A urinary tract infection (UTI) is an infection that affects part of the urinary tract. Most UTIs are ascending infections of bacteria that colonise the vaginal wall and eventually, the urethra. From the urethra, the bacteria can travel upwards and infect the bladder (lower tract infection) or continue from the bladder up the ureters and infect the kidneys themselves (upper tract infection). There are a number of general guidelines and suggestions that will help women avoid UTIs in most instances and help block bacterial migration.
The first important way to prevent an UIT is always wipe from the front to the back after using the bathroom. Do not try to reach from behind because germs from the rectum can be transferred to the hand and the tissue. After bowel movements, clean the area around the anus gently, wiping from front to back. Never wipe twice with the same tissue. Any wiping motion that starts nearer to the rectum and then approaches the bladder-opening area moves potentially pathogenic bacteria closer to the bladder.
Take showers and avoid prolonged baths. Bath water may fairly quickly become contaminated by the bather’s own skin florae. Sitting in a tub allows bacteria to reach the bladder opening area.
Use tampons for period
Tampons are advised during the menstrual period rather than sanitary napkins or pads because they keep the bladder opening area drier than a sanitary pad, thereby limiting bacterial overgrowth.
It is extremely important to avoid long intervals between urinating. Try to empty the bladder at least every 4 hours during the day while awake. When feeling the need to empty the bladder, it is strongly advised not to “hold it” until a more convenient time or place.
It is recommended not to wear tight-fitting undergarments made of non-breathing materials. With such fabrics, moisture builds up which leads to softening of the skin and bacterial over growth adjacent to the opening of the bladder. Cotton underwear for general use is suggested.
It is recommended to drink more water. Start with 1 extra glass with each meal. If urine appears any darker than a very pale yellow, this means not enough liquid is being ingested; increase the fluid intake. Cranberry juice and pills have benefit in reducing urinary infections. They appear to be most effective amongst younger women.
When engaging in physical activity and exercise, make sure to empty the bladder frequently and drink plenty of water and other fluids. It is advised to take special precautions after sexual activity; which may also increase risk because it can introduce bacteria into the bladder area. The bladder should be emptied after intercourse. Some patients are advised by their doctors to take a urinary antiseptic or antibiotic after sexual activity. Avoid the use of spermicidal jelly that kills sperm as well as normal vaginal florae, which are important in suppressing colonization with pathogenic bacteria.
An estrogenic vaginal cream may help increase resistance to bladder infections. It may be suggested for women after menopause even if an oral oestrogen supplement or patch has already been prescribed. The cream helps keep the tissues around the bladder healthy and more resistant to infection. If a medication has been prescribed as preventive therapy, follow the physician’s instructions carefully.
The guidelines and suggestions help most women avoid bladder infections, most of the time. If an infection develops in spite of these precautions, promptly seek medical help. A urine specimen for examination should be provided. Seek prompt attention for excessive vaginal discharge or other signs of vaginal inflammation and infection. If an antibiotic has been prescribed for this purpose, begin taking it and follow the course. In some cases, the physician may request additional tests (e.g., kidney radiographs or examination of the bladder) please have these conducted immediately.
What is UTI?
When it affects the lower urinary tract, it is known as a bladder infection (cystitis) and when it affects the upper urinary tract, it is known as kidney infection (pyelonephritis). Symptoms of lower UTI include pain during urination and frequent urination. Symptoms of kidney infection include fever and flank pain, usually in addition to the symptoms of a lower UTI. In rare instances, there could be blood in urine. In the very old and the very young, symptoms may be vague or non-specific.
The most common cause of UTI is Escherichia Colibacteria, which normally live in the bowel (colon) and around the rectum, though other bacteria or fungi may be the cause in rare instances. Risk factors for UTI include female anatomy, sexual intercourse, diabetes and obesity. Although sexual intercourse is a risk factor, UTIs are not classified as sexually transmitted infections (STIs). Kidney infection, if it occurs, usually follows a bladder infection, but may also result from a blood-borne infection. Here’s how to handle the incidence of the UTI, and how to prevent in the first place.
The author is an obstetrician and gynaecologist at Fortis Hospital in Vashi