So I have had my Studer pouch neobladder for about 2 1/2 years. After the surgery, multiple urologists at M.D. Anderson emphasized that future urinalyses would be pointless because of the neobladder and the bacteria load associated with the intestinal wall construction.
Since my "installation", I have had a few UTI's. With the first one, it was a surprise. Basically I felt kind of crappy, then the flank pain set in. It felt like an elephant was kicking me in the kidneys continually. I called my urologist at M.D. Anderson and he had me come into the ER. At the ER, they did a very basic physical exam (vitals and tapped on my back to identify the areas that hurt, then palpated my abdomen). There was no urinalysis, which was weird, but expected. They told me that with neobladder UTI's, they basically confirm the symptoms and then prescribe an antibiotic, usually Leviquin. Same thing happened for the next one, too.
So, I decided that since this seemed so routine, my normal doctor could handle it and I would save the long drive and expense of using M.D. Anderson, which is pretty much always an ER visit.
I explained the process that M.D. Anderson used for UTI's when I visited my normal doctor, why they didn't do a urinalysis and he still REALLY wanted to do both a urinalysis and a urine culture. I figured, what the hell, insurance covers it and it'll make him more comfortable. No surprise that the UTI was confirmed by both tests.
Anyway, I got the flank pain again this afternoon. Being currently unemployed and uninsured until 3/1, I felt like doing those additional tests was just going to cost me more out-of-pocket money. Even after talking about it, he was still pretty uncomfortable just treating with Levaquin but he did agree to it and even gave me samples for the 10 day treatment (Leviquin is expensive!). I REALLY like this doctor, have a long history with him and can see why he has these concerns.
What protocol do your doctors follow when they suspect a UTI? It would be so nice to be able to present him with some documentation or a standard of care for this that we are both comfortable with.
By the way, strictures are not an issue... ruled out by all those other tests regularly done by M.D. Anderson at regular intervals.
Thanks for your help!
Christine