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So I did 10 days of the Cephalexin and there was no change in the discomfort in my lower abdomen which is my only symptom currently.

I went to see a doctor here in Bali and after hearing the whole story he thought it might be bladder stones so I had a sonogram. The images and results are attached.

One question I have is, is it possible that the stones caused the infection or is that likely something totally separate?

Please let me know your thoughts with regards to possible causes and treatments.

Category: Urologist

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Category: Andrologist
Dr. Gautam Banga is online now

Expert:  Dr. Gautam Banga replied 4 Days.


Welcome back to DoctorSpring

I have gone through your reports. The stones and the infection would be related. Either the stones caused the infection or the infection resulted in stone formation.

In your case the latter is more likely . That means a long standing infection caused the precipitation of stones.
In your case the most characteristic feature was milky white discharge from penis. Most likely cause for this is a urethritis like Gonococcal or Chalmydia. But since the microscopy was suggestive of G+ organisms we suspected a prostatitis. Now you have a (possible) bladder infection also.

So there is a Lower Urinary Tract infection for which we need to find 1. cause 2. organism and start an appropriate treatment.
As I said earlied. Culture should be the first approach to go. If you have discharge then culture of that discharge will do. If not early morning clean midstream urine sample is next best option. A prostatic massage and culture is also needed.

Antibiotic if needed has to be based on this. You might need prolonged duration of antibiotics. Moreover you will need a cystoscopy and stone evacuation. Repeat ultrasound to check residual urine and uroflowmetry to know your urine flow status. A complete blood count, STD tests, Fasting Blood Sugar has to be done.

I would recommend you to be under the care of a Urologist. I understand this could be frustrating, but we can treat and resolve this problem without much complications. Do not trouble yourself with the diagnostic studies and treatment plans. Better leave it to your Doctor's discretion.

Hope this helps
Feel free to ask followups
Thank you

Patient replied :

I forgot to mention that all discharge stopped about 10 days ago. Also as of today the discomfort in my lower abdomen is reduced.

Does this change anything?

Expert:  Dr. Gautam Banga replied 3 Days.

This suggest there was response to the antibiotic. But for sure a culture is indicated as well as the other tests. Especially since the bladder shows signs of cystitis.

Adult males should not get UTI / Urethritis without a reason. So we need to find out what the reason is. Do consult a Urologist and get evaluated. A good evaluation now will prevent further complications. Thank you

Dr. Gautam Banga
Category: Andrologist
MS Surgery: MGM Medical College & M.Y Hospital Indore
Residency: M.Ch, Urology, SMS Medical College & Hospitals Jaipur
Medical School: MBBS, BJ Medical College, Pune, 2001
Training in Urethral Reconstructive surgery: Kulkarni Reconstructive Urology center, Pune
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