Recurrent urinary-tract infections

The urinary tract starts with the kidneys, which filter blood and turn waste into urine. The ureters are tubes that carry the urine from the kidneys to the bladder, from which it passes through the urethra to exit the body.

The most common types of urinary-tract infection are cystitis, a bladder infection, and urethritis, an infection in the urethra. Kidney infections (pyelonephritis) are rare but more serious.

A UTI can be present at multiple sites.

A UTI happens when certain bacteria not typically found in urine get into the urinary tract and multiply. The typical culprit is E. coli, which exist in the intestines of humans and animals. From the urethra, the bacteria can spread upward into the bladder and, rarely, into the kidneys.

In women’s bodies, the urethra is short and near the rectum. It’s easier, therefore, for bacteria to colonize a female bladder. Other risk factors include:

• A lack of proper hydration. The urinary tract’s natural defense to intruding bacteria is to flush the system. Drinking water helps your body do its job.
• Abnormal anatomy in the urinary tract.
• A bladder that’s not entirely emptied.
• Reflux. Children often get a UTI because the urine shoots back into the ureters from the bladder.
• Sex. Not everyone will develop a UTI because of sex, but some people do.
• An immune system condition, which can predispose you to develop a UTI.
• A history of kidney stones.
• Menopause. A lack of estrogen can affect the healthy bacteria in the vagina that normally acts as a barrier to keep E. coli from the urethra.
• Prior surgery on the bladder.

• You may have one or more of the following:
• An urgent or frequent need to urinate, but only a little comes out.
• A burning pain when you urinate.
• Urine with a strong odor
• Cloudy, blood-tinged urine
• An ache in your lower abdomen or back.
• Fever or chills.
• Other conditions can mimic a bladder infection, such as dryness due to a lack of estrogen or a sexually transmitted disease. Consequently, it’s essential to have the right diagnostic test. A urine culture will reveal if bacteria are present.

Your health care provider will perform a thorough evaluation. If warranted, your doctor may order an ultrasound of your kidneys or conduct a cystoscopy, during which a small camera is inserted into the urethra so the doctor can see into the bladder.

Lifestyle changes can help:

• Drink plenty of water.
• Consume two 8-ounce glasses of cranberry juice a day or taking one supplement twice a day. Cranberry helps prevent the bacteria from binding to the urinary tract. (Tell your doctor about any medications you are taking. Cranberry juice can interact with certain pharmaceuticals.)
• Fully empty your bladder.
• Avoid products that affect the bacteria in the vagina, such as spermicides.

If lifestyle changes aren’t enough, your health care provider may recommend methenamine, which stabilizes the PH in your urine, so it’s inhospitable to bacteria. If you’re in menopause, you might find relief with a topical estrogen cream that encourages good bacteria in the vagina to keep E. coli from reaching the urethra.