Prevention of Urinary Tract Infections (UTIs)

 

Urinary tract infections (UTIs) are some of the most common infections. Although anyone can get a UTI, women are more susceptible because they have shorter urethras, which makes it easier for bacteria to ascend into the bladder. At least 60% of women experience a lower urinary tract infection (involving the urethra and bladder) during their lifetime. Occasionally, lower UTIs spread to the upper urinary tract (involving the ureters and kidneys). Upper UTIs are more difficult to treat, and have the potential to turn into sepsis (infection of the bloodstream). To prevent the spread of the infection, medical professionals recommend antibiotic treatment for lower UTIs before they have a chance to progress.

Urinary Tract Infection During Pregnancy

The Importance of UTI Prevention

Preventative measures for UTIs are especially important during pregnancy. Even asymptomatic UTIs can be extremely dangerous to unborn babies, potentially resulting in premature birth and permanent conditions such as cerebral palsy (CP) or even death. Medical professionals should recommend preventative measures, as well as screen pregnant patients for UTIs and provide prompt treatment if one is detected.

Risk Factors for UTIs

There are many factors that increase the risk for recurrent UTIs, including:

  • Age (children and the elderly are more susceptible)
  • Young women who are sexually active
  • Use of urinary catheters 

Also, people with:

  • Spinal cord injuries
  • Neuropathic bladders (bladder dysfunction caused by neurological damage)
  • Multiple sclerosis
  • Certain types of cancer
  • Diabetes mellitus
  • Kidney problems

Preventing UTIs with Medication

Some people with recurrent UTIs take medications in order to prevent them. Depending on individual circumstances, doctors may recommend the following:

  • A single dose of antibiotics taken after sexual activity
  • A low dose of antibiotics or antiseptic taken every day
  • Self-started antibiotics (patients with recurrent UTIs may be prescribed antibiotics that they can take at the onset of symptoms)
  • Vaginal estrogen therapy (9, 10, 11)

Medications to prevent UTIs are usually prescribed after other preventative measures do not work. Although medication may involve more side effects than other strategies, for some patients, it may be necessary in order to prevent recurrent UTIs.

Preventing UTIs Through Dietary Methods

Drinking Water to Prevent UTIs

Drinking water is one of the simplest, cheapest ways to prevent UTIs. Drinking a lot of water will result in more frequent urination, which helps flush bad bacteria out of the urinary tract. One study of premenopausal women revealed that drinking more water decreases the chance of having a UTI by 48%. Being well-hydrated has numerous other health benefits in addition to UTI prevention, and lacks side effects.

Other Dietary Methods

People may better resist bacterial growth leading to UTIs if their urine has a high pH, and if they have higher levels of important metabolites formed in the gut. Diet can influence both of these. Calcium supplements and alkalizing agents can be used to raise urine pH, and foods that are high in antioxidants (examples include berries, tea, and dark chocolate) can help with metabolite production.

Preventing UTIs Through Hygiene Practices

Although people who practice good hygiene may still struggle with recurrent UTIs, there are certain hygiene-related precautions that can lower the risk. These precautions include:

  • Wiping from front to back after using the bathroom
  • Avoiding wiping twice with the same toilet paper/tissue
  • Showering instead of taking baths – sitting in a tub, especially for a prolonged period of time, can allow bacteria to migrate into the bladder
  • Washing from front to back in the shower
  • People with severe, recurrent UTIs may consider sterilizing washcloths. 
  • Using tampons instead of sanitary napkins/pads. Tampons keep the bladder opening dryer, which prevents bacterial overgrowth. However, it is important to note that tampons pose the risk of toxic shock syndrome (TSS), and must be used as instructed.  
  • Urinating frequently. This will help flush bad bacteria out of the body before it has a chance to multiply.
  • Avoiding irritation of the genital area with allergens such as feminine deodorant sprays, bubble bath, vaginal creams, soaps, etc. These could change bacterial makeup and increase the risk of a UTI.
  • Wearing loose-fitting underwear made of breathable material (cotton is often recommended). This will help prevent moisture from accumulating and leading to bacterial overgrowth.

Preventing UTIs after Sexual Activities

Sexual activity is a major cause of UTIs. These precautions can help to reduce the risk:

  • Gently cleaning the genital area before and after sex (avoiding irritating “cleaning” substances)
  • Urinating after intercourse. It may also be a good idea to drink two extra glasses of water.
  • Avoiding spermicidal jelly. In addition to killing sperm, this kills healthy vaginal bacteria, which can make it easier for infectious bacteria to multiply. Diaphragms and vaginal douching can also increase the risk of developing a UTI.
  • Taking a urinary antiseptic or antibiotic after sexual activity, as recommended by a physician.

 

Sources

  1. CDC – Urinary Tract Infection
  2. Healthline – Everything You Need to Know About Urinary Tract Infection
  3. Sultan Qaboos Univ Med J – Recurrent Urinary Tract Infections Management in Women
  4. American Family Physician – Asymptomatic Bacteriuria in Adults
  5. Urological Science – Prevention and treatment of complicated urinary tract infection
  6. Medscape – Prevention of Urinary Tract Infection (UTI) in Women
  7. Mayo Clinic – Urinary Tract Infection (UTI)
  8. American Family Physician – Recurrent Urinary Tract Infections in Women: Diagnosis and Management
  9. Healthline – Water Can Reduce UTI Risk… If You Drink 6 Glasses a Day
  10. UpToDateRecurrent urinary tract infection in women
  11. Emedicinehealth – Toxic Shock Syndrome
  12. Am J Public Health – Epidemiology of urinary tract infection: I. Diaphragm use and sexual intercourse.
  13. NEJMA Prospective Study of Risk Factors for Symptomatic Urinary Tract Infection in Young Women
  14. J Gen Intern Med – Sexual Intercourse and Risk of Symptomatic Urinary Tract Infection in Post-Menopausal Women
  15. Clinical Infectious Diseases – Recurrent Urinary Tract Infections Among Women: Comparative Effectiveness of 5 Prevention and Management Strategies Using a Markov Chain Monte Carlo Model

 

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