By Natasha Ginzburg, MD
Urinary tract infections can be a painful and sometimes serious problem for many women. For some women, infections seem to come on at regular intervals. While many women may have only a handful of bladder infections in their lifetime, others seem to suffer from them almost constantly.
What is a urinary tract infection?
These infections of the bladder or urinary tract are sometimes called “UTIs” or “bladder infections.” The symptoms of typical UTI include burning and pain during urination, feeling the urge to urinate much more frequently throughout the day, and having significant urgency to urinate. Some people may also experience low back or lower abdominal pain.
What causes urinary tract infections?
The vast majority of UTIs are caused by bacteria that ascend (go up) the urinary tract from the urethra. These bacteria are found normally in the area between the rectum and vagina, but sometimes are able to work their way into the bladder. Most typical UTIs (about 80 to 90 percent) are caused by the bacteria E.coli.
What do you do if you get frequent UTIs?
Some patients will have recurrent urinary tract infections — those with more than two or three infections in a six-month period. There can be many reasons for someone to have frequent UTIs. A very important first step is to ensure that all the infections are properly diagnosed. A urine “dip” in the office is not sufficient to diagnose a urinary tract infection — the only true test to confirm infection is a urine culture.
It is critical to obtain urinary cultures for patients who have symptoms of frequent UTIs. There are other diseases that can masquerade as urinary tract infections. In those patients, treating the UTI over and over again will never solve the problem, because something else entirely is causing the symptoms. Additionally, knowing which type of bacteria is responsible for the infection can help to tailor the most appropriate treatment. Some patients will need specialized testing to determine if there is an specific reason that is putting them at risk for the infections.
For patients with UTIs that are proven by repeated abnormal urine cultures and normal urologic testing, there are a number of methods to prevent recurrences. For many post-menopausal women, estrogen cream can significantly decrease the risk of infections. Preventive treatments with cranberry tablets, vaginal probiotics, vitamin C, methanamine and D-mannose have also been explored. If you suffer from frequent UTIs, it is important to talk with your primary care physician or urologist. She or he can ensure that all avenues to minimize your risk of recurrence are addressed.