Transcription:
Urinary Tract Infections

Melanie Cole (Host): According to the National Institutes of Health, urinary tract infections are one of the most common types of infection and account for around 8 million visits to the doctor each year. They can affect the kidneys, bladder, and the tubes that run between them. My guest today is Dr. Michael Louie. He’s a specialist in urology and a member of the medical staff at Corona Regional Medical Center. Welcome to the show, Dr. Louie. What exactly is a urinary tract infection and who is most at risk for these?

Dr. Michael Louie (Guest): A urinary tract infection is when you get frequency, burning, and urgency with urination. Sometimes you can have some pain or pressure in your pelvis, or abdomen, or back, and a low-grade fever, or even some blood in the urine and that’s how you know you might have some bacteria in the urine.

Melanie: And who would be at risk? Are there certain things that might predispose somebody to having these kinds of infections?

Dr. Louie: Usually women are affected more than men, and that’s because their urethra is a little bit shorter. When you get a urinary tract infection, most women between the ages of 18 and 70 are at most risk, so it includes most women.

Melanie: As many women that I know that have gotten UTIs at some point in their life, that burning feeling, you don’t always know that’s what it is because it could be chaffing, or dryness, or anything else. What would send you to the doctor? Would it be that you see blood, or wouldn’t you always see that?

Dr. Louie: You don’t always see blood, but basically, once you get the frequency and urgency feeling and that bladder pain, you should probably go see your urologist or your primary care physician to evaluate you with a urine culture to see and diagnose whether you really have a urinary tract infection or whether you just have some chaffing as you explained.

Melanie: And how does a urologist treat a bladder or urinary tract infection?

Dr. Louie: As I mentioned before, first, we’d like to get a urinalysis and a urine culture. It helps determine if you do have blood if you have any inflammatory cells in your urine, and then also determines the type of bacteria that you have growing in the bladder. That affects how we prescribe antibiotics for you, so it’s very important to get the culture. After we get the culture, then we will usually prescribe a three-day course of antibiotics and for most women that are sufficient.

Melanie: Do antibiotics always solve the problem? Can these bacteria hide, or can it move around? Can it move into other organs or surrounding tissue?

Dr. Louie: You’re absolutely right, it can move mainly from the urethra – where you get the burning and urgency first – and then the pelvic pain. That means it might be in your bladder and in severe cases it can move into your kidneys and cause something called pyelonephritis, which is an infection in your kidney. That causes high-grade fevers and chills and requires probably IV antibiotics for treatment.

Melanie: People hear about some of these home remedies to prevent or control them? Do any of these carry any weight – cranberry juice or any of these other things they might try at home?

Dr. Louie: Some of the homeopathic remedies do have some credence, and I do recommend them often with my patients because anything to prevent a urinary tract infection is better than taking antibiotics. I usually do recommend taking four ounces of cranberry juice when you can remember to. Cranberry pills are also used for prevention. Some people may also not know about D-Mannose powder or pills. They’re used in the same way cranberry juice or pills are used, probably once a day. The way D-Mannose works is that it does not allow the E. Coli bacteria to stick to your bladder wall and increases the chance that you’ll just pee out the bacteria.

Other things that you can use are Activia yogurt or your culturing. Those are just two types of things I recommend. What those do is that they give you good bacteria called lactobacillus, which crowd out the bad bacteria so that they don’t have a chance to grow in you.

Melanie: Some women try some of these products like Summers Eve or vaginal washes, can any of these contribute to UTIs?

Dr. Louie: In fact, they can, because these astringents or hard washes really wash away that good bacteria that I was talking about and they might even cause micro tears in your skin down there that also propagate the bacteria. I do not recommend using anything but standard soap and watch to wash your genitalia.

Melanie: What is somebody is someone who has recurrent UTIs, and they just keep getting them, what do you tell them about these?

Dr. Louie: If someone has recurrent urinary tract infections, it usually means they’re having two or more infections every six months. For these women, I usually recommend first, five things to prevent these recurrent infections because that’s the best thing to do besides just giving antibiotics for this. The number one thing is to stay hydrated. Always keep your urine clear when it’s coming out of your body. The second thing I recommend is to not hold your urine. Always listen to your bladder and empty it right away when you feel the need to empty it.

Number three is that cranberry use, cranberry pills, or D-Mannose powder, something to help the bladder out so that it can block the bacteria. Number four, I recommend that lactobacillus, either yogurt or drinks to repopulate the good bacteria in your bladder. And number five, make sure you don’t have any constipation. That actually is a reservoir for the bacteria, and that’s where they come from. Having constipation can also lead to confusing symptoms of frequency and urgency as well.

Melanie: When people wipe themselves, as it were, Dr. Louie, can that also – because we hear about infections that way if you’re wiping the wrong way. And what about urinating after sex? Can that also help to clear you out?

Dr. Louie: Absolutely, so the basics for bathroom hygiene for women is to wipe front to back and that just keeps the front genitalia clean. And then your comment about urinating after sex, that has also been studied, and the evidence does show that that does prevent infection. That leads me to stating that for women who always have infections after sex, they are best treated using a single dose of antibiotics right after sex. That almost prevents all of their more severe urinary tract infections.

Melanie: And what about other things like perfumed products in the genital area -- or even diaphragms or tampons – are any of these things that women should look to as a cause or at least something that can contribute to UTIs or recurrent ones?

Dr. Louie: There has been data showing that spermicides, diaphragms, and sexual intercourse can cause increased urinary tract infections, so you just have to be careful with that. Unfortunately, you really have to, through trial and error, figure out which one works for you. In terms of tampon use versus menstrual pads, there have been some studies that show tampon use is possibly better because it doesn’t keep the whole vaginal area moist during the menstrual cycle, but that’s the data for these specific types of events.

Melanie: That’s really good information. In the last few minutes, Dr. Louie, what should people with recurrent urinary tract infections -- or someone who’s got one for the first time -- what would you like them to know about them? What do you tell people every day about these?

Dr. Louie: Go back to basics, the things that you read about and hear about every day and that is, drink enough water to keep your urine clear. Don’t hold your urine. Make sure that you practice good bathroom behavior, wiping front to back, urinate all of the time after sex, and make sure you don’t have constipation. Those are some really easy things – you don’t have to spend any money, bring in any other outside things into your life -- these will help prevent urinary tract infections.

Melanie: And why should they come to Corona Regional Medical Center for their care?

Dr. Louie: We have great doctors there and are a really good multidisciplinary approach to diagnosing your condition as well as managing it.

Melanie: Thank you, so much for being with us today, Dr. Louie. That’s great information. You’re listening to Corona Regional Radio with Corona Regional Medical Center. For more information, you can go to CoronaRegional.com, that’s CoronaRegional.com. Physicians are independent practitioners who are not employees or agents of Corona Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks, so much for listening.