Male 74 years old On going urinary tract infection &nda

Patient

Q: Male 74 years old
On going urinary tract infection – 7 months now. Several courses of antibiotics.
Ultra sound shows only moderate enlargement of prostate and some inflamation– bladder normal.
Urinate every 30 mins to one hour day and night. Painful.
Two drugs, Spasmo-lyt and Flavoxate prescribed to decrease frequency of urination had no effect.
Have been taking Permixon 160 mg for five days – no changes in symptoms.
Two days ago started regimen of Ciprofloxin 500mg twice a day. Pain has subsided.

Doctor

A:   HI Sir.

Read and understood your history of undulating urinary tract infection for 7 months with frequency and pain - antibiotics - USG showing moderate enlargement of prostate - Spamo-lyt and Flavoxate did not helps - Permixon 160 for 5 days not helping - pain subsided with Cipro 500 for 2 days.

My advice would be as follows:
First of all I would like to do per-rectal digital examination to see for the size, shape, granularity bossing of the prostate as this is the information no other investigations can give.
Secondly, to continue Ciprofloxacin for at least 3 weeks to contain the infection as it is helping you on clinical grounds.
Continue plenty of oral fluids.
To tests the blood for diabetes, kidney function tests and so on.
Urine culture, particularly for anerobic and AFB.

Referral to the Urologist to see whether TURP can help you and if, yes to subject you for prostatectomy.

I hope this should help you get symptom free.

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