More than 50% of women will have at least one urinary tract infection during their life time. Many will have recurrent episodes of UTI. It is heralded by burning while passing urine and can lead to lower abdominal pain, vomiting, fever, tiredness, back pain and rarely kidney dysfunction. It is very common in sexually active women. Proper understanding of its cause and knowledge about preventive measures are required for every woman. Normal urine does not contain any bacteria. However, vagina contains good bacteria like lactobacilli. Before a UTI, harmful bacteria grows near the vicinity of urethra and in vagina. Once they enter the bladder and stick to its walls, it can cause inflammation of bladder wall (cystitis). If still not treated, they can ascend along urinary tubes (ureter) to enter kidney and cause pyelonephritis or kidney abscess, which are life threatening conditions. The following simple and proven measures will keep UTI at bay and make your life healthier and peaceful. Please do follow and share among your loved ones.
1.  Drink a lot of water Drinking plenty of water can help to flush out the bacteria which do enter the bladder once in a while. Always watch your urine color. If it is getting dark yellow, it means that you are dehydrated and you need to increase your fluid intake.
2.  Don’t hold urine for a long time           If you hold urine for a long time, bacteria can multiply and cause an infection. Passing urine frequently, flushes the bacteria out and prevent UTI. Pass urine at least once in 4 hours. If you are getting recurrent UTI pass every 2 to 3 hours.
3.  Pass urine after sex           During intercourse, bacteria do enter into the urinary bladder. It gets flushed out while passing urine. Clean your genital region before having sex. More importantly, always make it a habit to pass urine after sex. If you still get UTI after sex, your Urologist may advise you on antibiotic prophylaxis to be taken after every intercourse.
4. Proper toilet hygiene           Always wipe from front to back. Bacteria are naturally abundant near anal region. If these bacteria enter the genital region, they can multiply and enter into the bladder, causing UTI. So, never wipe from back to front. Use two toilet papers, once for cleaning urine first and other for rest of the cleaning. If you are using water also, always keep the flow of water from front to back. Remember to remove tampon while passing urine. It can impede the flow of urine.
5. Avoid artificial feminine products           Douche can washout the health vaginal bacteria and natural protective substances from vaginal lining and make way for harmful bacteria to enter. Avoid douches. Also avoid other scented feminine hygiene sprays and bath products. These can irritate urethra and cause urethritis.
6. Choose your birth control method wisely Use of diaphragms and unlubricated or spermicide containing condoms, can lead to bacterial overgrowth. Spermicides alter the natural vaginal pH. Try other safer methods of birth control if you are getting recurrent UTIs.  
7. Avoid regular use of bathtubs           It is preferable to take a shower than use a bathtub if you are getting recurrent UTI. In a bathtub, water will contain bacteria from all over the body along with chemical. These can easily enter vagina and urethral region. 8. Take natural remedies           Cranberries contain proanthocyanidins which prevent bacteria from sticking onto bladder wall. Though it cannot treat an active UTI by itself, it can supplement the treatment and help in prevention of future UTI.           D-mannose is another natural remedy which helps to reduce UTI. Apples, oranges and peaches are naturally rich in this sugar.           Take curd or yogurt, which are rich in lactobacilli, regularly. These ‘good’ bacteria will then colonize the vagina and prevent the growth of ‘bad’ bacteria.
9. Take Vitamin C supplement           The acidity of urine is nature’s way of preventing bacterial growth. Bacterial infection makes the urine alkaline. Moderate vitamin C supplementation of about 500 to 1000 mg per day can further acidify urine and reduce bacterial growth.
10. Role of estrogen cream           Estrogen is required for a healthy vaginal lining. Low estrogen in postmenopausal women leads to dry and unhealthy vaginal mucosa which then leads to growth of harmful bacteria. Use of vaginal estrogen creams in patients without a history of breast cancer or uterine cancer can help to restore healthy vaginal lining and helpful vaginal bacterial flora and thus prevent UTIs.
11. Choose appropriate underwear           Poor aeration and moisture promote bacterial overgrowth. Choose cotton inner wears and loose fitting clothes. Avoid tight jeans and nylon underwear. These will trap moisture and help bacterial growth. After a workout or swimming session, change wet clothes quickly and keep the local parts dry and clean.

12. Prevent bladder prolapse
          Regular Kegel’s exercise (training for pelvic floor muscles) can prevent a prolapse of bladder and uterus which can then obstruct urinary flow and cause UTI.           
       In spite of all these measures, if you are still getting recurrent UTIs, consult your Urologist for a detailed evaluation and appropriate management. 

Doctor Dr. Raguram Ganesamoni, 2018073117:38:43

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