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Michael Frey, MD
May 21, 2021

Urinary Tract Infections



UTIs are one of the most common infections among individuals, especially women. More than half of women will have at least one UTI at some point in their lifetime.


CAUSES OF URINARY TRACT INFECTIONS

In most cases, Escherichia coli (E. coli) is the cause of a UTI. Since the urethra is close to the anus, it is easy for bacteria from the large intestine to enter the urethra. From there, the bacteria travels up to your bladder and can continue on to affect your kidneys if left untreated.


Contributing factors:

  1. sex: the physical act of intercourse exposes a woman’s urethra to bacteria from the anal area. After contact is made, it is easy for bacteria to travel into the urinary system and cause an infection.

  2. bladder prolapse in the vagina

  3. urinary incontinence

  4. kidney stones

  5. menopause

  6. distortion in the anatomy of the kidneys, bladder, or ureters.

  7. pregnancy


SYMPTOMS

  1. Intense urge to go to the bathroom, but only produce a small amount of urine

  2. Frequent need to urinate

  3. Burning sensation during urination

  4. Loss of urine control

  5. Pelvic pain (in women) and rectal pain (in men)

  6. Dark or cloudy urine

  7. Foul-smelling urine

  8. Blood in urine

Upper tract UTIs affect the kidneys and can be potentially life-threatening if the bacteria move from the kidneys into the blood. These signs include:

  1. Pain and tenderness in the upper back and sides

  2. Chills

  3. Fever

  4. Nausea

  5. Vomiting


TREATMENT

1. Antibiotics, such as Fosfomycin, Macrobid, Bactrim, Cipro, and Keflex.

2. Drink plenty of water, to help flush out the infection-causing bacteria.

3. You also might find a heating pad useful to soothe the pain.

4. Pyridium can help with the pain, but beware, it may turn your urine orange.

PREVENTION

You can take these steps to help reduce your risk of developing a UTI:

  • Drink cranberry juice: It’s not just an old wives’ tale! There is a tannin in cranberries that helps prevent E. coli bacteria from adhering to the bladder wall and causing an infection.

  • Wipe from front to back: Doing so helps prevent bacteria in the anal region from spreading to the urethra.

  • Empty your bladder soon after intercourse: Sex is a common trigger for UTIs but can be prevented by cleaning the genital area before any sexual activity, and by urinating afterward.

  • Avoid potentially irritating feminine products: Feminine products such as deodorant sprays, douches, and powders can irritate the urethra and increase your risk of developing a UTI.

  • Change your birth control method: Diaphragms can increase bacteria growth, while unlubricated condoms or spermicidal jelly can irritate your urinary tract.

  • Keep your genital area dry: Wear cotton underwear and loose-fitting clothes; avoid tight jeans and nylon underwear, as they can trap moisture and grow bacteria.

  • Avoid holding urine for long periods of time: If you don’t empty your bladder regularly, bacteria is more likely to sit and multiply in the bladder.


Chronic or recurrent UTIs:

  • If you have three or more UTIs a year, you may need treatment for recurrent UTIs.

  • We may consider a sonogram of the bladder and kidneys.

  • For postmenopausal women, vaginal estrogen may help.

  • Sometimes a consultation with a Urologist is necessary.

  • D-mannose: naturally occurring sugar found in certain fruits, prevents bacteria from sticking to the walls of the urinary tract or bladder. The bacteria are then flushed out on urination.

  • Taking a preventative daily antibiotic to prevent chronic UTI infections is very effective at reducing the recurrence of UTI's. Options for antibiotic prophylaxis include: daily, every day or only after sex (when UTI's are mainly associated with sex).

  • Probiotics



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