Urinary Tract Infection (UTI)

Although UTIs can be easily treated with antibiotics, the prevention of UTIs or the avoidance of further infection is more important.

About 25% of women with acute cystitis develop recurrent UTIs. Most recurrent infections are from bacteria present in the faecal or periurethral reservoirs. Some strategies can be undertaken to reduce the risk of recurrent infections.

1. Lifestyle changes
   • Sexually active women should attempt to void immediately after intercourse to reduce the risk of coitus-related introduction of bacteria into the bladder.
   • As the source of the bacteria comes from one's own bowel, it is important to wipe yourself from front to back in order to avoid faecal contamination of the urinary tract (especially during an episode of diarrhoea) after going to the toilet.
   • Daily consumption of cranberry juice or cranberry tablets.
   • Avoid use of diaphragms and spermicide by considering other forms of contraception.
   • Potential irritating vaginal deodorants and bubble baths should be avoided and a high standard of personal hygiene should be maintained at all times. This involves washing the genital area with water during baths and especially after intercourse.
   • Drink plenty of water. In order to prevent recurrent UTI, a minimum fluid intake of two litres a day is recommended (more if exercising strenuously or on hot days). Oral fluids should be increased to three litres or more a day if symptoms of UTI are suspected, irrespective of the degree of frequency of urine. Regular and complete bladder emptying is advisable to prevent the accumulation of infected urine in the bladder.
2. Prophylactic antibiotics
   • A once-daily dose of an appropriate antibiotic may be indicated in patients with a history of multiple episodes of UTI to minimise the risk of recurrence of infection.
3. Treatment of any existing structural abnormalities
   • If recurrent UTI occurs against a background of structural abnormalities in the urinary tract (e.g., stones, kidney cysts), consideration should be given to the treatment of these conditions to eradicate the source.
4. Treatment of any vaginal / lower genital tract infection
   • These infections may spread to the urinary tract. As such, they should be treated promptly if present.