Dealing with Urological Issues Abroad: Medication and Symptoms Explained - Urology

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I am abroad, but I have run out of medication?


Hello Doctor, three weeks ago I started experiencing frequent urination, so I went to the hospital for a urinalysis (but I urinated after drinking a lot of water).
Two weeks ago, I began to feel itching in the urethra, and urination became burning and painful (but there was no hematuria or discharge).
At that time, the urinalysis results came back normal! However, I clearly had itching symptoms, so the doctor prescribed me a week’s supply of Doxycycline.
A week ago, since I was going to France, the doctor prescribed me another week’s supply and said, “You should be almost fine after finishing this week’s medication.” Yesterday I finished the medication, and the urethra is indeed no longer painful, but there is still some itching and a feeling of incomplete voiding.
So, currently in France, I visited a family physician, who said, “Doxycycline is very weak; I don’t understand why Taiwanese doctors prescribe this medication.” He then prescribed me Ofloxacin.

May I ask: my urinalysis results are normal; does drinking a large amount of water before the test affect the results? (I drank enough that my urine became clear.) Additionally: (1) Should I refrain from taking the French doctor’s medication for now, drink plenty of water for the next few days, and wait to see how it goes? Ofloxacin seems to be a last-resort antibiotic with very strong effects, so it’s better not to take it unless absolutely necessary.
(2) The Taiwanese doctor’s medication is finished, but there is still some itching in the urethra, indicating that the bacteria may not have been completely eradicated.
If I don’t take action now, they could potentially return with stronger antibiotic resistance, so I should take the French doctor’s strong medication immediately to eliminate them and prevent future issues.
Which of these two perspectives is correct? (I won’t return to my home country until next Friday, so what should I do this week?)

Xiao Wang, 20~29 year old female. Ask Date: 2019/06/29

Dr. Du Shixi reply Urology


Hello: Some medications are used as a last resort.
According to the physician, it is sufficient to take the strongest one.
If there are no symptoms and urine tests are normal, there is no need for medication according to health insurance regulations.
However, it is important to pay attention to lifestyle factors: drink enough water, avoid holding urine, and refrain from spicy foods, alcohol, and ensure safe sexual practices to prevent recurrence.
If you find it difficult to maintain these lifestyle changes, then taking medication may be necessary to prevent recurrence.
Wishing you good health.

Reply Date: 2019/06/29

More Info


When dealing with urological issues, particularly symptoms like frequent urination, burning sensations, and itching, it is essential to understand the underlying causes and the implications of the medications prescribed. In your case, you have experienced symptoms that suggest a possible urinary tract infection (UTI) or another urological condition, despite normal urinalysis results.
Firstly, regarding your question about drinking a lot of water before a urinalysis: Yes, consuming excessive amounts of water can dilute your urine, potentially affecting the concentration of substances that are typically tested for in a urinalysis. This dilution can lead to false negatives for certain infections or conditions, as the bacteria or other indicators may be present in lower concentrations than they would be in more concentrated urine. Therefore, it is generally recommended to follow the specific instructions given by your healthcare provider regarding fluid intake before a urinalysis.

Now, addressing the two perspectives you presented:
1. Delaying the use of the French doctor's prescription (of Ofloxacin) and opting to drink more water: This approach has merit, especially if you believe that your symptoms are mild and may resolve on their own. Increasing fluid intake can help flush out the urinary tract and may alleviate some symptoms. However, it is crucial to monitor your symptoms closely. If they worsen or do not improve within a few days, it may be prudent to reconsider using the prescribed antibiotic.
2. Starting the French doctor's antibiotic immediately to prevent the potential for antibiotic resistance: This perspective is also valid, particularly if you suspect that the initial treatment was insufficient. If the symptoms indicate that a bacterial infection is still present, and you have been advised that Ofloxacin is a stronger antibiotic, it may be wise to take it to ensure that the infection is fully cleared. Delaying treatment in the face of persistent symptoms could indeed lead to complications or the development of antibiotic-resistant bacteria.

Given these considerations, the best course of action would be to balance both perspectives. If your symptoms are mild and manageable, you might choose to increase your fluid intake and observe your condition for a couple of days. However, if you notice any worsening of symptoms, such as increased pain, fever, or the development of new symptoms, you should not hesitate to start the Ofloxacin as prescribed by the French doctor.
Additionally, it is essential to communicate with your healthcare providers about your symptoms and any changes you experience. If you decide to take the Ofloxacin, ensure that you complete the full course of antibiotics as prescribed, even if you start feeling better before finishing the medication. This practice helps prevent the development of antibiotic resistance and ensures that the infection is fully eradicated.

In summary, while both approaches have their merits, the decision should be based on your current symptoms, their severity, and your overall health. If in doubt, consulting with a healthcare professional who can assess your condition in person would be the best course of action.

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