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UTI & Urologist Recommendation

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    UTI & Urologist Recommendation

    Can someone recommend a good urologist in the Southern California area near West Covina? I am switching my insurance from Kaiser to Blue Shield PPO in September and I am looking for an urologist who is familiar with SCI patients.

    I am a C5/6 quadriplegic complete. I have been using a foley catheter for more than 18 years. For the past 5 years, I suffer from chronic UTI. Most antibodies do not kill the bugs I have. As soon as I stop the treatment, the symptom returns. My family doctor finally put me on long term Macrodantin 100mg daily but I still get symptoms. My Kaiser urologist told me there is nothing he can do for me because the foley will always introduce bacteria. He wants me to cath intermittently. I can not cath myself and I don't have someone to cath me. My urine culture typically shows multi-organisms and the lab frequently discard my sample assuming it is contaminated.

    My UTI symptoms usually developed at night. The foley catheter is connected to an Urocare 2000cc night drain bottle through a plastic tube. For some unknown reason, the urine only flows when I am in the sitting or elevated position while in bed. If I am lying down flat on my back, the urine pools in the bladder and does not flow. Many times a night I must sit up to let the urine drain from the bladder. My bladder has shrink over the years and it can only hold very little urine before it starts to spasm. I often wake up in sweat at night because of AD due to bladder is full. I take ditropan when I have symptoms. During the day my foley is connected to a leg bag. I don't have this problem sitting in chair.

    I suspect the bacteria multiple while the urine stagnate in the bladder. This may be the reason for my frequent UTI. Has anyone experience a similar problem? I did not have this problem when I was first injured. This problem started in the last a few years.

    My Kaiser doctors are clueless. I finally decide to pay more premiums and switch to Blue Shield PPO so I can have more choices of doctors. There must be someone out there who can help me.

    Thank you for your advice.

    Welcome to CareCure. Please complete your profile. I am assuming you are male??

    Your urologist is right. With an indwelling catheter you will always have bacteria (colonization). This should not be treated unless you have symptoms such as AD, fever, chills, flank pain (if you have sensation), excessive leaking around the catheter, malaise, and/or elevated blood white blood cell count (WBC).

    What size and kind of Foley catheter are you using?

    Do you have a urethral or SP indwelling catheter?

    You should be on an anticholenrgic (like Ditropan) all the time to reduce pressures, reduce the risks for reflux, and reduce bladder spasm.

    When did you last have tests for bladder or kidney stones? Have you been evaluated for possible prostatitis (if you are male)?

    I would recommend calling the SCI clinics at both Rancho Los Amigos and Casa Colina in Pomona to see if they can recommend a good urologist in your area. You should also check with your physiatrist to see if they can make a recommendation.

    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.


      Dr Ginsberg

      Dr Ginsberg who is the Chief of Urology at Rancho and has a private office at USC Medical Center would be a great choice. I live in Arizona and I fly to see him as well as some of my friends.I am not sure where West Covina is but if you are close he is one of the best in the Country.
      If you are by San Diego there is a doctor at the San Diego VA who is great as well and has a private office. He does the Botox and my mind just went blank on his name. I know patients from Arizona who go to him as well.



        Thank you very much for the recommendation. I will contact the Casa Colina SCI clinic.


          I did my rehab down in sunny socal @ Rancho.
          When I finally got Medicare I was able to see outside dr's.
          Anyway a good guy that lots of SCIs see is Dr. Barton Wachs in Long Beach, CA.
          good luck