Dear Doctor,

I am 43 and prone to urinary tract infections. I have tried several tablets recommended by the gynecologist but nothing seems to work? What can I do to decrease/stop getting them? Gloria

Dear Gloria,

For how long have you been having urinary tract infections? How frequent and how severe are the episodes?

Women are more prone to frequent Urinary Tract Infections (U.T.I.) due to multiple reasons. Short length of the urethra (tube connecting the urinary bladder to the exterior) makes it easy for infecting microbes to enter the bladder. Any contamination over the genitals, even as in using public toilets or poor hygiene or unclean undergarments, can easily cause U.T.I.

Infection can also be acquired during sexual intercourse. Dampness over the private parts during menstruation, creates a favorable environment for microbes to grow, thus causing U.T.I. Acidic environment of the urinary tract also becomes favorable for germs to grow, causing infection.

In some women, the uterus tends to prolapse outside the lower end due to trauma caused by multiple pregnancies and deliveries. This causes pressure and irritation on the bladder and results in frequent U.T.I. Women with diabetes or other immune depressed conditions like HIV are more prone to Urinary Tract Infection.

Frequent U.T.Is can be prevented by certain measures. Drinking enough water helps to cleanse the urinary tract via more urine formation. Good personal hygiene, particularly during menses goes a long way in preventing U.T.I. Always use clean and dry underwear.  After sexual intercourse, a lady should pass urine and cleanse her private parts. This helps in removing any contamination over the genitals. Avoid sex with somebody having a suspected sexually transmitted disease. Itching, irritation over the genitals, any discharge or sore over private parts are signs of an S.T.D.

If somebody has diabetes, it should be kept well controlled with dietary measures and medicines.

An episode of U.T.I can be diagnosed by simple microscopic examination of the urine and treated by suitable antibiotic. However it does not prevent future infections, hence one has to be careful. At times, the antibiotic used may not be effective in clearing the infection caused by a particular microbe. A culture of the urine sample (mid-stream sample of first morning sample of urine) helps to identify the specific infection causing germ and the antibiotic which would be effective.

Dr. Rachna   Pande is a specialist in internal medicine.