35 y. male .. suffering form burning ptblm in inner glanss penis area.. burning micuration since 6 mnth pain presnt single site .. no effect frm any antibiotic.. when he go for toilet prblm increse.. plz sugeest best dx and rx..

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Dear Jitendra, while writing history, you said, 35 years male and looking at the reports I saw the age of the patient is 28 years !! Anyway, from reports, it seems to be a case of chronic cystitis. Possibilities are :- 1 ) Inadequate antibiotics taken 2 ) Inappropriate antibiotics selection. These may responsible for Bioflim production and difficult to eradicate, to get the patient symptoms free. Advice : - 1 ) Urine for culture and sensitivity and to check whether the strain is producing Bioflim, in vitro or not. 3 ) It will be benificial for the patient if you refer to this case to Nephrologist / Urologist for evaluation and management.

RFT and relevant tests are not mentioned. Further emperical use of antibiotics may cause harm to the patient.
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Jitendra, Sonologist says cystitis so you treat?. Is it right? No symptoms of UTI, and urine is normal. Do his PR exam and Pt feels the same pain in glans then it is prostatitis (non bacterial) or call it prostatodinia Treatment is prostatic massage, regular coitus, seitz bath. pelvic floor muscle exercises

CYSTITIS IS THE DIAGNOSES. BURNING MICTURITION , DIS URIA IS PRESENT .GIVE.ALKALYSING AGENT LIKE DISODIUM HYDROGEN CITRATE SYP.2 TAG T.I.D. ALONG WITH THAT TAB.NORFLOX 40O MG .B.D.IF BURNING IS SEVERE EVEN TAB .PYRIDIUM CAN BE GIVEN . RAJESH GOPAL.

ddx chronic cystitis .no bph. might be bladder neck deformity.external meatal constriction. needs urine cst. exclude dm. tt accordingly with cst report. .

dear doc pls get cbc, urine cs done. add plenty of fluids. urinary alkalizers , fruits like orange , pineapple in diet. hope it is useful. pls be kind enough to provide a bit more elaborate history. thanks for sharing

6 months is very long history.. two possibilities u should think one is either infection is treated with insensitive antibiotics and second there might be some anatomical or pathological obstruction in urinary tract. so please get urine culture and sensitivity ... work up for diabetes also. and if all negative then go for urological procedures like IVP OR RGP ... DON'T use antibiotics irrationally cause intermittent sensitive antibiotics may give false urine culture report...

Cystitis @Dr. Sandeep Pemira ?

Thanx Dr.Neeraj for tagging me. Pt Symptomatic since 6 months, but no relief with meds. Even then, we cannot rule out the possibility of Infections. So , we can ask for Urine culture and sensitivity and depending on culture reports we can prescribe the antibiotics for adequate duration. Second possibility can be erosion of mucosa over the urethral surface which must be irritated with the passage of urine It can be confirmed by Cystoscopy. Till then u can prescribe him with urine alkanizers like Syrup Cital 2tsf in TDS.
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cystitis is treated w septran ds tab n levoflox 1st w septran fr 10 days n ltr levo fr 14 days...

Urethritis, advised gram positive & negative antibiotics.

Ask for other LUTS DRE - prostate tenderness

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