The struggle and pain are real. Any woman or man who has suffered from a urinary tract infection knows it’s true. UTIs are annoying, painful, and they disrupt the flow of an individual’s everyday activities. In their worst stages, having reached the kidneys, they may even become debilitating. Having experienced one is enough. No one wants to go through that condition again. However, many will, especially women.
What is a recurrent UTI and what are the risks of getting them?
The luckiest individuals will never suffer from a urinary tract infection. Those that have had one consider themselves lucky to be among the ones who only get one. Yet, there are a large number of individuals who get them several times; sometimes more than one in a month. An individual is considered to be having recurrent urinary tract infections if they suffer from two or more in six months that are documented by cultures.
An individual is at risk due to the following:
- Bad hygiene
- Sexually active
- Immune system compromise
- Former UTI
Recurrent UTIs are either due to a new bacterium entering the urethra or bacteria that was never eradicated from the urinary tract by the treatment an individual was given.
Most often, the infection comes from what is left behind after treatment. If an individual stops taking their medication because they “feel well” then the antibiotics are unable to finish their jobs. Some bacteria will remain, and a UTI will recur.
It is also a possibility that bacteria can lay dormant, or “hide”, from the antibiotics or even the urine test. Bacteria can group into clusters which form a shield, called biofilm, around themselves that makes them invisible in urinalysis and protected from antibiotics. Once the individual’s immune system is weakened by the antibiotics, these hidden fighters will emerge and run rampant. Since only free-floating bacteria can be found during testing, the individual may not even be diagnosed with a urinary tract infection in the first place.
Understanding the risks: Who is more likely to have recurrent UTIs?
As we age, our immune systems weaken. Infections of any type are more common, and often more detrimental to our health. Elderly people, mostly women due to hormone changes or giving birth, have weakened muscles surrounding their bladder. This condition may cause incontinence, inability to empty the bladder completely, and less flow of urine. All of these allow bacteria to cling to the bladder and grow. Menopause is also an issue for older females. Estrogen is reduced, and it is no longer a protection for the vagina. Many older individuals need catheters; during or after surgery, or daily in order to release urine at all. Catheters irritate the urethra and bladder, and they may carry bacteria.
Diabetes can cause an individual to have nerve damage that can cause bladder dysfunction, or compromised blood flow to the urinary tract. Some of the medications that are taken for diabetes have specific side effects; namely UTIs. These medications are meant to filter the sugar intake through the blood and release the access into the urine. Bacteria feeds on this sugar and uses it to grow. If the sugar infused urine dries outside the urethra it then becomes a gateway for bacteria to reach the urinary tract.
During pregnancy the uterus gets larger and may put pressure on the bladder. This can cause an obstruction, or even a blockage. Urine is then unable to flow properly, and the bladder never empties completely. As the urine sits in the bladder, bacteria clings to the walls where it grows and spreads.
Due to genetics, it is possible to be born with cells that may attract bacteria. This gives the bacteria that causes urinary tract infections; namely E. coli; an easy way to spread through the system.
A woman’s anatomy makes her more susceptible to UTIs. A female’s urethra is much shorter than a males, giving a shorter road to travel to the bladder. Worse yet, some women’s urethras are shorter than others. Add to that the fact that some women have wider urethras, and weaker muscles in that area, allowing for less flow of urine and a wider highway for bacteria. Lastly, a woman’s urethra is very close to her anus, where E. coli is commonly located in abundance.
Sexual activity allows the spread of bacteria. A woman and her partner should wash before sexual encounters as well as after. Urination immediately after sex can wash away bacteria before it becomes a problem. Always wash before switching from anal to vaginal sex.
Good hygiene is a must. Shower often, instead of bathing. Wear clean, cotton underwear. Wipe from front to back. Do not hold in urine and allow bacteria to grow.
If patients have a compromised immune system (HIV, multiple sclerosis, diabetes, chronic illness) they should speak with their doctor about preventative treatments.