Recurrent Urinary Tract Infections in Women

Many women suffer from urinary tract infections (UTIs or cystitis). UTIs are a very common diagnosis among women of all ages. Some women suffer from recurrent UTIs, where their infections occur after a previous UTI has been treated and resolved.

UTIs are infections in any area of the urinary system including the urethra, bladder, ureters and kidneys. Many factors and behaviors contribute to UTIs. Infections are commonly caused by a well-known bacteria called E. coli that colonize the bladder and other areas of the urinary tract. Loss of resistance to bacteria and incomplete emptying of the bladder compromise the bladder’s natural mechanisms to keep the area sterile and keep women infection-free. Women with relatively short urethras or structurally abnormal urinary tracts are more exposed to contamination and therefore more prone to uncontrolled bacterial growth and infection. Being genetically predisposed to UTIs or having a weakened immune system are thought to establish a difference between women who simply have occasional UTI episodes and women who live through several infections for years on end. Other factors such as stress and menopausal changes can also increase chances of a UTI.

Some women are asymptomatic but most women report a combination of the following symptoms: frequency of urination, painful urination or dysuria, voiding in small amounts, and cloudy, bloody, or foul-smelling urine. In addition, if the patient is experiencing fever, abdominal, pelvic or lower back pain and vomiting, or if the patient has just treated a UTI, it is important for health care professionals to see if the patient has an infection in the kidneys. Recurrent UTIs need to be closely monitored and rapidly treated because they can often progress to the kidneys and ureters and cause a kidney infection also known as pyelonephritis. In that instance, the body tries to respond to the infection and inflammation, and abscesses can develop in the kidneys as well.

Important factors that may lead to contamination of the urinary tract are procedures such as cystoscopies and catheter insertions and activities such as sexual intercourse. In fact, many women report an increase in UTIs during their honeymoon after they have engaged in sexual activity for the first time or after a long period of abstinence. They are diagnosed with “honeymoon cystitis” which is an infection of the bladder caused by sexual activity. Bacteria, as previously mentioned, that are often found in the pelvic and gastrointestinal area find their way to the urinary tract and can cause infections.

Furthermore, individuals suffering from other conditions such as Type 2 diabetes have a higher risk of developing a UTI than individuals without diabetes. It is thought that diabetic individuals have a more difficult time managing a UTI because of poor blood circulation and high glucose levels in the blood. In that instance, white blood cells are not able to fight infections properly, and bacteria grows uncontrollably and individuals take more time to recover.

Diagnosis of a UTI involves a urinalysis, a test that studies the content of urine. The urinalysis can reveal the presence of nitrates and red and white blood cells which are consistent with UTIs. A urine culture that tests for bacterial growth should be done to confirm the diagnosis and continue with the treatment process.

UTIs are mostly treated through antibiotic therapy such as Macrobid, Bactrim, or Ciprofloxacin for three to seven days depending on the severity of the infection. Many health professionals advise to drink more fluid, maintain good hygiene, and urinate after intercourse to remove bacteria and lower the risk of contracting an infection. Health professionals today are also seeking more ways to treat UTIs as bacteria are becoming more and more resistant to prescribed antibiotics. Most providers increase medication dose or prescribe IV instead of oral antibiotic pills to treat patients if they have recurrent or resistant infections.

In either case, if you or someone you know has experienced these symptoms, take the time to speak with your doctor and discuss ways to improve your condition and your overall health.

Stephanie BAGUIDY Pre-Medical Student contributed to this article

Dr. Angelo Gousse is a Urologist with offices in Aventura and Miramar serving all South Florida (Miami, Fort Lauderdale, West Palm Beach, Kendall, South Miami, Sunny Isles, Brickell, Boca Raton) and international clients. Dr. Gousse has been selected as an honored member of Trademark Top Doctors of America Honors Edition 2018.