Iam a male 54 yrs otherwise healthy  but a patient of  hypotonic bladder that was operated for twice for 1.TURP & BOO  2.regrowth of BOO and difficulty in passage of catheter during CISC(5-6times a day). Two years after surgery i suffer from pain during and after catheter insertion , very painful post ejaculation, recurrent pain between scrotum and rectum, clinical infections once in 45days-2months. During August15 my urologist put me on Sulf +trimeth BID for 30 days and symptoms regressed to nearly 80% But painful catheterisation, ejaculation  recurrent bouts of burning sensation at the entrance of bladder persists.Cranberry prepartions, vit C are not helping so also use of sterile catheters(not covered by insurence in my country) Are IV antibiotics are needed in my case repeatedly if so what may be the choice .. urine cultures are often negative. Can reTURP is a sane option
 What are the chances of developing resistant infections,sepsis& early death in future.. Are there any new treatments..My responsibilities dictate me to live for at least for another 10 yrs. Is it possible. Urologists are not very much intersted in my case classifying as recurrent low response case.


You could have post prostatectomy prostatitis which would explain some of your symptoms and the response the Sulfa-trimeth which you took for 30 days.  Painful catheterizations suggests either stricture (scarring) or infection.  Re-TURP will not help if the prostatic passage is open.  IV antibiotics are not indicated for this based on the information provided.

I can give you no statistics on the likelihood of sepsis or death as there is no data and we don't even have a confirmed diagnosis of your situation yet.  I suggest you consult an academic center urology program that will deal with your situation when the local physicians won't.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved 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.

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

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.

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. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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