This topic is about dealing with recurrent urinary tract infections (UTIs) and kidney infections after having an ileal-conduit urostomy. A person with both an ileostomy and a urostomy has been facing frequent and serious infections, which have led to hospital stays. Here’s a breakdown of their experience and some advice they’ve received:

- The person has had six serious infections in the past year, with symptoms like nausea, fever, vomiting, and changes in urine color and clarity.
- They have undergone multiple urine cultures to identify the bacteria causing the infections.
- Short courses of the antibiotic Cephalexin have only provided temporary relief.
- Currently, they are taking Trimethoprim daily, which is helping to control the infection, but there is a concern about the bacteria becoming resistant to this medication.
- Amoxycillin was also tried in the past.
- A specialist mentioned that only four classes of antibiotics remain effective for treating UTIs in this situation. The recurrent infections are attributed to the bowel segment used in creating the ileal conduit, which naturally sheds bacteria into the urinary tract. Despite high fluid intake, infections persist.
- The person is seeking advice from others with similar experiences on how to manage these ongoing infections.

Additional context includes:

- The person does not use a catheter and is not sexually active due to impotence following surgery.
- They underwent extensive surgery that removed the bowel, bladder, prostate, and anus, with a healing period of about 12 months.
- They are looking for practical strategies to reduce the frequency of infections.

Advice and insights shared include:

1. Recurrent UTIs can be caused by various factors, but in this case, the explanation that the conduit segment continually produces bacteria seems plausible. Long-term use of prophylactic antibiotics might be necessary.
2. Long-term antibiotic use is generally a last resort due to the risk of bacteria developing resistance and potential immune system issues. It’s important to weigh the benefits against these risks.
3. Emotional support is crucial. Maintaining a positive outlook and connecting with other double ostomates for shared experiences and coping strategies can be very helpful. One person offered to discuss management approaches privately.