Medical input request
 

For the doctors here...I acquired a very persistent bug while in the rehab hospital from all of the catheters being inserted over a period of 4 months.

It pops up every now and then as a UTI. I just finished another round of Cipro and the lab test came back negative for culture but the lab insists that the infection is still active.

Here's the gross part, every morning I pass a mucous plug with my urine. It does not recur during the day but it is there every morning. While on Cipro the mucous is greatly reduced and sometimes absent.

Can there be another cause of the mucous?

Not knowing anything about your medical history, there's still some nidus for infection. Somewhere the bacteria are allowed to hide out and are protected from eradication. Any catheters still left inside? Bladder/kidney stones? Are you diabetic or otherwise immunocompromised? Some sort of prostate enlargement? Diverticulitis? Has your genitourinary anatomy been altered in any way such that urine isn't flowing out properly? What does your urologist say?

Hi Noah, thanks.

The urologist did an internal scope and claimed evrything anatomically was fine. No catheters now, no stones, no immuno problems, some BPH and some IBS. I am taking 500mg sulfa for the IBS.

I suffered hyperflexion at C5 and the attendent muscular atrophy (though I am largely recovered from the atrophy) so maybe incomplete emptying is the problem?

Incomplete emptying from spinal cord injury can be a problem. It has to be at the appropriate spinal level, but I'm sure your neurologist can answer that question. A voiding cystourethrogram can be done to see if you're retaining anything. They also have little portable ultrasound machines that can approximate how much fluid is in your bladder.

Irritable bowel may also be an issue. Is it IBS? Or is there any chance of Crohn's or diverticulitis?

Colonscope confirmed IBS with a possibility of advancing to colitis. But the sulfa seems to keep it in check. How would a colon problem produce urinary mucous?

If there is an infection from the dirty colon that escapes the confines of the bowel (like a diverticular abscess from the sigmoid colon), it can erode into neighboring structures like the bladder. The bladder then gets recurrent infections because it's being seeded by the abscess that originated from the colon.

Right, got it. Have to believe that the GE would have spotted an abcess but it has been two years since the last colonoscope. Time to schedule a new one.

Thank you Noah. Your input has given me what I need to try and gain more control over this. I truly appreciate your time. You're a gem.

Not saying you should not get a colonoscopy to follow-up on your IBS; that's a good idea. But a colonoscopy may very easily miss a diverticular abscess. This is where the clinical acumen of your physicians (the people actually seeing you and putting their hands on you--not some keyboard jockey from halfway across the country) comes into play. If they suspect a diverticular abscess, then a CT scan would be more appropriate to make this diagnosis. Like fixing a car, it's about having the right tool for the job. So it comes down to what the job is--what you're trying to accomplish. What's the differential diagnosis? What are the possibilities causing the problem? And then what are the tests that can be done to corroborate or exclude those diagnoses?

I'll certainly discuss the entire situation with the gastro specialist. I'd never have thought of a CT. If you were closer I'd give you the work! Good advice, many thanks Noah!

I was going to suggest that you stop with the cheap women...

But I think Noah is more on the right path....

In my condition thats all thats available to me!:D

Jeeezz Noah, I'm in awe of your knowledge.

Thread's like this are the reason I keep coming back to Pelican.

Simply astounding knowledge Noah. I think your new screename should be Moses II...!