What are the causes?
Constipation, incomplete bladder emptying, incontinence, bladder prolapse, following intercourse, or post-menopause can be involved. Often there is no underlying structural abnormality. Some women are just more prone to infections.
What tests might be required?
A mid-stream urine test to confirm a true infection, as other bladder conditions can mimic this, a cystoscopy, and an ultrasound of the bladder and kidneys.
Things to do
Drink plenty of fluids. Void after intercourse. Wipe from front to back after voiding. Treat infections early. Acidify the urine by taking oral Vitamin C or Cranberry Juice. Cranberry juice also contains some antibacterial agents but any effectiveness in preventing urine infections has not been proven. Stop these once you get an infection as they will only make the urine burn more. Hiprex is another antibacterial agent and a prescription is required for these tablets. Ural will alkalinise the urine and reduce the burning when you have an infection.
Things to avoid
Constipation, Spermicidal jellies and the Diaphragm increase the risk of infections.
Self-Start Therapy
This aims to ensure early treatment and reduce the inconvenience of urine infections. Patients are given a script of antibiotics to start themselves when symptoms of a urine infection occur. Symptoms should settle quickly within 24 -48 hours but the antibiotic course should be completed. If symptoms fail to settle then drop of a mid-stream urine test for analysis to check the bacteria are not resistant to the antibiotic you are taking. Most infections will respond to a 3 day course of antibiotics, some require longer.
Antibiotic Prophylaxis
This is where a low dose of antibiotics are taken on a regular basis to prevent infection. It may be one tablet every night or every alternate night or each time following intercourse if infections generally are triggered by this.
Vaginal Oestrogen
This can reduce the infection rate in post-menopausal women. It can be used in either a cream or pessary form and is inserted using an applicator. Use it every night for the first week and then continue with just twice a week.
Important Information:
If you have severe or persisting symptoms, are generally unwell, or have kidney pains, fevers or shakes you should seek medical help. Such severe infections generally require admission to hospital for intravenous antibiotics and further investigations.
Version: V2, July 2013
