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Urology/Possible UTI

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QUESTION: Hi Doctor....appreciate your time.....I'm 69 and usually in excellent health.  I've been a distance runner for over 20 years and run every day.....I also have an excellent health record....heart, blood work, etc.....Anyway, a few days ago I noticed difficulty urinating. My PCP noticed some white blood cells in my urine so prescribed cipro 500mg and flomax.....Been on both for 2 days and have noticed some improvement but still a lot of difficulty urinating....scary to finally urinate and still feel like i have to again and can't......I'm trying to avoid the ER and hoping this will get better soon.....but scared i won't be able to urinate. I also notice that I get some chills once in awhile.....just hoping for your advice to see if i'm on the right course and that things should clear up soon....thanks so much

ANSWER: Don:

An infection is the most likely, but prostate enlargement is also likely given your age.  You are probably on the right medication.  If things don't get better, let your physician know.

---------- FOLLOW-UP ----------

QUESTION: Thank you Dr. for your response.  Unfortunately I wound up in the ER.  A CT scan showed a kidney stone so they had to insert a catheter (first time for me) and I go back to the urologist tomorrow.  The ER Dr. said that the catheter was the best solution for a couple of days to allow urination.  He also said that my prostrate is probably somewhat enlarged (as you said). Guess my questions are:  Since the difficulty urinating came on suddenly is the stone the likely reason rather then the prostate?  Also, since this is my first time with a catheter I guess my fear is that after it's removed tomorrow will I be able to urinate or will I continue to struggle and this time with pain because of the catheter.  Thanks so much for your time

Answer
Don:
Stones don't typically cause urinary problems, but if lodged near the bladder then they can.  Prostate is probably enlarged anyway.  

There may be some mild burning with the catheter out, but this is usually quite minor.  I expect you will be able to urinate when the catheter is removed, but we won't know for sure until it's tried.  

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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 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.

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

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