Ongoing Confusion About UTIs


(Science Times)

More than half of American women will develop a UTI in their lifetime. (As opposed to about 14 percent of men.) Kalpana Gupta, a professor at Boston University’s Chobanian & Avedisian School of Medicine who studies patients with urinary tract infections (UTIs), says that although these infections are common, It is almost always a frustrating and humiliating experience. These patients “felt some personal responsibility,” he said. “Like they did something wrong.”

In most cases, he says, urinary tract infections (called bacterial cystitis) aren’t very related to any individual behavior. The main reason UTIs are more common in women is that they have shorter urethras than men, which makes it easier for bacteria to reach the urethra; for men, Gupta notes, UTIs are almost always part of a larger health problem.

The vast majority of UTI cases are caused by E. coli, a bacterium that lives in the gut and sometimes in the perineum. “We don’t yet understand 100 percent” how and under what circumstances the bacteria migrate to and infect the urinary tract, the researchers said.

Ja-Hong Kim, a urologist at UCLA Health, says many misconceptions about UTIs stem from the paucity of high-quality research on the topic. These are some of the most common questions patients ask specialists.

Is it possible to have a UTI without the burning sensation?

this is possible. UTIs can occur anywhere throughout the urinary tract, including the urethra, bladder, kidneys, and, in men, the prostate, Kim explained. For a problem to be considered a UTI, the patient must have certain symptoms and confirm the presence of bacteria in their urine.

Many of the well-known symptoms, such as burning sensation and constant toilet trips, “are known from studies of young, otherwise healthy, college-aged women,” Gupta said. But in reality, symptoms can vary.

In older adults, a UTI may be accompanied by a fever or a feeling of fullness, he explained. Some patients had low back pain, suggesting that the UTI could be in the kidneys, which would make it a more serious case that could lead to sepsis and kidney damage, although those findings are “very, very rare,” King said.

Is it because I’ve had sex?

unnecessary. Benjamin Bricker, chief of urogynecology at NYU Langone Medical Center, says women are almost always advised to urinate before and after intercourse to flush out any germs, but the practice isn’t supported by any evidence. “I don’t have any studies that show that urinating before or after sex reduces infection risk,” he says.

Interestingly, however, this may work for some women, she added.

The most common hypothesis about the relationship between sex and UTIs is that during penetrative sex, bacteria from the skin of the perineum are pushed into the urethra, which can lead to UTIs, Gupta said. Another reason is that certain products, such as spermicides, alter the vaginal microbiota and can create an environment where bacteria proliferate and migrate to the urethra. But some women don’t get UTIs when they’re sexually active, even if they don’t urinate before or after.

Is it a health issue?

Doctors often tell women that good hygiene, such as cleaning from front to back, not wearing wet bathing suits for long periods of time, and avoiding tight underwear can reduce the risk of AND YOU. The rationale is that cleaning from front to back reduces the chances of bacteria in the stool being pushed into the urethra, as well as irritating the vaginal area from wet bathing suits or tight underwear.

These practices do not cause harm, Gupta mentioned, but they also have no scientific evidence, adding that giving such advice in the context of UTIs could end up giving women an obsession with cleanliness.

“The bottom line is that the risk of contracting a UTI is not related to how much we bathe,” swimsuits or our choice of clothing, he said.

Are antibiotics my only option?

Not always. “Imagine when you’re hiking and you scratch yourself on a tree and the scratch turns a little red. Since your body can fight off these bacteria, you don’t need to take antibiotics,” says Brooke. “Urinary tract infections are caused by bacteria like any other,” many healthy young patients find that the body is eventually able to expel the bacteria on its own. He explained that although antibiotics are part of the usual treatment regimen, it is worth doing the culture first, which will take some time, to determine the best course of treatment.

In mild cases, good hydration can help the body clear the infection, says Brooke. There are some over-the-counter pain relievers, such as Tylenol, ibuprofen, and AZO, that can help reduce discomfort while your body is working.

Some research published in April suggests that there may be some truth to the long-held notion that blueberries protect against UTIs. In a meta-analysis of 50 randomized controlled trials, cranberry products (juice, tablets or capsules) reduced the risk of reinfection in women with recurrent infections, children with urinary tract Other groups had no effect, such as older men or pregnant women.

For menopausal women, declining hormone levels can alter the vaginal environment and increase the risk of UTIs. In this case, vaginal estrogen could be an “excellent way” to prevent infection, Brook said.

More than half of American women will develop a UTI in their lifetime. (Michelle Mildenberg/The New York Times)

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