Women’s Urologic Health: UTIs One of the Most Common Complaints

For women, maintaining urologic health comes with certain challenges, doctors say. As women age, they may become more prone to urinary problems such as recurrent urinary tract infections (UTIs), urinary incontinence, overactive bladder and pelvic organ prolapse. But the good news is that women don’t have to live with their symptoms, as most of these conditions are treatable with surgery, medication or changes to lifestyle and diet, according to a urologist with Baptist Health South Florida.

(Watch video: Dr. Lunan Ji with Baptist Health discusses common urologic problems women experience. Video by George Carvalho.)

Lunan Ji, M.D., specializes in general, reconstructive and female urology and is experienced in robotic and minimally invasive surgery. He sees patients for a variety of urological conditions, including voiding dysfunction, incontinence, prostate and urinary disorders, pelvic organ prolapse, kidney stones and erectile dysfunction.

Dr. Ji says that urinary tract infections, or UTIs, are one of the most common bacterial infections treated in the United States. Worldwide, the number of UTI cases is estimated at 150 million per year. According to the National Kidney Foundation, one in five U.S. women will have at least one UTI in their lifetime. Nearly 20 percent of these women will have another UTI and 30 percent of those will have yet another. Of this last group, 80 percent will have recurring UTIs. It has been estimated that each year, more than 13,000 deaths are associated with UTIs.

“UTIs are very common infections,” Dr. Ji says. “They occur when bacteria – usually from the skin or the rectum – enter the urethra and infect the urinary tract.” A bladder infection, or cystitis, is one of the most common type of UTIs, he says. If not treated promptly, the infection can travel up to the kidneys and cause more serious problems, such as a kidney infection, or pyelonephritis, another type of UTI. “Kidney infections are less common than bladder infections but tend to be more serious,” Dr. Ji says.

Women are more likely to develop UTIs than men because women have a shorter urethra, which makes it easier for bacteria to reach the bladder, Dr. Ji explains. “To prevent bacteria from the bowels from getting into the urinary tract, women should always wipe from front to back after going to the bathroom,” he says. “They should also cleanse the genital area every day and prior to having sex.”

Common risk factors for UTIs

Aside from gender, there are other common risk factors for UTIs, according to the U.S. Centers for Disease Control & Prevention (CDC). They include:

• A previous UTI
• Sexual activity
• Changes in the bacteria that live inside the vagina, or vaginal flora, which can be caused by menopause or the use of spermicides
• Pregnancy
• Age (older adults and young children are more likely to get UTIs)
• Structural problems in the urinary tract, such as an enlarged prostate in men
• Poor hygiene, such as with children who are potty-training

Another cause of UTIs are urinary catheters, which are used on some hospitalized patients as well as by patients at home who have certain health conditions. According to the National Healthcare Safety Network, each day the urinary catheter remains, a hospitalized patient has a 3-7 percent increased risk of acquiring a catheter-associated urinary tract infection, or CAUTI.

This, says Dr. Ji, can lead to such complications as prostatitis, epididymitis, and orchitis in males, and cystitis, pyelonephritis, gram-negative bacteremia, endocarditis, vertebral osteomyelitis, septic arthritis, endophthalmitis, and meningitis in both male and female patients.

Accurate diagnosis key to effective treatment of UTIs

UTIs usually come with obvious symptoms, according to Dr. Ji. “Some of the common symptoms of a urinary tract infection can include burning with urination; foul-smelling or cloudy urine; going to the bathroom frequently or needing to rush to the bathroom. In some cases, the patient may experience fever and chills,” he says. Symptoms of a kidney infection, meanwhile, can include fever, chills, lower back pain or pain in the side of your back, and nausea or vomiting.

Many women, as soon as they develop symptoms of a UTI, reflexively ask their doctor for antibiotics, which are effective in treating bacterial infections. However, Dr. Ji says, an accurate diagnosis is essential in treating UTIs.

“If you have symptoms, try to obtain a urine culture before starting antibiotic therapy,” he advises, noting that sometimes other illnesses, such as sexually transmitted diseases, have symptoms similar to UTIs. “Before we can determine the best course of treatment, we need to figure out if your symptoms are being caused by an infection or by something else.”

Can cranberry juice help prevent UTIs?

Many women drink cranberry juice in the hopes of preventing UTIs but research on this has produced conflicting results. Raw cranberries do contain antioxidant proanthocyanidins, or PACs, that can prevent bacteria from attaching to the walls of the urinary tract, says the National Kidney Foundation.

“There have been many studies done on this and although there’s nothing absolutely conclusive, there’s enough evidence to suggest that cranberry supplements do reduce the risk of urinary tract infections,” says Dr. Ji. “Studies done with cranberry juice have been less positive, however.”

In one study, researchers discovered that taking cranberry capsules containing 36mg of PACs daily reduced the frequency of UTIs in young people aged 12-18 years with recurrent infections. According to another study, cranberry juice on its own is unlikely to have the same effect, as most store-bought cranberry juices do not contain enough PACs to prevent bacterial adhesion.

Minimizing your risk for UTIs

Women can lower their risk of developing UTIs by following a few simple steps with their personal hygiene, according to Dr. Ji. “When being potty-trained, girls should be taught to wipe front to back,” he advises. Other steps women can take to prevent UTIs include:

• Urinate after sexual activity

• Stay well-hydrated

• Take showers instead of baths

• Minimize douching, sprays or powders in or around genitals

If you do develop a UTI, Dr. Ji recommends seeking treatment as soon as possible. “The most important thing is to know what is causing your symptoms and to treat it before it leads to more serious illness,” he says. “Recurrent UTIs are a real problem for many women, and long-term antibiotic therapy isn’t always a solution as it comes with side effects.”