Q: I have a 24 years old wife. I got married last month. During marriage my wife was having severe lower abdominal pain. Her culture suggested a UTI. She took an antibiotic course and was okay. In between she developed lower abdominal pain again. So we met a gynaecologist, she suggested to get an ultrasound done. The report of his ultrasound indicated the presence of a small renal calculus. There was minimal free fluid seen in the pelvis. So the doctor suggested to take the ELISA test for TB. Her reports are IgG 176 SU, IgM 0.64 and IgA 281 SU. Is she suffering from TB? Are there any other tests required? We plan to expand our family. Will this affect her chances of conception?

A:It is surprising why TB serology was ordered. Based on the details submitted, it is clear that your wife was having pain in the lower abdomen - the causes for this could be many, but is more likely to be due to a urinary tract infection (UTI) or the renal calculus, or a mixture of both. UTIs limited to the bladder (cystitis) can be painful and annoying. But serious consequences can occur if the infection spreads to the kidneys (pyelonephritis). Symptoms of UTI can include the following: - a strong, persistent urge to urinate; - a burning sensation when urinating; - passing frequent, small amounts of urine; blood in the urine (haematuria) or cloudy, strong-smelling urine. Cystitis may occur in women after sexual intercourse and is also known as ''Honeymoon cystitis''- in young recently married women. But even girls and women who aren't sexually active are susceptible to lower urinary tract infections because the anus is so close to the female urethra. Also, women have a shorter urethra than men have, which cuts down on the distance bacteria must travel to reach the bladder. In fact, half of all women will develop a UTI during their lifetimes, and many will experience more than one. Most cases of cystitis are caused by Escherichia coli, a bacterial species commonly found in the gut. Women in particular may benefit from the following preventive steps:

• Drink plenty of liquids, especially water, which dilutes your urine and may help flush out bacteria. Cranberry juice may have infection-fighting properties. Avoid coffee, alcohol, and soft drinks containing citrus juices and caffeine until your infection has cleared.
• Urinate promptly when the urge arises. Avoid retaining your urine for a long time after you feel the urge to void.
• Wipe from front to back, after urinating and after a bowel movement, helps prevent bacteria in the anal region from spreading to the vagina and urethra.
• Empty your bladder as soon as possible after intercourse. Also, drink a full glass of water to help flush bacteria.

Not all kidney stones cause symptoms. They're often discovered when you have X-rays for an unrelated condition or when you seek medical care for other problems, such as blood in your urine or recurring urinary tract infections. The pain becomes agonising only when a kidney stone breaks loose and begins to work its way down from your kidneys to your bladder through the connecting tube (ureter). TB ELISA has little diagnostic role since it suffers from poor sensitivity and specificity - i.e. it misses diagnosing many cases and wrongly diagnoses many others. I would suggest that the results of this test be ignored and a detailed clinical evaluation be done by a urologist.