is usually free of bacteria, viruses, and fungi but does contain fluids, salts, and waste products. An infection occurs when tiny organisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. The urethra is the tube that carries urine from the bladder to outside the body. Most infections arise from one type of bacteria, Escherichia coli (E. coli), which normally lives in the colon.

Here is another fact most people don't realize: When you brush your gums, or have a big poop, you can have a transient bacteremia (bacteria in the blood) that can be cultured with blood cultures. Your immune system quickly kills them, so it is virtually never a problem unless you are immuno-compromised. Infectious diseases is one of the most interesting areas of medicine and were among my favorite courses in med school.
Link Posted: 3/16/2006 6:43:03 PM EDT

Originally Posted By C-4:

Originally Posted By The_Reaper:
My ex-wife used to get UTIs all the time.

Doc told me the stick test only looked for blood.
False. It also looks for leukocyte esterase (from white blood cells) and nitrites (nitrates get reduced to nitrites by bacteria).
I was misinformed then.

If you have a stone, it will produce blood.
Yes. A small rock scraping against the ureter will cause it to bleed.

So the stick test, if described accurately, will yield a false positive.
False.
Again, misinformation from a different physician


Stones and UTIs are totally unrelated.
False. It depends on the type of stones. Magnesium Ammonium Sulfate stones are caused by UTI's.

A stone will not cause a UTI, because urine is sterile.
Urine is not sterile. That is a very common misconception.
NIH vs. C-4


And a UTI will not cause a stone.
The vast majority of UTI's do not cause stones, but they can and do.





Link Posted: 3/16/2006 6:47:09 PM EDT

Originally Posted By C-4:
Originally Posted By The_Reaper:

Doc told me the stick test only looked for blood.
False. It also looks for leukocyte esterase (from white blood cells) and nitrites (nitrates get reduced to nitrites by bacteria).




I'm guessing the doctor told me their test looked for blood because he thought
that would be something my simple mind could understand.

Link Posted: 3/16/2006 6:58:56 PM EDT

Originally Posted By The_Reaper:

Originally Posted By C-4:
Originally Posted By The_Reaper:

Doc told me the stick test only looked for blood.
False. It also looks for leukocyte esterase (from white blood cells) and nitrites (nitrates get reduced to nitrites by bacteria).




I'm guessing the doctor told me their test looked for blood because he thought
that would be something my simple mind could understand.





I probably talk and explain waaaaay more than most docs. I can't help it.

The doctor was not BS'ing you though. You do look for blood in a UTI. Because of all the inflammation from the infection, you will get red blood cells in the urine. But it is only one of several factors that are used in making a diagnosis of a UTI. Symptoms are very important. You can do a urine dip test on several dozen urine samples in normal, otherwise healthy women and find 'positive' tests.
Link Posted: 3/16/2006 7:50:59 PM EDT
Kidney stones and UTIs do go hand in hand SOMETIMES.

Often times, the stones are a prelude to the UTI. There are so many factors / variables, it's hard to decide where to begin.

I had both of them about 5 months ago.
Link Posted: 3/16/2006 7:53:36 PM EDT
[Last Edit: 3/16/2006 7:56:28 PM EDT by drjarhead]

Originally Posted By The_Reaper:

Originally Posted By C-4:

Originally Posted By The_Reaper:
My ex-wife used to get UTIs all the time.

Doc told me the stick test only looked for blood.
False. It also looks for leukocyte esterase (from white blood cells) and nitrites (nitrates get reduced to nitrites by bacteria).
I was misinformed then.

If you have a stone, it will produce blood.
Yes. A small rock scraping against the ureter will cause it to bleed.

So the stick test, if described accurately, will yield a false positive.
False.
Again, misinformation from a different physician


Stones and UTIs are totally unrelated.
False. It depends on the type of stones. Magnesium Ammonium Sulfate stones are caused by UTI's.

A stone will not cause a UTI, because urine is sterile.
Urine is not sterile. That is a very common misconception.
NIH vs. C-4


And a UTI will not cause a stone.
The vast majority of UTI's do not cause stones, but they can and do.








Urine is considered a sterile body fluid based on the very small amount of bacteria in it. Same as tears. Certainly, obtaining some, even by sterile technique and allowing bacterial growth to occur would prove C-4 correct.

For that matter, if urine is so fucking sterile how do women get urinary tract infections in the first place?
Hmmmm?

Another one for you. Women get more frequent UTIs in the summer. Why? Because they are not voiding as much and the urine sits in their bladder where bacterial growth can occur. All because there is some residual amount of bacteria in there.
Further realize that most bacteria are motile---they move!

Urine is a great culture medium. Carbon source, nitrogen source, energy source, water, body temp, etc.

But the bottom line is that bacterial growth is the concern more than contamination as it is already contaminated, and the conditions which allow growth are present in the bladder. By voiding it is kept cleared out to so called "sterile" levels.


And FWIW, there are quite a few things tested for on the urine dipstick. Do a search on it,
Link Posted: 3/16/2006 8:11:33 PM EDT
She forgot to mention that she started feeling this way the day before yesterday. I told her to slam down water all day long, which she did. She felt fine yesterday(and stopped drinking a ton of water) and now she feels bad again today. To me that would indicate a stone over an UTI, but I'm no Doc.



I know I'm not pregnant, and I know it's not my cycle.






Gotcha. But I would never do Xrays or a CT on a child bearing age woman without verifying first. Some get mad about that, I don't care.




She better not be. I've been fixed, had a nut removed, then the other one radiated everyday for 4 weeks. I know it is still possible......but I would think the chances are pretty slim. Unless she's been........








Link Posted: 3/16/2006 8:16:32 PM EDT

Originally Posted By Kooter:
She forgot to mention that she started feeling this way the day before yesterday. I told her to slam down water all day long, which she did. She felt fine yesterday(and stopped drinking a ton of water) and now she feels bad again today. To me that would indicate a stone over an UTI, but I'm no Doc.




The reverse IMO but I wouldn't base a diagnosis simply on that.
Link Posted: 3/17/2006 12:41:14 AM EDT
yes they go hand in hand my wife has hereditary kidney stones and from time to time suffers terribly.
Link Posted: 3/17/2006 3:31:06 AM EDT

Originally Posted By drjarhead:

For that matter, if urine is so fucking sterile how do women get urinary tract infections in the first place?
Hmmmm?



Again, getting my information from physicians...

I was told that women get UTIs primarily because of sex, masturbation,
douching, etc that actually pushes bacteria up inside of the urinary tract.
Doc said that is why sexually active women get UTIs FAR more often than
women who aren't. It is actually referred to as "honeymoonitis" by this doctor.
Pretty much the same as what the NIH was eluding to.

At the same time, we were told that if my wife would go pee after sex,
she would reduce if not eliminate UTIs all together.

Link Posted: 3/17/2006 9:37:14 AM EDT
[Last Edit: 3/17/2006 9:39:38 AM EDT by drjarhead]

Originally Posted By The_Reaper:

Originally Posted By drjarhead:

For that matter, if urine is so fucking sterile how do women get urinary tract infections in the first place?
Hmmmm?



Again, getting my information from physicians...

I was told that women get UTIs primarily because of sex, masturbation,
douching, etc that actually pushes bacteria up inside of the urinary tract.
Doc said that is why sexually active women get UTIs FAR more often than
women who aren't. It is actually referred to as "honeymoonitis" by this doctor.
Pretty much the same as what the NIH was eluding to.

At the same time, we were told that if my wife would go pee after sex,
she would reduce if not eliminate UTIs all together.




Good advice for sure.
Void after intercourse.
Wipe front to back and not the other way around
More fluids

Bacteria gain entry to virtually every portion of the body though most are considered sterile(for practical purposes). They are not as sterile as a sealed container that has been boiled for certain, however. I could give many examples including things like cellulitis.

Basic fact is that UTIs in women are pretty damn common. I saw 3-4 daily. I saw that many in men approx yearly. I guess we are superior due to a longer urethra moved out away from the remainder of the body somewhat. Thank God we have our own outdoor plumbing.
My wife always gives me shit when we go snowmobiling because I can just stop and whip it out. Heheheh.
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