Urinary Tract Infections

Urinary Tract Infections Care at Southland Urology

Recurrent urinary tract infections (UTIs) are a common and often frustrating condition, defined as having two or more UTIs within six months or three or more within a year. These infections, while typically treated with antibiotics, can significantly impact a person’s quality of life due to frequent pain, urgency, and discomfort. For some individuals, understanding and addressing the underlying causes is key to long-term prevention and management.

Understanding Urinary Tract Infections

Understanding Recurrent UTIs

A urinary tract infection (UTI) is an infection in any part of the urinary system—kidneys, ureters, bladder, or urethra. Recurrent UTIs are a frustrating and common issue for many people, especially women, though men can also be affected. The condition is often a source of significant discomfort, including pain or burning during urination, frequent and urgent urination, and pelvic pain. Unlike a one-time infection, a recurring problem suggests an underlying factor that makes a person more susceptible to these infections.

Causes and Risk Factors

The most common cause of UTIs is bacteria, primarily E. coli, which typically enters the urinary tract through the urethra. For women, the female anatomy makes them more prone to UTIs, as the urethra is shorter and closer to the anus. Other risk factors for women include sexual activity, menopause (due to changes in vaginal flora), and the use of certain types of birth control. In men, recurrent UTIs can be a sign of an underlying issue, such as an enlarged prostate (BPH), kidney stones, or a structural abnormality in the urinary tract. Other risk factors for both sexes include a compromised immune system, diabetes, and certain medical conditions that prevent the bladder from fully emptying.

Diagnosis

Diagnosing a UTI typically involves a urinalysis, which checks a urine sample for white blood cells, red blood cells, and bacteria. A urine culture is then performed to identify the specific type of bacteria causing the infection and to determine which antibiotics will be most effective. For recurrent UTIs, a doctor may order additional tests to uncover the root cause. This may include a renal and bladder ultrasound, a CT scan, or a cystoscopy, a procedure that uses a thin, lighted tube to examine the inside of the bladder and urethra for any structural issues.

Non-Surgical Treatment and Prevention

The primary treatment for an active UTI is a course of antibiotics. For recurrent infections, a doctor may prescribe a low-dose, long-term antibiotic regimen for several months to prevent future infections. Behavioral changes are also crucial for prevention. These include drinking plenty of water, urinating after sexual intercourse, and for women, wiping from front to back. In some cases, preventative measures such as vaginal estrogen therapy for post-menopausal women or D-Mannose supplements can be recommended to help maintain urinary tract health.

Surgical and Minimally Invasive Options

Surgical intervention for recurrent UTIs is typically reserved for cases where an anatomical or structural issue is the confirmed cause. For men, a transurethral resection of the prostate (TURP) may be performed to relieve a prostate obstruction causing poor bladder emptying and recurrent infections. For both men and women, surgery may be necessary to remove kidney or bladder stones that can harbor bacteria and lead to infections. In rare cases where a vesicovaginal or vesicointestinal fistula (abnormal connection between the bladder and another organ) is the cause, surgical repair is required.