Urinary Tract Infection.

[Tanoshi]

UTI is unusual for a man, but I've now suffered from 4 infections.

This occurs only after taking long overseas flights, no infections in-between.

 

I've seen a Urologist, had urinal, blood and scan tests, all being clear and showing no sign of the cause.

I'm now wondering if this is somehow caused by high altitude flying or anxiety, although I have no concerns about flying.

 

In April I suffered my third infection after a long haul flight. After a course of anti-biotics the Urologist suggested I try taking Uroflow.

Whilst on this medication, I just completed another long haul flight and the day after arriving I'm suffering from UTI again.

I drink only bottled water, no alcohol. 

 

[Sheryl]

It is easy to dehydrate on flights.

 

Drink a lot more water (or other nonalcoholic liquid) and make a point of getying up to pee often is best advise I can give.

 

I don't really understand what the urofliw was expected to contribute....do you have an enlarged prostate not mentioned?

 

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[BritManToo]

8 hours ago, Tanoshi said:

UTI is unusual for a man, but I've now suffered from 4 infections.

Probably the most common form of STD a man can get.

A course of Cipro 500 cures it for me, about 100bht for 10 tabs in a bubble pack.

It's a bacterial infection, can't see it being something you could catch on a flight.

 

Can't see Uroflow (tamsulosin) doing anything, that's medicine for prostrate problems.

[phycokiller]

how do you know its UTI? you wouldnt get it from a plane flight, unless you did naughty things in the toilet and even then the symptoms wouldnt show immediately, altho I suppose it could make the symptoms more noticeable if you already had it. A lot of people have it but dont have symptoms, maybe thats the case with you until it is exacerbated by plane flights. I am not a doctor

[xylophone]

11 hours ago, Tanoshi said:

I've seen a Urologist, had urinal, blood and scan tests, all being clear and showing no sign of the cause.

Not quite sure what you mean about this, especially when you said everything was clear and no cause was found?

 

If you had an infection then everything wouldn't be clear because it would show in the urine sample that you had an infection?

 

If you are unable, or fail to urinate on a regular basis, especially on a long flight where dehydration is a possibility, then a UTI is possible from the urine which is left in the bladder and not expelled, which is probably the reason the specialist gave you the Uroflo medication, because he thought you had bladder emptying problems, or possibly prostate enlargement problems (BPH) and this medication can assist with bladder emptying.

 

You can get tests done to ascertain the amount of residual urine in the bladder and this may be helpful, as well as tests to measure the urine flow.

 

On flights, even more than usual, drink plenty of water.

 

[Taggart]

Back in the 90's I developed urinary track infection at least three or four different times.  The last time while visiting Thailand I almost died from it.  The doctor in the hospital couldn't get the fever down.  My wife saved my life insisting I be transferred by ambulance to a different city and hospital in Chiang Mai.  The doctor at the new hospital was a peacock (thought a lot of himself) but managed to use the correct drugs to get the fever down.  Yes, I was told it was rare in men.  I started drinking cranberry juice.  I would bring cranberry pills with me to take while travelling.  Every morning I still to this day cook my oats porridge with added frozen cranberries and other berries.  Slowly and steadily since the start of the new century I've improved my diet.  No more junk food.  Haven't had any sign of urinary tract infection in the last couple of decades.

[Tanoshi]

3 hours ago, Sheryl said:

It is easy to dehydrate on flights.

 

Drink a lot more water (or other nonalcoholic liquid) and make a point of getying up to pee often is best advise I can give.

 

I don't really understand what the urofliw was expected to contribute....do you have an enlarged prostate not mentioned?

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

Full story;

Never had an issue until 6 years ago, since then I've contracted UTI the day after taking a long haul flight.

On a previous trip, my GP suggested I seek professional advice on returning to Thailand.

The Thai Urologist had me take an online questionnaire to evaluate the seriousness of the problem.

I then had urine and blood samples tested along with a scan to detect any stones, which according to the Urologist can be a cause of the infection. Everything was clear except my PSA was 3.4 (normal 0 - 2). My prostate gland was slightly enlarged, but he suggested that was probably swelling caused by the infection.

 

I only drink water, lots of it.

One of the problems highlighted on the questionnaire was the feeling that I never fully empty my bladder.

I can drink litres of water and not feel the need for the toilet for hours, but after going once, I'll probably be back 10 minutes later.

When I feel the need to go, I can't hold it for long, I need to go!

The Uroflow was I believe prescribed to overcome that problem.

 

On my most recent trip I drank loads of water in flights and made plenty of visits to the toilet.

The day after landing I once again had a UTI infection.

This was whilst taking the prescribed Uroflow.

 

I'm due to see the Urologist again in another month for another PSA test.

 

Question:

1. Is it possible that high altitude flying for several hours can cause the Prostate gland to swell.

2. Can a swollen prostate gland cause irregularities with urine retention.

 

 

[Tanoshi]

1 hour ago, xylophone said:

Not quite sure what you mean about this, especially when you said everything was clear and no cause was found?

 

If you had an infection then everything wouldn't be clear because it would show in the urine sample that you had an infection?

 

If you are unable, or fail to urinate on a regular basis, especially on a long flight where dehydration is a possibility, then a UTI is possible from the urine which is left in the bladder and not expelled, which is probably the reason the specialist gave you the Uroflo medication, because he thought you had bladder emptying problems, or possibly prostate enlargement problems (BPH) and this medication can assist with bladder emptying.

 

You can get tests done to ascertain the amount of residual urine in the bladder and this may be helpful, as well as tests to measure the urine flow.

 

On flights, even more than usual, drink plenty of water.

 

Excellent analysis.

Please read my reply to Sheryl in the above post.

Appreciate your input.

[Tanoshi]

3 hours ago, BritManToo said:

Probably the most common form of STD a man can get.

A course of Cipro 500 cures it for me, about 100bht for 10 tabs in a bubble pack.

Grow up.

We don't all live in Pattaya and think with the little head.

[Tanoshi]

1 hour ago, phycokiller said:

how do you know its UTI? you wouldnt get it from a plane flight, unless you did naughty things in the toilet and even then the symptoms wouldnt show immediately, altho I suppose it could make the symptoms more noticeable if you already had it. A lot of people have it but dont have symptoms, maybe thats the case with you until it is exacerbated by plane flights. I am not a doctor

Because a quick urine test confirms it's UTI.

In-between,  after a course of antibiotics the same tests show no infection.

[Tanoshi]

39 minutes ago, Taggart said:

Back in the 90's I developed urinary track infection at least three or four different times.  The last time while visiting Thailand I almost died from it.  The doctor in the hospital couldn't get the fever down.  My wife saved my life insisting I be transferred by ambulance to a different city and hospital in Chiang Mai.  The doctor at the new hospital was a peacock (thought a lot of himself) but managed to use the correct drugs to get the fever down.  Yes, I was told it was rare in men.  I started drinking cranberry juice.  I would bring cranberry pills with me to take while travelling.  Every morning I still to this day cook my oats porridge with added frozen cranberries and other berries.  Slowly and steadily since the start of the new century I've improved my diet.  No more junk food.  Haven't had any sign of urinary tract infection in the last couple of decades.

Thanks for highlighting your experience.

Yes, I've been told by my GP and a number of women that Cranberry juice really helps.

Didn't know you could purchase Cranberry pills.

 

On my most recent trip back home to see family, I knew I had UTI again the day after arriving.

I drank loads of Cranberry juice. It did help to alleviate the symptoms, although not a cure.

 

I never suffer with UTI other than when I take a long haul flight.

I'll follow your advice though and drink more Cranberry juice. Many thanks for the confirmation.

[jenny2017]

35 minutes ago, Tanoshi said:

Full story;

Never had an issue until 6 years ago, since then I've contracted UTI the day after taking a long haul flight.

On a previous trip, my GP suggested I seek professional advice on returning to Thailand.

The Thai Urologist had me take an online questionnaire to evaluate the seriousness of the problem.

I then had urine and blood samples tested along with a scan to detect any stones, which according to the Urologist can be a cause of the infection. Everything was clear except my PSA was 3.4 (normal 0 - 2). My prostate gland was slightly enlarged, but he suggested that was probably swelling caused by the infection.

 

I only drink water, lots of it.

One of the problems highlighted on the questionnaire was the feeling that I never fully empty my bladder.

I can drink litres of water and not feel the need for the toilet for hours, but after going once, I'll probably be back 10 minutes later.

When I feel the need to go, I can't hold it for long, I need to go!

The Uroflow was I believe prescribed to overcome that problem.

 

On my most recent trip I drank loads of water in flights and made plenty of visits to the toilet.

The day after landing I once again had a UTI infection.

This was whilst taking the prescribed Uroflow.

 

I'm due to see the Urologist again in another month for another PSA test.

 

Question:

1. Is it possible that high altitude flying for several hours can cause the Prostate gland to swell.

2. Can a swollen prostate gland cause irregularities with urine retention.

 

 

5

Something here doesn't sound right. Uroflow was prescribed to me after I thought I had problems with my prostate. Just looking at the side effects of Uroflow is breathtaking and you shouldn't rely on one Thai doctor's advice.

 

  1. Not that I've ever experienced, or heard of it.

   2. A swollen prostate can easily influence the urine retention. 

 

An enlarged prostate doesn't always cause urinary problems. Studies indicate that the size of a man's prostate gland has little influence on the type or severity of his urination problems. I don't want to post any links because there's so much irritating information on the net. 

 

  I've had a UTI once after an 11-hour flight from Europe to Thailand, but I don't know if the flight was the cause of it. I even had blood in my sperms and was scared shirtless. The holiday turned out to be a nightmare, always scared of having something very serious. 

 

  After coming back home, I went to a great urologist, had my urine, sperms, and blood checked and it turned out that it was a pretty common infection, no idea where it came from.

Uroflow is a prescription drug with enormous side effects, better go to the bathroom more often than taking such medication.

 

You'll have to get your system checked by a good urologist. You could have prostate problems that are causing these symptoms. I don't really trust my Thai urologist, to be honest. Best of luck! 

 

  

  

[Sheryl]

Full story;
Never had an issue until 6 years ago, since then I've contracted UTI the day after taking a long haul flight.
On a previous trip, my GP suggested I seek professional advice on returning to Thailand.
The Thai Urologist had me take an online questionnaire to evaluate the seriousness of the problem.
I then had urine and blood samples tested along with a scan to detect any stones, which according to the Urologist can be a cause of the infection. Everything was clear except my PSA was 3.4 (normal 0 - 2). My prostate gland was slightly enlarged, but he suggested that was probably swelling caused by the infection.
 
I only drink water, lots of it.
One of the problems highlighted on the questionnaire was the feeling that I never fully empty my bladder.
I can drink litres of water and not feel the need for the toilet for hours, but after going once, I'll probably be back 10 minutes later.
When I feel the need to go, I can't hold it for long, I need to go!
The Uroflow was I believe prescribed to overcome that problem.
 
On my most recent trip I drank loads of water in flights and made plenty of visits to the toilet.
The day after landing I once again had a UTI infection.
This was whilst taking the prescribed Uroflow.
 
I'm due to see the Urologist again in another month for another PSA test.
 
Question:
1. Is it possible that high altitude flying for several hours can cause the Prostate gland to swell.
2. Can a swollen prostate gland cause irregularities with urine retention.
 
 

#1 not AFAIK

#2 Definitely yes. Enlarged prostate prevents the bladder from fully emptying and the retained urine in the bladder predisposes to infection.

Now the uroflow makes sense, doctor thinks the enlarged prostate is the underlying cause.

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[JHolmesJr]

UTIs are weird...not all are due to sex altho uncovered BJs can light the fuse.

 

Ive read that sometimes it can be a deep seated infection....have you ruled out chronic prostatitis?

 

That stuff is like a smouldering haystack.....the fire looks out but then it starts uo again.

 

Needs at least a 3 month course of alternating antibiotics....Bactrim for 2 weeks, ofloxacin for 2. Repeated 3 times after that.

[phycokiller]

10 hours ago, Tanoshi said:

Because a quick urine test confirms it's UTI.

In-between,  after a course of antibiotics the same tests show no infection.

perhaps you could try having a test pre flight next time you fly next time just to be sure

[xylophone]

11 hours ago, Tanoshi said:

Didn't know you could purchase Cranberry pills.

Yes you can and believe it or not the pills are more effective than the juice according to info/tests that I have seen.

 

Some people pooh pooh the cranberry juice thing but the fact is that it is a particular type of "sugar" in it which helps prevent bacteria from adhering to the side of the bladder, so it is not a cure as such but it does help.

 

As Sheryl has said, the prostate could be a problem in preventing the bladder from emptying fully AND it is not just the external size of the prostate which matters, because the tissue growth IN the prostate "squeezes" the urethral part  and prevents the urine flow to a greater or lesser extent, and the urine left in the bladder is a breeding ground for bacteria.

 

I have had this for decades now and the antibiotics I have taken for it would fill a pharmacy. And it wasn't helped by a botched operation in a urologists office in NZ where he tried a bladder neck incision, only to cause scar tissue which eventually made things worse.

 

Even had a TURP 10 years ago which helped for a while, then another bladder neck incision here a couple of years ago which hasn't helped at all, so now am back on a similar drug to uroflow to try and hep...…...maybe another prostate TURP is on the cards but I am reluctant to go there again.

 

Prostatitis is a possibility, however if a bacterial infection has been found then they can culture it and use the best antibiotic to try to cure it...……….the main problem being that the majority of antibiotics do not easily penetrate the prostate, so many months worth may have to be taken, then another one tried and so.

 

Unfortunately for us men there can be a situation where the bacteria in the prostate is protected by a "biofilm" which shield it and stop antibiotic from entering, so they don't work effectively.

 

However for now I would get some tests done...…...a flow test on the urine, then ultrasound on the bladder and poss a prostate secretion test to see if it is harbouring bacteria.

 

Good luck.

[Tanoshi]

Many thanks for all the replies.

Question is what comes first, the chicken or the egg.

 

I've had routine tests at normal times (12 months after an infection) and the results were negative for infection, and enlarged prostate.

On each of the 4 occasions I've had a UTI, it's been the day after landing from a long haul flight going back home.

It's never happened taking a long haul flight back to Thailand, or during day to day living. (Probably still got antibiotics in my system).

That fact seems to coincidental to ignore.

 

The Urologist is of the opinion that the infection caused the slightly enlarged prostate, which is why he recommends another test in a few weeks. He expects my prostate gland to be normal again. From my previous experiences it takes about a month after a UTI for everything to return to normal. However from your replies it would appear the likely cause is an enlarged/swollen prostate affecting the urinal flow and an infection subsequently follows.

That makes common sense and complies with the sensation I experience that something is strangling the urinal flow.

Still puzzled why this only happens on a long haul flight and not at any other time.

[jb4446]

Sounds like sub meatal stenosis,narrowing at end of cock causing blockage/pain.  Need it opening ,one click and its done,530 baht govt hospital,but you have to insist on having it,and no more pills,instant relief

[JHolmesJr]

On 7/7/2018 at 10:16 AM, xylophone said:

the main problem being that the majority of antibiotics do not easily penetrate the prostate

 

quinolones do....as does trimethoprim sulfamethoxazole.

[Tanoshi]

On ‎7‎/‎7‎/‎2018 at 11:25 AM, jb4446 said:

Sounds like sub meatal stenosis,narrowing at end of cock causing blockage/pain.  Need it opening ,one click and its done,530 baht govt hospital,but you have to insist on having it,and no more pills,instant relief

It's not meatal stenosis in my case.

 

[Tanoshi]

8 hours ago, JHolmesJr said:

 

quinolones do....as does trimethoprim sulfamethoxazole.

Which particular quinolone type antibiotic would you recommend.

 

Trimethoprim is good, but due to it's high sulphur content I've had two allergic reactions, resulting in hives, from that particular drug.

[Sheryl]

The gold standard treatment would be to have a urine culture & sensitivity done and select appropriate antibiotic based on result.

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[xylophone]

9 hours ago, JHolmesJr said:

 

quinolones do....as does trimethoprim sulfamethoxazole.

Now quinolones are not recommended as they are not that effective any more (overprescribed) and some of the latest research suggests not effective in a high % of cases.

 

Believe me, having suffered for decades and seeing specialists in the UK, NZ and here, and having treatment with just about every antibiotic known, even over long periods of time, I have much info saved on this subject. Even considered visiting a specialist in the Philippines who operates a clinic solely dealing with this issue and who favours DIRECT antibiotic injection into the prostate, and whose results seem good, but measuring methodology is questioned.

 

If one really wants to get into the ins and outs of prostate and antibiotics then the in-depth research shows piperacillin + tazobactam showing promise...……..https://academic.oup.com/cid/article/50/12/1641/305217  

 

Fluoroquinolones have emerged as the preferred antibiotics for treating bacterial prostatitis, and several have been approved by the US Food and Drug Administration (FDA) for this indication. Compared with concentrations in plasma, drug levels are generally higher in urine, similar in seminal fluid and prostatic tissue, and lower (albeit therapeutic) in prostatic fluid [43, 44]. One concern with these agents is the growing problem of fluoroquinolone resistance, which generally requires treatment with a third-generation cephalosporin (eg, ceftazidime or ceftriaxone) or a carbapenem (eg, imipenem or ertapenem) [45]. Table 2 provides information on other antibiotics that may be useful for treating bacterial prostatitis, based on pharmacodynamic data, case reports, or FDA approval for treating UTIs.

Although penicillin G achieves poor prostatic concentrations, piperacillin has good levels and has been used successfully to treat CBP. Cephalosporins, despite being weak acids with low lipid solubility, can attain therapeutic levels in prostatic fluid or tissue (Table 2). Aztreonam, imipenem, and some aminoglycosides can attain levels in prostatic tissue that exceed the minimum inhibitory concentrations of most Enterobacteriaceae. Prostatic concentrations of minocycline and doxycycline are at least 40% of the corresponding serum concentrations. Erythromycin—and probably other macrolides, as well—can develop high prostate concentrations. Clindamycin and trimethoprim readily enter prostatic fluid, and levels of these drugs in prostatic fluid may exceed levels in plasma. The prostatic concentration of sulfamethoxazole is much lower, raising doubts that it synergizes with trimethoprim. Nitrofurantoin prostatic levels are likely nontherapeutic. Table 3 outlines the advantages and disadvantages of commonly used antimicrobial agents for the treatment of CBP.

PS. Bacterial prostatitis SHOULD be able to be cured with an antibiotic but the most recent research has shown that a number of bacterial organisms can be the culprits. And reaching them through the prostate's mechanisms is a problem...…..that's why not much progress has been made over MANY years.

The once considered Gold Standard was doxycycline and this did help me after taking it for 3 months at a time. but the symptoms would return in a month or so.

More recent research has focused on poss infection of the prostate from other areas such as the seminal vesicles and the number of poss culprits (bacteria etc) would astound you.

[Tanoshi]

13 minutes ago, Sheryl said:

The gold standard treatment would be to have a urine culture & sensitivity done and select appropriate antibiotic based on result.

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I had a urine culture test completed by my UK GP two years ago, which only confirmed I had a UTI.

 

Never had a urine culture tested when I'm not suffering from having any infection. (as now)

Would you recommend a new test regardless of.

[Sheryl]

A culture does more than confirm that you have an infection, it identifies the exact bacteria responsible and if (as is usual) a sensitivity test is also done it identifies what antibiotics the bacteria will respond to.

 

If the trst only showed you had an infection then it was likely just a urinalysis or urine nitrate test and not a culture.

 

There is no reason to do a culture if you have no signs of infection.

 

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[xylophone]

3 minutes ago, Sheryl said:

A culture does more than confirm that you have an infection, it identifies the exact bacteria responsible and if (as is usual) a sensitivity test is also done it identifies what antibiotics the bacteria will respond to.

 

If the trst only showed you had an infection then it was likely just a urinalysis or urine nitrate test and not a culture.

 

There is no reason to do a culture if you have no signs of infection.

 

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Agree with Sheryl and for some reason the urologists here (in the hospitals I have visited) seem reluctant to do a culture even when an infection is present. So demand it.

 

Also worthwhile remembering that many men and women can have a chlamydia infection and have no signs whatsoever.

[Tanoshi]

5 minutes ago, Sheryl said:

A culture does more than confirm that you have an infection, it identifies the exact bacteria responsible and if (as is usual) a sensitivity test is also done it identifies what antibiotics the bacteria will respond to.

 

If the trst only showed you had an infection then it was likely just a urinalysis or urine nitrate test and not a culture.

 

There is no reason to do a culture if you have no signs of infection.

 

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He definitely carried out a culture test. After 2 days he changed my antibiotic prescription to Trimethoprim and 3 days later I had an allergic reaction and came out in hives.

 

As already stated, I've never suffered a UTI in Thailand.

Only on my last 4 visits back to the UK have I suffered and I'm their for a limited time visiting family.

The <deleted> always hits the fan the day after I arrive.

 

After a course of antibiotics I'm usually just clear of any infection by the time I'm returning to Thailand.

Never suffer with a UTI on the return leg, but then I've probably still got antibiotics in the system.

[xylophone]

On ‎7‎/‎7‎/‎2018 at 10:30 AM, Tanoshi said:

The Urologist is of the opinion that the infection caused the slightly enlarged prostate, which is why he recommends another test in a few weeks. He expects my prostate gland to be normal again. From my previous experiences it takes about a month after a UTI for everything to return to normal. However from your replies it would appear the likely cause is an enlarged/swollen prostate affecting the urinal flow and an infection subsequently follows.

That makes common sense and complies with the sensation I experience that something is strangling the urinal flow.

Sorry got off track with the prostate and all that info...……...but shows that it is an area which is difficult to treat.

 

As Sheryl said, in the case of a UTI the culture will show the bacteria responsible and treatment can be given...……..but getting back to your statement above, the likely cause would be the poor urine flow in emptying the bladder thereby setting you up for a UTI. 

 

Likely culprits will be prostate enlargement, bladder neck problem or a neurogenic bladder...….UTIs follow.

 

Flow tests and ultrasound of bladder to see amount of residual urine are key indicators.

[xylophone]

1 hour ago, xylophone said:

Also worthwhile remembering that many men and women can have a chlamydia infection and have no signs whatsoever.

Change that to "no symptoms whatsoever"...…………..so if Tanoshi has had urine tests done then it SHOULD have picked up chlamydia even when no symptoms, so poss to disregard that route of investigation.

[JHolmesJr]

3 hours ago, Tanoshi said:

Which particular quinolone type antibiotic would you recommend.

 

good question....I would recommend Ofloxacin 400mg (Oflox)....for treating nether regions.