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[itried]

About a year ago, I had a serious UTI that became a kidney infection after a round of antibiotics for the original UTI didn't work. I was traveling overseas in a remote area and had no way to acquire a fresh round of effective antibiotics, so I lived with the UTI for two weeks until I got home; by then the infection had traveled to my kidneys, and I spent a week in bed recovering.

Now, a year later, I pee every three hours, no matter how much water I'm drinking or how hydrated I am. Is it possible that the infection caused permanent damage (irritation?) to my urinary tract? I was tested again last spring after my final round of antibiotics, and my urologist detected only a "trace" of bacteria and WBC in my urine and gave me the all clear. When I was being treated for my kidney infection, I had a lot of blood work done, so I think they would have told me if I'm diabetic (another reason for frequent urination). I'm 42, so it doesn't seem like frequent urination associated with aging would be a problem.

Peeing a lot is not a big deal during the day, but it's getting pretty disruptive to my sleep.

[biomancer]

I can think of a few complications from a long UTI that would lead to frequent urination:

#1 - You're not fully cured - if you have a latent, low-intensity infection your bladder will be trying to get it out.  I hope that this is not the case, but if there was still "a trace" of bacteria and WBCs in your urine, your infection wasn't really completely gone a year ago. 

#2 - Your bladder is scarred and can't stretch as far as it used to.  I think this is more likely.  (FWIW, my bladder is scarred from several adhesions, so I can't go as long as I used to between bathroom breaks.) If you're having to urinate every 3 hours but there's not a lot of liquid to get rid of, this is probably the likely culprit.  There's not a whole lot that can be done about bladder scars/adhesions, as the surgery to remove them usually causes the formation of new ones.

#3 - Your kidneys were damaged enough that you don't reabsorb as much liquid as you used to.  If you're now urinating the same volume after 3 hours that you used to urinate at 6 or 8 hours, then this may be the case.  If this is the case, you should probably see a urologist again to determine the extent of the damage.

#4 - The infection triggered an "overactive bladder" problem of the sort that might be treatable with medication. 

#5a - I confess I don't know whether you're male or female, so this may not apply:  if you're male, you may have  prostate infection or other prostate swelling.  Prostate problems almost always lead to frequent urination, and often difficult urination.  42 is young but not unheard-of for conventional sorts of prostate problems (hyperplasia, etc.), and an infection can happen at any age.

#5b - If you're female, and you've been pregnant (and especially if you gave birth to a large-ish baby), your uterus may be prolapsing and falling against your bladder.  (FWIW, my  Mom has this problem.)  There are implantable uterine slings to remedy this, but they have complications and risks of their own (and Mom had one put in but her surgeon botched it...), but a lot of women simply live with it, or get fed up with other uterine problems and have a hysterectomy.  Whether or not you've been pregnant, you could also be dealing with endometriosis, as endometrial tissue growing on the bladder can make the bladder contract more frequently.

[itried]

Uh oh. I was going out on a limb in asking whether there could be residual issues from this one prolonged, serious infection a year ago, but now it seems that my concerns may be warranted. It sounds like I might want to visit the urologist again to check on this. Good grief.

Thank you for your thorough and thoughtful response, biomancer; I had no idea about some of these possible issues. Now I have information and specific questions to ask when I go back to the doctor.

(Regarding your last two points: I'm a woman and I've never been pregnant.)

[biomancer]

I didn't mean to scare you, ITried, and I'm not a physician - just a well-rounded biologist who serves as the family medical advisor.   I do think it would be worthwhile to see a physician, though.

[itried]

No worries biomancer; I asked for information, and you provided it from your experience and knowledge. I tend toward denial, so it's probably good to be nudged back to the doctor, as I sense that something has changed since that infection. Thank you again.

[crowie]

Biomancer has covered a lot more than I know, but I just wanted to mention that when I was diagnosed with a UTI I was told by my doctor that once you've had one you are more susceptible to them recurring in the future.  So this could be unresolved from the original UTI, or it could be a recurrence.  It is possible to have a low-level UTI and not have symptoms (such as painful urination) that might otherwise motivate you to go to the doctor. 

[itried]

crowie, thank you for this reminder. Until two years ago, I'd been fairly lucky to not have many UTIs as an adolescent and adult; that changed a couple of years ago when I became sexually active with one particular partner, and since then I've had the issues I describe. I'm going to make an appointment with my urologist this week, to discuss this issue and get another check-up. Thank you for your thoughts too, crowie.

[ucprof]

I had a kidney infection a few years ago.  It cleared up and I am basically fine now no lasting effects.  It took a while before all the plumbing was back to normal.  A while was several months but not years. If you are prone to UTI anyway you want to get them checked out and treated regardless of where they are in your system.

Also get the other internal organs near the bladder checked out.  If you are female then uterine fibroids can grow in the 40s and start pushing on the bladder causing these same symptoms.  Likewise an ovarian cyst of some sort can also push on the bladder if it becomes large.  Sonograms can detect all that stuff.  For men there is the prostate however 40s would be a little young for prostate symptoms like this. 

For UTI you want them to check both the immediate "stick" test and also have them do a culture.  I've had false negatives on both at times.  With the kidney inf I think my stick test was negative but the culture was positive and I was very ill.  There is an uptick in drug resistant bacteria getting into the gut and these can be difficult to treat if they are implicated in UTI.

Finally I swear by cranberry juice but you have to get the real stuff not the 8% juice stuff.  And you drink a bunch of it and treat it as more of a preventative than something that will cure a full blow UTI.  For the latter you need the real drugs.

In general if you are in your 40s there are a number of things (most are very treatable and benign) that can cause frequent urge to urinate.  The major plumbing items (e.g. things that should not be there and take up space) and infections should be diagnosed and treated.  My experience with a full blown kidney infection (one that was diagnosed from CT scan) is that it should be completely treatable and should not cause symptoms after it clears.  I was very sick with it I was in the hospital on IV for a week and then home in bed for a week on antibiotics after that and in pain the entire time.  Once it cleared though I was basically fine. 

[ucprof]

I also will add that I have had UTIs that were not cleared by either cefalexin or sulpha drugs.  I had to go on full blown cipro and sometimes for two weeks rather than one week.  In the hospital I was on cipro IV for a week.
The culture has shown my bug was resistant to some drugs - the culture was key.  I still remember the night they put the IV with the correct drug in my arm - my whole body responded to that drug it was pretty amazing the result when I finally got an antibiotic that worked.

[itried]

Thank you for your input ucprof. My bug was resistant at first also, which is why the first round of antibiotics didn't work. By then I was stuck for two more weeks in a country with frighteningly inadequate medical care.

[reener06]

So, I am a diabetic with a long history of UTIs. I have wondered about damage too, but have not experienced that (yet). What I do experience is that when I have symptoms of UTIs and they do a culture, it's always abnormal, that is, not what they expect. They put me on meds b/c of the diabetes, but I get the impression that if I didn't push for that, not all docs would medicate me. In my experience, when I'm not medicated, it goes to the kidneys fairly quickly.

The last few UTIs have shown few symptoms and one had none, and the next thing I knew I had a high fever and was very sick. I don't know if it's my anatomy or the frequent UTIs or a combination of both.

Also, I can't drink cranberry juice that much--too much sugar. I have found that you can take cranberry supplements and these work well too. And lots and lots of water, little caffeine, etc.

Good luck--and thanks biomancer for all the info. I found it quite helpful.

[itried]

reener06, thank you for sharing your own experiences. I had no idea about cranberry supplements! I'll read more about those.

I have an appointment with my doctor on Friday, and now I will arrive more informed. Thank you all so much. I'll keep you posted.

[biomancer]

I'll keep my fingers crossed for you tomorrow, ITried.

Reener brought up an excellent point.  Cranberry is really good for the urinary tract - whether you're drinking cranberry juice, eating dried or fresh cranberries, or taking cranberry pills.  Several good biomedical studies have demonstrated its effects.  There are natural fruit acids in cranberry that decrease the pH of the lining (epithelium) of the bladder and ureters, and this inhibits the ability of most bacteria to latch onto the lining and grow. 

[itried]

Thank you biomancer. I'll write again when I know more.

[mixedmetaphor]

Chime on the cranberry supplements and also on the culture; physicians are often so sold on e coli as the culprit that they don’t consider there might be something else going on in there that needs more vigorous treatment.

Also, it might be valuable to discuss dietary adjustments with your physician.  I had frequent UTIs as a child and adolescent, and I spent a full year as an undergrad with a UTI that I just couldn’t get rid of completely (the health center on campus pretty much screwed me).  It culminated in a debilitating kidney infection that left me sleeping 18 hours a day and put me on meds for many weeks.  I even passed two kidney stones on my own in my dorm bathroom.  Sad times.

A year later, for various reasons, I adopted a vegetarian diet.  There’s some research (that seems valid to my humanities-trained eyes, at least!) that indicates that decreasing animal proteins in one’s diet can decrease strain on the kidneys.  Since going veg almost 15 years ago, I’ve only had one kidney infection and two UTIs.  My mother is the only woman in her entire family who still has both kidneys, so we obviously have hereditary problems.  I see my diet as one relatively easy way to push against the certain doom of genetics.