Bladder Infections

Have you had a bladder infection this year?  If so, you’re not alone:  each year, nearly one in ten women experience the classic urinary burning and frequency that signal a urinary tract (or bladder) infection (UTI).  This is also called acute cystitis.  More than half of all women have at least one UTI in their lifetime.  In the United States, UTI’s are account for 3.6 million doctors office visits by women 18 to 75 years old, accounting for direct costs of $1.6 billion.

While UTI’s in girls are relatively common due to poor toilet hygiene practices, the most important risk factors for UTI’s in young women are a history of previous episodes of UTI’s and frequent or recent sexual activity.  Celibate women rarely have cystitis unless they have another risk factor (e.g. diabetes).  While the use of spermicidal agents is very important to prevent unintended pregnancies and transmission of sexually transmitted diseases, it may increase the chances of a UTI by two to three times.  Women with frequent recurrences are more likely to have a maternal history of cystitis and to have had cystitis at an early age. 

The risk of UTI’s also increases in elderly women living in institutional settings or who have conditions associated with impaired urinating or poor toilet hygiene.  Estrogen deficiency may also contribute to UTI risk. Among generally healthy postmenopausal women, sexual activity is a less important predictor of cystitis than it is in younger women.  Recurrent  UTI’s in this age group are more likely in women who have cystoceles (bladder prolapse) or urinary incontinence or in those who have previously had genitourinary surgery.

Most acute UTI’s are uncomplicated and easily treated with a short course of oral antibiotics.  However, occasionally, they can spread upwards towards the kidneys and cause an infection called pyelonephritis.  Signs of these complicated infections include fever, chills, or lower back pain.  Women at greater risk for pyelonephritis include those with diabetes, pregnancy, immunosuppression, previous pyelonephritis, UTI symptoms persisting for more than 14 days, or those who have structural abnormalities of the urinary tract.  Although UTI’s are fairly easy to treat,most women have sporadic recurrences.  Up to one half of women with a UTI may have another UTI within one year. 

Antibiotic resistance has also become a significant problem with treating UTI’s as well as other infections.  Women whose symptoms are not resolved in 2-3 days should discuss this possibility with their physicians.   While there is a medicine available over-the-counter without a prescription to treat urinary pain or discomfort (UriStat), this medicine does not treat the actual infection and taking it should not be considered a substitute for seeking medical attention.

Created: 9/5/2003  -  Donnica Moore, M.D.