Query - Adrenals and UTI

[Jantayl]

Over the past year or so I have tried reducing daily dosage of Pred. I get down to 5mg and then I get a UTI and have to go up again. I am beginning to wonder if there is a connection with the Adrenal, Kidney and Urine causing an infection each time. I find this strange and wonder what anyone’s thoughts are - am I being paranoid! I do have another health issue - Chronic Bladder Retention - and GP just gives this as reason for the infections……this has happened 3 times this year. I now fear reducing at all?!

[PMRpro Ambassador]

Is this real UTIs? i.e. confirmed by a urine culture each time? Or just dip?

Your GP could well be right - not fully emptying the bladder and/or urine being in the bladder a long time can be an underlying cause. Have you seen a urologist? I have a parallel problem- the urethra is narrow and that causes emptying problems at times. I've had urethral stretches 3 times and each time the effect lasts something like 8 or 9 years before the UTIs start up again. Just waiting for a urology consultation in August - hope they'll do it again.

My concern in your place would be that you just aren't feeling the UTIs at higher doses of pred - only when you get to a lower dose is it painful. Doesn't mean there isn't infection there though.

[Jantayl in reply to PMRpro]

Yes it is an infection - confirmed by urine culture - given antibiotics each time - in hospital last year for intravenous antibiotic. I have been diagnosed by urologist - bladder does not work therefore do ISC - catheterisation 4/5 times daily. I just wondered about the connection between the lower doses of pred and these infections - whether just coincidence? I am now trying 5.5mg again but am ever fearful of another infection. Thanks

[SnazzyD]

Seems to me there needs a bit more investigation. If there is an infection popping up the dose will reduce the inflammation and any signs of infection will be suppressed but the infection still active. If there is chronic infection from an organism it is helped by reducing your immune response against it. What are your symptoms and has an organism been identified?

[Jantayl in reply to SnazzyD]

Yes an organism has been identified - antibiotic Co-amoxiclav then Co-trimoxazole which cleared infection last time - 3 weeks ago. Beginning to wonder though if I shall ever get below 5mg pred as this has been happening since April 2020 when I briefly got down to 4.5mg. And I just wondered about the connection - if any - between PMR and my bladder issues. Thanks

[Roxyart]

I too have got repeated UTIs when I lowered my prednisone my doctor said it had nothing to do with it but I did however stop drinking alcohol and I haven't had another one since