Urine infection when to worry?

Hi,

Sorry to hear that your husband is suffering from his treatment.

I've recently finished my 1st round of BCG. I was plagued with UTI's during this time. I had antibiotics 3 times during the BCG course, the UTI started after the 1st BCG treatment.

The BCG treatment itself causes inflamation in the bladder, making the wall of the bladder very sore & red & it's normal to experience pain & bleeding because of this & to be rushing to the loo for a wee frequently, but it could also be that the antibiotic is not the right 1 for the particular infection.  I was up & down to the loo about every 10 minutes at times, so it is 'normal' for this to happen.

If you get no response from the nurses & you are worried, I would get your husband to do a wee sample and either take it to your GP or to the hospital if you can, so that they can test it to make sure he doesn't need a change of antibiotic. If you go to the department  at the hospital where your husband has the BCG treatment they can test the sample for you there & then & can speak to a Doctor who can then give you a new prescription if needed.  They say just to take paracetamol for the pain, but if that's not helping, they may be able to prescribe something else. 

Also, as difficult as it can be, he must drink as much water as he can, preferably 2-3 litres, this can really help a lot. I found it really difficult to drink this amount at first, because when you are constantly feeling like you are going to wet yourself, the last thing you feel like doing is to drink a lot.  I found I could drink much more milk easier than I could water, so I substitute some of the water intake for milk, but some people recommend lemon barley water. 

They tried 3 antibiotics with me, the 1 that worked the best was Nitrofurantoin 100mg caps. 

I have the BCG maintenance treatment starting in January & have found that taking oregano capsule supplements & aged black garlic supplements 1 a day each, has helped keep the UTI at bay so far.

I hope that your husband is ok & that things improve for him. We are all different, some people sail through BCG with no side effects, but some of us have a harder time of it. .All the best to you both. 

Thank you x

UTI'S and blood in your wee are par for the course it seems, especially after anything that involves a catheter. I had a TURBT last June and two weeks later had a particularly nasty  UTI with temps up to 39 deg, was referred urgently to urology consultant, who put me on a month of anti Biotics (Trimethiprim) following that up with an anticeptic called Methenamine Hippurate (Hiprex) to be taken twice a day for 6 months. Since then big improvements on all points. I had 4 months of Chemo, followed by 5 weeks of daily radiotherapy after the TURBT and have just had a massive bleed that meant a very fast trip to A&E and a days stay to have 8 hours of bladder irrigation and a check cysto which revealed that I have radiation cystitus which caused the bleed and is now clearing up nicely , its along road I am afraid but you need to speak to Urology not Oncology if you want advice 

That sounds like a terrible ordeal to go through Molliedog. I'm glad you are mending well. 

After reading your post, I think I may have been destined for a similar fate if it wasn't for having a TULA this week. The urology consultant thankfully noticed some problems caused by radiotherapy & rectified it with the laser. I'm so glad they decided to do a TULA instead of a TURBT this time around or I may have ended up with a massive bleed too. 

I had 2 TURBT's this year before the TULA & neither detected that some big blood vessels had been exposed & damaged by the radiotherapy. The consultant was really surprised that I hadn't experienced a lot of blood loss, but luckily for me I hadn't experienced any noticeable blood loss at all. He killed off the blood vessels with the TULA laser, so hopefully he's helped me avoid that.

I'm going to ask if it's possible to have TULA'S instead of TURBT'S from now on. 

I've heard that Hiprex is really good. Seems they use it a lot in America for people who've got general long standing UTI's. 

I'm guessing... is TULA Trans Urethral Laser Ablation?

Yes, that's right Denby.  I found it so much better than the TURBT. It's really quick, takes between 10 - 20 minutes, they can take biopsies, no general anaesthetic & you can go home as soon as it's done. Painless & no side effects. Saves a lot of surgery time for the hospital & they don't need as many staff to be present during the procedure, so there are many benefits for the patient & hospital. . 

They have a monitor next to you so you can see inside your own bladder & watch them carry out the procedure if you want to. Otherwise you can just stare up at the ceiling wearing the snazzy glasses they make you wear to protect your eyes from the laser. 

Thanks Sirius. This is another 'why Oh why does the NHS not keep up with improvements and help get the dreadful waiting lists down'? Presumably they can't find the pennywise pound foolish cost of training the surgeons and buying the lasers.

My OH has just got out of over 2 weeks in a big general hospital. Seems they only have a single portable ultrasound 'veintrace' to help them get IVs into and bloods out of hard-to-find-a-vein patients. It lives in A&E, and orthopaedic ward have to annoy busy anaesthetists to come and help them because they haven't got the machine to guide them. Dr agrees cannot be cost effective not having one, so I took time out to inform PALS. Not had a response yet...

Yes, it seems ridiculous that when there is something that could really help the hospital & patients, some NHS trusts are slow on the uptake. The laser thing probably does cost a lot, but I was watching a video the Urology consultant who did my TULA has up on Youtube & he says it pays for itself within 9 months, so that's got to be worthwhile. 

TULA frees up surgeons, operating theatres, anaesthetists, nurses & saves on surgical equipment for people on the waiting list who really need bigger operations. 

I think the consultant who did my TULA pushed for my local hospital to start using it. I was reading on the NICE website that it's not been widely used as there is not enough evidence to prove it's effectiveness, but that's not what I've read elsewhere. 

To have only 1 portable ultrasound in a hospital? That is so bad. 

The money the government have wasted on the COVID fiasco & for funding other peoples wars would be better spent on such things. In fact, if the government ran as efficiently as the Urology Dept at my local hospital, we'd all be better off. 

If you haven't got your health or good health care, you have nothing.