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Why is my mother's condition not improving?

Q: My mother, 50 years old, is a known case of hypertension, diabetes, chronic pyelonephritis and chronic kidney disease. She recently underwent surgery for re-implantation of the right ureter and double J (DJ) stenting of implanted ureter. Though she is under regular follow up and proper diet, she falls sick very often due to urine infection. She has undergone cystoscopy and stenting almost 4-5 times with no improvement. She was hospitalised a few days back and the doctors said that they didn't have any option but to keep a catheter for a week and see the progress? Is there any further treatment you suggest?

A:At times eradication of urinary tract infection becomes tricky. In this situation your urologist/physician will have to rule out any specific reason for this problem. Things which cross my mind are - 1. Urinary bladder is functioning normally. 2. Documentation of disappearance of reflux after surgery, 3. Documentation that there is no obstruction at the site of surgery or at any other place. Placement of stent (does not rule out obstruction) and urinary catheter to improve drainage to solve this crisis appears logical but long-term strategy would need to be planned to find lasting solution for the problem.

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