(UTIs/Cystitis)
Recurrent urinary tract infections are a common problem and can be very troublesome for women. Most are well aware of ways to try and minimise the frequency of urinary tract infections.
These include:
Having a good fluid intake
Avoiding constipation
Emptying your bladder after sexual intercourse
Having a healthy, balanced diet
Most women know about these measures, and many still have recurrent UTIs despite meticulous care. Going to the doctor and getting a prescription for antibiotics can be stressful, as this is often out of hours. There are other measures that can be taken to try and reduce the frequency of UTIs, thereby minimising antibiotic use.
Antibiotics in recurrent urinary tract infections
At Bay Urology, we try and minimise the use of antibiotics if at all possible, and if we have to use antibiotics, we use as short a course as possible. We give some women who have frequent recurrent UTIs a prescription for antibiotics to start taking as soon as they develop symptoms of an infection. This minimises the hassle of having to go to a doctor (often after hours) to get a prescription.
For women who have urinary infection specifically related to intercourse, a single antibiotic after intercourse can be very effective.
Other Options for Recurrent UTIs
While there may not be a lot of evidence for these, other remedies certainly can be helpful for some women.
These include:
Cranberry juice or tablets - cranberry works well for some women although the effect is variable. It is a good, simple option, and apart from the taste, has few side effects.
Hiprex- an antibacterial medication. It works more like an antiseptic than an antibiotic and can be an effective preventative. It can cause gastrointestinal side effects, but these are not common.
D–Mannose - The main bacteria that cause urinary infections is E. coli. This causes infection by sticking to the surface of the urethra, moving into the bladder, and then multiplying. D-Mannose works by attaching to the bacteria, rather than the bacteria adhering to the urethra. Again this can work very well. It has few if any side effects. This can be very effective in some men and women. It can be purchased as a tablet.
High dose Vitamin C - 1000mg a day can be effective at reducing the frequency of UTIs
Ialuril - a liquid medication that is introduced into the bladder via a urethral catheter. It is used in women with recurrent UTIs or with chronic bladder pain. It helps to restore the natural lining of the bladder. It can be very effective in women who have a chronically inflamed bladder, where the lining of the bladder is obviously affected. Usually, a series of installations is required. The medication is not funded and is expensive. It is instilled via a catheter on a weekly basis for 4-6 weeks.