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Urinary Tract Infections

The Facts

Urinary tract infections are one of the most common disorders, second only to upper respiratory tract infections. According to the American Medical Association 25-35% of women between the ages of 20 and 40 have had a urinary tract infection. Most of these infections occur in healthy women with normal urinary functioning.

Your urinary tract consists of the kidneys, ureters, bladder and urethra. Your kidneys filter more than 45 gallons of blood in a day. Urine passes from the kidneys through 2 ureters into the bladder. You eliminate urine through your urethra, a narrow canal about 2 inches long in women, that funnels urine from the bladder to outside the body. A urinary tract infection or "UTI" can be a bacterial infection of any part of the urinary tract.

What Causes a UTI?

The organism responsible for 80% of UTI's is Escherichia coli. This bacterium is normally found in the digestive tract and is present on the skin around the rectal area. In women, intercourse can irritate the urethra making it more likely for bacteria to enter the urinary system. If left untreated, the infection can ascend into the kidneys, which is a more serious condition.

Symptoms

Typical symptoms include burning with urination, frequency of urination, and an intense urge to urinate, even if only a few drops of urine are passed. Some women notice that they need to get up at night and some experience back or lower abdominal pain. The urine may also look different, may smell different, and may be tinged with blood. If the infection is in the kidneys, fever, nausea, chills, and back pain are common.

Treatment

Other than drinking lots of water at the first sign of infection to flush out your system, it is not wise to attempt self-treatment. Your health care provider will prescribe antibacterial drugs. The choice of drug and how long you take it will depend on your history. If you have recurrent infections you may be prescribed low doses of antibacterial medications for an extended period. Your health care provider will go over your medication with you and give you instructions for use. It is important to take all the pills you are prescribed. Do not stop taking the pills because you feel better.

How Do I Prevent UTIs?

  • Drink at least 8 oz. of water and/or cranberry juice. Drinking lots of water dilutes the urine and flushes bacteria out of the bladder. Cranberry juice does contain a substance that prevents E. coli bacteria from adhering to the bladder lining so drink it everyday if you like it. Eliminating caffeine and soft drinks helps in the prevention of UTIs by decreasing irritation to the urethra. Urologists often recommended elimination of these beverages if recurrent infections are a problem.
  • Urinate at least every 4 hours during your waking day. Women who urinate less frequently are more subject to infection because their bladder will distend and have difficulty emptying itself thoroughly.
  • Be careful how you wipe yourself after urinating or after a bowel movement. Wipe from front to back so that the bacteria from your anal area are not pushed into the urethra or the vagina.
  • If you are having intercourse, empty your bladder before sexual activity. A full bladder puts increased stress on the tissues. Drink 2-3 glasses of water after sex and urinate when you have the urge to do so. The goal is to have a good steady stream of urine to wash any bacteria from the bladder.
  • Wash your genital area or shower before sexual activity to minimize the chance that bacteria can be introduced into the urethra during sex.
  • If you use a diaphragm for birth control and have repeated infections, you need to have your diaphragm size checked. Spermicides may also cause irritation, which may promote infection. If the diaphragm is the cause of the UTIs then another form of birth control will have to be used.
  • If you feel dry with intercourse use a water-soluble personal lubricant. Products such as ForPlay or Astroglide help decrease friction and stress on tissue, which can lead to infection.
  • Avoid feminine hygiene products such as sprays, deodorants, powders or douches which may irritate the urethra.
  • Change sanitary pads and tampons frequently during menstruation.
  • Don't use perfumed toilet paper, heavily scented soaps or powders in the vaginal area. Some laundry detergents, bleaches and fabric softeners leave residues that can be irritating or cause allergic reactions. Use unscented products if you are sensitive.
  • If you have frequent, recurrent UTIs in spite of these precautions, your health care provider may want to prescribe a medication to prevent infection or schedule a consultation with a specialist.

If you have any questions or if any of this information is unclear, please be sure to speak with one of the providers in the Women's Health Program. The telephone number for an appointment is 603/646-9401.

Last Updated: 4/5/10