With many women having repeat infections, sometimes for years on end, it is essential for women to be very cautious. The leading cause of infection is usually wiping from back to front after using the bathroom. That’s because the urethra – the tube that transports urine from the bladder to the outside of the body – is located close to the anus. Bacteria from the large intestine are in the perfect position to escape the anus and invade the urethra. From there, they can travel up to the bladder, and if the infection isn’t treated, continue on to infect the kidneys. Having sex can also introduce bacteria into the urinary tract.
Bladder Infections (UTI) IDENTIFICATION
According to the Johannesburg-based urologist, Dr. Corne van Graan, typical UTI symptoms are frequent urination, burning pain when you urinate, lower abdominal pain, back pain and cloudy or bloody urine with an unusual smell. If you suspect you have a UTI, you need to see a doctor. When you are at the doctor's, after history and examination, you will be asked to give a urine sample, which will be tested for the presence of UTI-causing bacteria. “This will confirm if there is an infection or not,” he says. Dr. Corne says women are prone to UTI because their urethra is shorter. “Diabetic patients are also more likely to get urine infections due to the excess sugar in the urine,” he says. “Also, after menopause, women are likely to get urine infections because their private parts and urethra become dry.”
WHO IS AT RISK
He adds that other people who may get UTIs often include those with urinary catheters (partially flexible tubes that collect urine from the bladder in ill patients) due to illness and cannot empty their own bladder, men with prostate problems since an enlarged prostate gland can cause the bladder to only partially empty. Babies, especially those born with congenital abnormalities of the urinary system, are also likely to suffer. Dr. Pieter le Roux, a urologist, says the exact incidence of UTI in South Africa is not known. “They are much more common in women than in men,” he says. He also says surveys screening for bacteriuria (bacteria in the urine) have shown that 1 percent of schoolgirls aged five to 14 have bacteriuria and that this figure increases to 4 percent by young adulthood and then by an additional 1 to 2 percent per decade of age. “This is an infection involving the
kidneys, ureters, bladder, or urethra. These are the structures that urine passes through,” he says.
TREATMENT OPTIONS
According to Dr. Corne, the mainstay of UTI treatment is an appropriate and adequate antibiotic course. The World Health Organisation reported UTIs are the second most common infection treated by antibiotics. “An uncomplicated UTI can be cured with three days of treatment. It is important to finish the full course of treatment because symptoms may disappear before the infection is fully cleared,” he says. He also adds that complicated UTI and kidney infections generally require two weeks of antibiotic treatment. He says women who have frequent recurrences with no identifiable cause may benefit from preventive therapy. “You can take a low dose of an antibiotic or antiseptic daily for three to six months,” he says.
STEPS TO AVOID INFECTION
Dr. Corne says a person can take additional steps to avoid an infection by drinking plenty of water every day. “Drink cranberry juice because it inhibits the growth of some bacteria by acidifying the urine,” he says. “Do not hold the bladder for too long because old, stale urine is a good medium for bacteria to grow. Also, pass urine immediately after sexual intercourse, or use an antibiotic after intercourse.” If symptoms are not improving in spite of treatment, Dr. Corne says it is important to call your doctor. “You should also return to your doctor immediately if you start to feel systemically ill with symptoms of fever and chills,” he adds. “This may indicate a more severe infection, which might need admission and antibiotics.” He also says that any pregnant woman who develops a UTI should be treated promptly.
WHAT TO DO
■ Drink lots of fluids to flush the urinary system. Water is the best.
■ Empty bladder regularly as soon as you feel the need rather than holding on.
■ For women and girls, wipe your bottom from front to back to prevent bacteria from around the anus entering the urethra.
■ Urinate shortly after sex to flush away bacteria that might have entered your urethra during sex.
■ Wear cotton underwear and loose-fitting clothes so that air can keep the area dry. You must avoid tightfitting clothes and nylon underwear, which trap moisture and can help
bacteria grow.
