Recurrent Urinary Tract Infections (UTIs)

It is estimated that about 80% of women will acquire a bladder infection
at some time during their life, and as many as 20% of women will have
problems with recurring infections. To better understand how infections
occur, it is important to understand the physiology of the urinary system.
The function of the urinary tract is to clean waste products from the blood.
The urinary tract begins with the kidneys, which sit high in the back. Blood
is filtered through the kidneys, which extract excessive fluid and waste
products to make urine. Once the kidney makes the urine, it is transported
down through tubes called the ureter to the bladder. The bladder sits in the
pelvis, which is in the lower abdomen. The bladder stores urine until full
then empties the urine to the outside through the urethra.

Detection, Diagnosis and Treatment

Identification of a urinary tract infection (UTI) is important to prevent
systemic infection to one’s kidneys and bloodstream. UTIs are common in
the reproductive aged female, postmenopausal females and in men. There
are many causes of urinary tract infections such as bacterial contamination,
which may be contracted from the anal region (improper wiping), and from
the vaginal flora. Bacterial colonization may be due to urinary retention;
when the bladder does not emptying completely and bacteria has an
opportunity to colonize and grow. This cannot only cause an infection, but
also, inflammatory changes to the bladder and urethra. Two of the most
common initiating events that can trigger UTIs are sexual intercourse and
vaginal douching. Symptoms are manifested as urinary frequency, urgency,
burning with urination, lower abdominal pain and sometimes blood in the
urine. Low-grade fever and low back pain may be present as well.
A urinalysis is a test that is performed to determine if white blood cells
(pus cells) or red blood cells are present, and then a urine culture is carried
out. Common bacteria examples are E. coli, Enterococcus, staphylococcus,
and Klebsiella. Once the bacteria are identified, an appropriate antibiotic is
prescribed for 3-7 days, unless the infection becomes recurrent.
Women with recurrent infections often undergo x-ray studies and a
procedure called cystoscopy (a way that a urologist may inspect the
bladder). A post void residual may be performed to ensure complete
emptying of the bladder.

Methods to prevent UTIs include Vitamin C 250mg morning and night,
and pure cranberry juice. The acid and enzymes from these two products
help to produce a less favorable environment for bacteria. More frequent,
complete emptying of the bladder helps to “wash out” bacteria from the
bladder. Recurrent UTIs may also be prevented with use of a daily low dose
antibiotic. A second approach is a prophylactic antibiotic for intercourse.