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About Stephen W. Leslie, MD
Expertise
Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience
Full time practicing urologist with 20 years experience. Assistant Clinical Professor of Urology at the Medical College of Ohio. Editor in Chief of eMedicine Urology internet textbook. Author of only book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison

Awards and Honors
Thirlby Award of the American Urological Association.

You are here: Experts > Health/Fitness > Urology > Urology > bladder infections

Urology - bladder infections

Expert: Stephen W. Leslie, MD - 11/2/2009

Question
My 93-year-old mother has always had urinary problems, and now she uses a self-catheter at least twice a day. She has a constant bladder infections, and both her urologist and family doctor have no solution other than to keep prescribing antibiotics. The urologist suggested an ongoing low dose, but I'm concerned about her building up an immunity.

I've been doing some research on the efficacy of probiotics, but need some guidance in whether to buy them for her, and if Yes, which ones. I've read that they must be coated in order to get past the stomach acid, that they must be in powder form rather than pressed into a pill, and that they should have a long shelf-life.

Please help me find a way to help my mom control these ongoing infections.

Many thanks,
B.J.

Answer
BJ:

The probiotics are intended to restore normal bacteria to the GI tract, not to treat UTI's. There is not enough information to make a good recommendation on this case. For example, are the infections all of the same organism (relapsing) or different germs each time (recurrent)? Have they checked for a focus such as a kidney stone? If the patient is on self cath twice a day, what is the volume that is obtained? Have they considered increasing the frequency? Cranberry juice and extra Vitamin C might be somewhat helpful. Low dose long term therapy with antibiotics is a reasonable approach. Another option is a permanent catheter. Perhaps a second urology opinion might be useful at this point.

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