What to do if I have chronic UTI for 2 years with high pus and epithelial cells?

Question #29584

2 days ago

What to do if I have chronic UTI for 2 years with high pus and epithelial cells? - #29584

Client_5ec9b9

Chronic UTI 2 years 3 bar.Uti hua or treatment proper hui usk bad bhi esr 42 he pus and epithelial cell high h mera asa kyu ?

How often do you experience UTI symptoms?:

- Frequently

What specific symptoms are you experiencing during a UTI episode?:

- Lower abdominal pain

Have you been treated with antibiotics for your UTIs?:

- Yes, multiple times

Have you made any lifestyle changes to help manage your UTIs?:

- Increased water intake

Have you had any imaging studies or tests done recently?:

- Yes, ultrasound or CT scan

Are you currently taking any medications or supplements?:

- No medications

Do you have any other health conditions that might affect your urinary health?:

- Not sure

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Doctors' responses

Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

2 days ago

Hello dear
See it represents either
Incomplete elemination of infection
Recurrent infection
It is showing still presence of UTI
Iam suggesting some tests for confirmation
Please share the result with urologist in person for better clarity and for safety please donot take any medication without consulting the concerned physician
Cbc
Esr
Serum ferritin
Serum tsh
Serum hb
Rft
Lft
Gfr
Serum creatinine
Serum bilirubin
Hemogram
Kidney USG
Urine analysis
Culture
Hopefully you recover soon
Regards

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

1 day ago

Hello
If you have had recurrent or chronic UTI symptoms for 2 years with repeatedly high pus cells and epithelial cells, it usually means either the infection is not fully clearing, there is reinfection, or there is an underlying cause that has not yet been identified.
High pus cells indicate inflammation or infection in the urinary tract, while high epithelial cells can sometimes mean contamination of the urine sample, but if they are persistently high, it can also suggest irritation of the urinary tract lining. An ESR of 42 shows ongoing inflammation somewhere in the body, which fits with chronic infection but is not specific to the urinary tract alone.
Common reasons this keeps happening include incomplete antibiotic treatment, antibiotic resistance, kidney stones, bladder issues such as incomplete emptying, diabetes, genital hygiene factors, sexual activity–related reinfection, or structural problems in the urinary tract. In women, recurrent UTIs can also be associated with vaginal infections or hormonal factors.
What you should do now is get a urine culture and sensitivity test done before starting any antibiotics again, because this identifies the exact bacteria and the correct medicine. If you have already had imaging like an ultrasound or CT scan, the next important step is to review those results with a clinician to look specifically for stones, residual urine, bladder wall thickening, or kidney involvement. Blood sugar testing is also important if not done recently, because uncontrolled sugar can cause recurrent UTIs.
If symptoms have been frequent for 2 years despite treatment, a referral to a urologist or gynecologist is usually recommended. They may consider longer-duration antibiotics, preventive low-dose therapy, evaluation for interstitial cystitis, or further tests such as repeat imaging or cystoscopy if indicated.
Seek urgent care if you develop fever, flank pain, vomiting, blood in urine, or severe pain, as these can suggest kidney infection.
Take care

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Dr. Nirav Jain

I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.

1 day ago

Hello, mai aapki takleef samajh paa raha hoon. Aapke symptoms simple UTI se zyada serious lag rahe hain. Aapko recurrent complicated UTI ya kidney involvement ho sakta hai. Abhi ek baar ye saare tests karwaiye- Urine Routine Microscopy Culture Sensitivity, CBC, ESR, CRP, RFT, HbA1C, Repeat Ultrasound of Abdomen+Pelvis. Inki reports ke hisab se antibiotics change karni hongi. Kabhi-kabhi lamba course (10–14 days) dena padta hai. Khoon pani piye. Aur pain ke liye Tab. Paracetamol 650mg lein. Urine hold na karein. Proper hygiene maintain karein. Intercourse ke baad urination (agar relevant ho). Urgently doctor ko visit karnin agar tez bukhar, tez kamar dard, ulti, low BP, chakkar aaye.
Yeh normal UTI nahi lag raha. Recurrent + systemic symptoms = proper investigation zaroori. Sabse important test: urine culture.
Dr. Nirav Jain
MBBS, D.Fam.Medicine

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

1 day ago

Hello
Aapka ESR 42, pus cells aur epithelial cells urine mein high hona, aur baar-baar UTI hona (2024 se ab tak 3 baar), yeh sab milke dikhata hai ki aapko chronic ya recurrent UTI ka problem ho sakta hai. Antibiotics lene ke baad bhi infection wapas aa raha hai, toh kuch important cheezein check karni zaroori hain:
1. Urine Culture Test: Yeh test zaroor karwayein, isse pata chalega ki kaunsi bacteria infection kar rahi hai aur kaunsi antibiotic uske liye best hai. Bina culture ke, sahi dawa milna mushkil ho sakta hai.
2. Imaging (Ultrasound KUB): Kabhi-kabhi bladder ya kidney mein koi structural problem (jaise stone, blockage, ya koi aur abnormality) hoti hai, jiski wajah se infection baar-baar hota hai.
3. Personal Hygiene: Safai ka dhyan rakhein, cotton underwear pehnein, aur urine ko zyada der tak na rokhein.
4. Diabetes ya Immunity Issues: Agar diabetes ya immunity weak hai toh bhi infection repeat ho sakta hai.
Aapko abhi yeh steps lene chahiye:
- Apne doctor se urine culture aur ultrasound KUB test ke liye bolein.
- Pura course antibiotics ka complete karein, lekin bina test ke baar-baar antibiotics na lein.
- Zyada paani piyen, aur har baar urine pass karne ke baad area ko dhoyein.
Thank you

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Dr. Nikhil Chauhan

I am currently working as a urologist and kidney transplant surgeon at Graphic Era Medical College & Hospital, Dehradun. It's a role that keeps me on my toes, honestly. I handle a pretty wide range of urology cases—stones, prostate issues, urinary tract obstructions, infections, you name it. Some are straightforward, others way more complex than you expect at first glance. Every patient walks in with a different story and that’s what keeps the work real for me. Kidney transplant surgery, though, that’s a whole different zone. You’re not just working on anatomy—you’re dealing with timelines, matching, medications, family dynamics, emotional pressure... and yeah, very precise coordination. I’m part of a team that manages the entire transplant process—from evaluation to surgery to post-op care. Not gonna lie, it’s intense. But seeing someone who’s been on dialysis for years finally get a new shot at life—there’s nothing really like that feeling. In the OR, I’m detail-focused. Outside of it, I try to stay accessible—patients don’t always need answers right away, sometimes they just need to feel heard. I believe in walking them through what’s going on rather than just giving reports and instructions. Especially in transplant cases, trust matters. And clear, honest conversation helps build that. Urology itself is such a misunderstood field sometimes. People ignore symptoms for years because it feels “awkward” or they think it’s not serious until it becomes unmanageable. I’ve had patients who came in late just because they were embarassed to talk about urine flow or testicular pain. That’s why I also try to make the space judgment-free—like whatever it is, we’ll figure it out. At the end of the day, whether I’m scrubbing in for surgery or doing OPD rounds, I just want to make sure what I do *actually* helps. That the effort’s not wasted. And yeah, some days are frustrating—some procedures don’t go clean, some recoveries take longer than they should—but I keep showing up, cause the work’s worth doing. Always is.

17 hours ago

I’m really concerned by your symptoms – this is NOT just a simple UTI.
Here’s why it keeps happening and what you must do urgently:
🚨 Why is UTI recurring despite full treatment?
1. Wrong or resistant antibiotics – Without urine culture & sensitivity, bacteria may not be killed.
2. Underlying kidney infection (pyelonephritis) – Explains fever, body aches, back pain (worse on bending), sweats, low BP, dizziness.
3. Structural issue – Kidney stone, reflux, or scar tissue (not always seen on sonography).
4. Chronic bacterial prostatitis (if male) or pelvic pathology (RIF tenderness – could be appendix, ovary, or ureteric issue).
5. Immunity problem – Recurrent UTIs with systemic symptoms (low BP, fast heartbeat, shaking) suggest possible sepsis or chronic inflammation (ESR 42 confirms).
⚠️ Red flags you cannot ignore
· Low BP + dizziness + fast heartbeat + body shakes → could be early septic shock or adrenal insufficiency.
· Chest pain + low energy → needs heart/lung evaluation.
· Seasonal pattern (Feb–March) → possible allergic or autoimmune trigger.
✅ What to do RIGHT NOW (next 24–48 hours)
1. Go to a hospital – not a clinic. You need:
· Urine culture + sensitivity (before any antibiotic)
· Complete blood count + CRP + blood culture
· Renal function test + electrolytes
· CT urogram (sonography misses many stones/abscesses)
2. Stop self-medicating – No more random antibiotics.
3. Monitor BP and fever – If BP drops further or confusion occurs, emergency.
🩺 Long-term prevention (after stabilization)
· Low-dose prophylactic antibiotic (only after culture)
· D-mannose supplement
· Rule out tuberculosis (genitourinary TB can mimic chronic UTI)
· Pelvic exam + cystoscopy if needed
I am a urologist – and I tell you honestly: this needs a senior urologist or infectious disease specialist immediately.
Dr. Nikhil Chauhan
Urologist

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

3 hours ago

Chronic UTIs over a span of two years with persistent high pus and epithelial cell counts indicate a potentially underlying issue that goes beyond a simple bacterial infection. It’s crucial to determine what might be causing these recurrent infections. First, a detailed diagnostic work-up should be considered, including a repeat urine culture and sensitivity test to identify the specific type of bacteria causing the infection and their antibiotic resistance pattern. Imaging studies like an ultrasound or a CT scan can evaluate anatomical abnormalities in your urinary tract, such as stones or structural issues that can predispose you to infections. An ESR level of 42 suggests inflammation; though non-specific, it can be part of a puzzle indicating chronic inflammation or an unaddressed infection. It might be necessary to consult a urologist, who can perform specialized tests, such as a cystoscopy to visually inspect the bladder and urethra. It’s also essential to review any lifestyle factors or habits that could contribute to recurrent UTIs, such as fluid intake, personal hygiene practices, or sexual activity, and make adjustments accordingly. Your current antibiotic treatment plan should be revisited, perhaps considering a longer course of antibiotics or prophylactic antibiotics if necessary. Apart from that, exploring the potential role of non-bacterial causes, like interstitial cystitis, could be valuable. Ensuring you stay hydrated and possibly incorporating probiotics could help restore urinary tract health. However, this is not a substitute for thorough medical evaluation and treatment, so timely engagement with a healthcare professional is crucial.

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