First Palpate the suprapubic region and confirm that there is no retention of urine with overflow. ( In elderly patients).
If there is burning sensation, fever or chills (UTI)
Tab. Norflox 400mg x bd x 5-10days
Other urinary antibiotics Cap. Chloromycin 500mg Qid. Tab. Septran-DS 1bd. Inj. Gentamycin 80mg IM x 8 hourly. Tab. Lomefloxacin 400mg. OD Tab. GRAMONEG 500mg tds. Tab. FURADANTIN 100mg. Qid Tab. Mandelamine 1g Qid
Cital x 1tsp in a glass of water x tds. Or barley water 1 glass x tds. Tab. PYRIDIUM 200mg 1-2 tds x after meals x if there is burning sensation while passing urine.
Tab. Flavoxate 200mg. tds. Plenty of water, and fluids e.g. coconut water, cold drinks.
Ask for urine examination and whenever possible urine culture to decide the antibiotic.
If burning does not subside within 3-4 days or recurs then, Urine culture must be done. Ask for X-ray K.U.B. and Ultrasonography.
If urethra is associated Purulent discharge per urethra. Ask for urethral smear for Gonococci. Tab. Norflox 400mg. 2 Stat.
If there Is no burning sensation (only frequency)
First think of Diabetes. If diabetes is ruled out, old man= prostate and young patient = Tuberculosis of bladder, or UTI.
If there is increased thirst, loss of weight. Ask for urine sugar and blood sugar curve. If positive, Refer ‘Diabetes’
If sugar is normal measure 24 hour urine output. If it is > 2000ml, refer to endocrinologist as? Disbetes insipidus.
If frequency is mainly at night with poor urine stream, in elderly male patient, probably prostate is enlarges. Tab. Speman 1-2 tds x 30 days (Ayurvedic) Cital tsp in glass of water x tds. Tab. Prazocin 1mg tds x if difficulty in passing urine is acute. If no relief, refer to a surgeon or urologist for P.R. cystoscopy and surgery.
Elderly male with frequency urine= Diabetes or Prostate.
A patient presenting with very severe urethral pain and urine falls drop by drop with straining – Think of a stone that has come down and lodged in urethra.
SMELLY URINE
Urine with strong pungent smell, is either infected urine or concentrated urine.
Check urine for U.T.I – microscopic and urine culture. Treat infection if any. If no infection , cause us under hydration and concentrated urine. Advise 1.5 to 2 litres of water everyday.
