Urinary Tract Infections (UTI's)

One of the most vexing problems women face are urinary tract infections. In this article, I thought I would share some information and advice on this frustrating problem.

Urinary tract infections (UTIs) are infections of the bladder or kidney. These are most often caused by bacteria. The typical symptoms include burning pain with urination and feeling the constant urge to urinate frequently. Sometimes, there can be pelvic pain and blood in the urine. If the kidneys are infected there can be upper back/side pain, fevers and even nausea/vomitting. A kidney infection can be very serious and may even require hospitalization. The good news is that urinary tract infections can be treated with antibiotics but it is important to seek care right away if you start feeling any of these symptoms. In addtion to asking about such symtoms, the doctor may do a urine test in the office along with a physical exam. This is because there are other conditions that can mimic a UTI such as a vaginal infections, certain STDs such as chlamydia, gonorrhea or even herpes. To help differentiate between all of these other conditions, the doctor may even decide to order a “urine culture”. A urine culture is a test where a doctor sends your urine sample to the lab and they can grow out the bacteria to not only confirm the infection but also to test which antibiotics work best against that bacteria. This can be important information if a patient does not respond to the first antibiotic the doctor gives them.

Some women find themselves plagued with the problem of getting recurrent UTIs. This is generally defined as at least 2 UTIs in 6months or 3 within a year. This problem can be triggered by sex - especially with a new partner. In those cases, we will sometimes prescribe a very small dose of antibiotic to be taken once, right after sex to prevent an oncoming UTI. In some women these recurrent infetions may be occuring because they have a constant, low lying amount of bacteria in the bladder and this bacteria is never quite wiped out with a short course of antibiotics. For them, we may give a more prolonged daily course of antibiotics for up to 6months or longer.

Women often ask if there is anything they cando to prevent these UTIs. Over the years we have suggested such measures as wiping from front to back, urinating after sex and taking cranberry supplements. None of these measures have actually been shown to make a difference in the available studies but there was one small study that showed that taking 2gms of D-Mannose a day for 6months did decrease the rate of recurring infections. This is an over the counter supplement so may be worth a try.

Remember that most women will get at least one UTI in their liftetime so don’t feel badly if it happens to you. Hopefully, this article will give you the knowledge needed to help you handle one if it does!