Recurrent Urinary Tract Infections

What are they?

A urinary tract infection happens when bacteria enters the bladder through the urethra and causes an inflammatory reaction in the bladder. Symptoms of urinary infection include urinary frequency, urgency and burning with urination.  Most women describe needing to run to the bathroom much more often than normal, as well as discomfort when they go. Other symptoms can be lower abdominal or back pain, general malaise, fever, or chills. Some women may also see blood in their urine.

Why do they happen?

Women are more prone to urinary infections because the female urethra is very close to the vaginal and anal openings. These areas are heavily populated with bacteria, and certain bacteria have special virulence factors that allow them to ascend the urethra and cause infections. Some women are more susceptible to this because of genetic factors, or because of a lack of estrogen after menopause.  Many women experience urinary infections after intercourse, and it is very important to identify this as a risk factor in order to prevent them.

What can I do about it?

If you are getting more than 2 bladder infections in 6 months, or more than 3 infections in a year, you have recurrent urinary tract infections. Usually, women are initially treated by their primary care doctors, gynecologists, or at urgent care centers. When multiple infections occur, or there is one prolonged infection where the symptoms persist beyond the course of antibiotics, referral to a urologist is warranted. When you see Dr. Kumar, she will evaluate you for risk factors such as kidney stones, not emptying your bladder completely, or genitourinary syndrome of menopause. In addition to a physical exam, she may recommend other tests such as an ultrasound or CT scan of the kidneys and bladder. If you are a healthy and sexually active woman, she will discuss options for antibiotic prophylaxis after intercourse. Dr. Kumar will make an individualized plan to prevent you from getting future infections.

Are there any other options besides antbiotics?

An ounce of prevention is worth a pound of cure. Dr. Kumar prefers to reserve daily antibiotic suppression as a last resort. She prefers to address the underlying factors that are making you more susceptible to getting infections. She may recommend using estrogen cream, a special type of cranberry supplement, or a probiotic suppository to maximize your prevention regimen. To avoid the collateral damage caused by systemic antibiotics, she may recommend instillations of antibiotic solution which just treat the bladder.