Many individuals have suffe=red from recurrent urinary tract infections despite having received the correct treatment. Having repeated urinary tract infections can take a toll on your life. Despite what many people think, recurrent urinary tract infections are not usually caused by poor hygiene or something else that individuals have brought on themselves.
What is an urinary tract infection (UTI)?
A urinary tract infection (UTI) is the invasion of your urinary tract (urethra, bladder and kidneys) with bacteria, which then causes you symptoms. Your symptoms will depend on the part of the urinary tract involved. If you have a mild infection, it can often clear within a few days – and may not always need antibiotics. More severe infections will probably require treatment.
Why do women often get recurrent urinary tract infections?
Recurrent urinary tract infections can occur in males and females, but they tend to occur more frequently in females. About 1 in 5 women get a second urinary tract infection (UTI), while some are plagued incessantly.
Urinary tract infections are usually caused by Escherichia coli, a bacterium that lives in the intestinal system. If E. coli are carried from the rectum to the vagina, they can enter the urethra (the tube that carries urine from the bladder) and infect the bladder.
Risk factors for UTI vary with age. Before menopause, the most common risk factors are sexual intercourse and the use of spermicides. It is felt that sex increases the number of bacteria in the bladder, and many experts advise women to urinate after sex to flush them out. Spermicides may kill off Lactobacilli, beneficial bacteria in the vagina, making it easier for E. coli to move in.
After menopause, certain physical changes help to set the stage for UTIs. The numbers of Lactobacilli in the vagina naturally decline. The bladder also contracts less strongly than it once did, making it more difficult to empty it completely.
Urinary tract infections are uncommon in men because of the longer length of the male urethra, antibacterial properties of prostatic fluid, and less frequent periurethral colonisation in men.
Are recurrent urinary tract infections genetic?
Often recurrent UTI can run in families and it is thought that there is a genetic reason for this – with a mildly altered constitution of the urine making you more susceptible to UTI. In both premenopausal and postmenopausal women, genes play a role as well. Having a mother or sister who has frequent UTIs is also a risk factor for recurrent urinary tract infections.
How to prevent urinary tract infections?
One of the most effective things you can do to help prevent cycles of recurrent infection is to make some simple changes to your lifestyle. These include:
• Wiping “front to back”: After going to the toilet it is important to push the toilet paper from the front, near your water pipe, towards your bottom. If you pull the paper from near your bottom towards your water pipe you can transfer bacteria closer to the water pipe, making it easier for them to cause an infection.
• Drink plenty of fluids: Many people just do not drink enough water or fluid. If urine is dark yellow, or brown, in colour it is showing you that you are dehydrated. If you do not drink plenty water, you often do not pass urine frequently. This means the bladder stores urine for a longer time between emptying, and so can act as reservoir of bacteria. You should try to drink enough fluid to keep your urine pale yellow or even clear. Aim for about 2 to 3 liters.
• Avoid soaps, shower gels and “intimate hygiene” products. Washing with soap or other products removes this natural protection of the vaginal secretions – and can even cause chemical irritation which promotes infection.
• Limit washing the vaginal area to once a day. Ladies with UTI often believe the infection comes as they are not clean enough – and so try to improve hygiene in the vaginal area by washing more than once a day. This practice, unfortunately, has the opposite effect as it washes the ‘healthy’ vaginal secretions away.
• Sexual hygiene: Many women experience “honeymoon cystitis” or UTIs, which occur after having intercourse. Passing water, and washing gently with warm water after sex, can help reduce the amount of bacteria present which may cause infection.
• Constipation: Avoid constipation with a diet full of fibre and a healthy intake of fluid. If this is a continuing problem then this may be something you wish to discuss with your doctor.
• Incontinence: Treating incontinence, whether urinary or faecal, can help reduce the risk of UTI, so if you are suffering with these symptoms please discuss this with your doctor.
Management of recurrent urinary tract infections
If you have recurrent UTIs, talk to your doctor. Your doctor, in addition to carrying out a detailed history and physical examination, will arrange for a number of investigations. The two of you can come up with a plan that is likely to be effective for you. Taking a low dose of one of the antibiotics used to treat UTI – nitrofurantoin, trimethoprim-sulfamethoxazole, and cephalexin – is the most reliable way of dealing with recurrences. However, bacteria may become resistant to an antibiotic over time, and it may not be effective in treating subsequent infections. If you have three or more urinary tract infections (UTIs) a year, ask your doctor to recommend a special treatment plan. You and your doctor will be able to decide on the best options available.
Conclusion
Urinary tract infections are very common in women. Some women, however, suffer from recurrent urinary tract infections. This can take a severe toll on the life of the affected individual. Fortunately, a number of treatment plans are now available to successfully treat recurrent urinary tract infections. If you are having recurrent urinary tract infections please see your doctor for an evaluation and proper management.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-eight years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
