Did you just step out of the bathroom with the urge to urinate again? You are probably thinking you just had too much water to drink, right? But could it be yet another urinary tract infection?
The prevalence of this painful condition continues to leave women frustrated by limited management options.
This, according to a new study led by urologist Dr Victoria Scott.
To give a voice to sufferers of recurring urinary tract infections, American researchers from the Cedars-Sinai Medical Centre led a study of 29 women who experienced recurrent UTIs to learn about the gaps in their care.
The study was published in the Journal of Urology last month.
Scott, a urologist at the female pelvic medicine and reconstructive surgery clinic at Cedars-Sinai, said women had also grown increasingly critical of health practitioners for failing to understand their experience while over-prescribing antibiotics as a treatment.
“We were inspired to conduct the study due to the large number of women coming to us feeling hopeless and helpless when it came to the management of their UTIs.”
UTIs are infections of any part of the urinary tract including the kidneys, ureters, bladder or the urethra. This term is commonly used to describe a bladder infection.
Antibiotics the enemy?
Prescribed antibiotics and fears over the potential long-term effects of medications were among the biggest concerns raised by participants.
Participants voice their frustration and resentment towards medical care providers for “throwing antibiotics” at them without presenting alternative options for treatment and not understanding the experience.
“Many of the participants were aware of the risks of bacteria developing resistance to antibiotics.”
“They also were aware of the ‘collateral damage’ of antibiotics and disruption they can have on the normal balance of good and bad bacteria throughout the body.”
Treatment and prevention
Although studies show that antibiotics are often the most effective treatment option for urinary tract infections, research also shows that up to 40% of bladder infections can be cleared with non-prescription steps that can include increased water intake and pain relief medications such as ibuprofen.
Among the steps to prevent and avoid urinary tract infection in women are drinking water, taking cranberry supplements or a low-dose antibiotic after sexual intercourse, and using vaginal oestrogen for those who are postmenopausal.
While over-the-counter treatments are preferred by many, Scott recommends seeing a doctor if a fever develops or symptoms persist beyond a day, as antibiotic therapy can be crucial for some infections to ensure they don’t spread from the bladder to the kidneys.
“Antibiotics are amazing drugs and in certain settings are lifesaving,” Scott said.
“There are absolutely some instances in which antibiotics are necessary, but it’s also important for women to be educated regarding all their options.”
Those who experience recurrent urinary tract infections should seek evaluation by a specialist. Some women will benefit from undergoing a kidney ultrasound or a cystoscopy, which uses a small camera that can be inserted into the urethra to give a view of the urethra and bladder to rule out anatomic abnormalities.
Scott notes that while less common, men also can experience urinary tract infections.
‘It takes one episode’
Some healthcare practitioners might not think that a single incidence of a urinary tract infection could have a significant impact on a patient’s life, said Scott. But when UTIs do recur without warning they can have a negative impact on the social life, work, families and relationships of women.
The study further recommended that physicians modify management strategies to address women’s concerns and to devote more research to improving non-antibiotic options for prevention and treatment of recurrent urinary tract infections, as well as management strategies that better empower patients.
“Unfortunately, we see many women who blame themselves for developing UTIs. It’s important to understand that UTIs are a very common problem and should not invoke shame” Scott said.
“If you are experiencing recurrent UTIs I encourage you to connect with a doctor who specialises in female pelvic medicine and reconstructive surgery to work together to come up with individualised prevention and management strategies.”
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