$Unique_ID{BRK01382}
$Pretitle{Infections or Parasites, Genitourinary System}
$Title{Urinary Infection Among Women}
$Subject{bladder infection cystitis}
$Volume{A-16, J-16}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


Urinary Infection Among Women


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QUESTION:  From all the discussions at the office, I believe that urinary
infection has to be pretty common among women.  Is it possible for you to
include a discussion of this condition in your most informative column?

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ANSWER:  Cystitis, or inflammation of the urinary bladder, is a very common
condition with one out of every five women experiencing an attack of it during
her lifetime.  It is caused by urinary tract infections or sexually
transmitted disease and is marked by burning in the bladder, pain in the
urethra, and difficult or painful urination.  Because of its high occurrence,
new diagnostic procedures are constantly evolving and recommended treatments
often vary.
     In any case, however, clinical history and physical examination are
particularly important in diagnosing cystitis.  Pelvic examination is
necessary to ruling out the possibility of other diseases, such as vaginitis,
may be the cause of the symptoms.  It is most important to determine if a
woman has a history of recurrent urinary tract infections or if she is at high
risk for sexually transmitted diseases because these factors will influence
our choice of treatment.
     To gain an accurate diagnosis for cystitis, a urine sample, taken from a
midstream specimen, is examined for bacteria and to detect red and white blood
cells.  Bacterial cultures are useful to determine the organism causing the
lower tract infection, and guide in the choice of the most effective
antibiotic treatment.  Escherichia coli is the most common bacteria identified
as the culprit.  However, if a sexual disease is suspected, chlamydia and
gonorrhea should be tested for and treated accordingly.
     In an uncomplicated first-time case, where no sexual disease is
suspected, cystitis treatment is fairly simple.  Single-dose or short course
antimicrobial therapy usually cures the infection.  If this therapy fails,
however, a longer course of treatment is recommended.  A three to five-day
regime should be successful, but if symptoms persist, the patient may need to
continue taking the drug for 10 to 14 days, or even longer in some cases.
     Even after extended treatment, some patients experience recurrent bouts
of the infection.  This can be due to a number of things, such as persistent
infection with the original organism, reinfection with the same or different
organism, poor antibiotic absorption, or resistance to the prescribed drug.
     For high-risk patients, there are a number of precautions and daily
practices that may help prevent infection.  Drinking plenty of liquids and
urinating frequently improve bladder washout.  Using prophylactics, avoiding
intercourse with a full bladder, and urinating after intercourse are also
helpful for patients experiencing postcoital cystitis.  Soapy bubble baths
that can cause urethral irritation should be avoided.
     Cystitis is a very common disease in women, and for most, is easily
treated.  However, if a patient experiences recurrent infection, additional
testing, and more intense treatment is in order.  In addition another painful
bladder condition, "interstitial cystitis" may be the underlying disease.
     Even when there are no complications, the patient should continue daily
precautionary practices, because severe or not, cystitis can cause a great
deal of discomfort, and prevention is always the best medicine.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
