Urinary tract infection is not caused by lack of hygiene – 09/09/2023 – Balance

More than half of women in the United States will have a urinary tract infection in their lifetime, compared with about 14% of men.

Although common, it is an experience often fraught with frustration and stigma, according to Kalpana Gupta, a professor at Boston University’s Chobanian & Avedisian School of Medicine who researches the infection.

“Patients feel some personal responsibility, like, ‘I’m doing something wrong.’ In most cases, the infection – known as bacterial cystitis – is only loosely correlated with personal behavior. The main reason why this infection is more common in women is that the female urethra is shorter than that of men, making it easier to reach bacteria to the urinary tract. In general, the condition in men is part of a larger health problem.”

The vast majority of cases are caused by the bacteria E. coli, which lives in the intestine and sometimes lodges in the perineum. How and under what circumstances bacteria migrate to the urethra and infect the urinary tract “has not been 100 percent figured out,” says Gupta.

There are many misconceptions surrounding the infection because there is very little quality research on the subject, says Ja-Hong Kim, a urologist at UCLA Health. Here are some of the most common questions patients ask specialists.

Is it still possible to treat the infection without the burning sensation?

Could it be. A condition can occur in any part of the urinary tract, which includes the urethra, bladder, kidneys and, in men, the prostate, says Kim. For a problem to be considered a condition, the patient must exhibit certain symptoms and have confirmed bacteria in their urine.

“Many of the most well-known symptoms, such as burning and the constant feeling of needing to go to the bathroom, come from studies of healthy, college-aged, young adult women,” says Gupta. But in reality, symptoms can vary.

According to her, in older people the infection can present as a fever or a feeling of a full bladder. Some patients have lower back pain, signaling that it may be in the kidneys – a more acute case that can lead to sepsis and damage to those organs, although these scenarios are “very, very rare,” says Kim.

Is it because I had sex?

Not necessarily. Women are often advised to urinate before and after sex to eliminate bacteria, but this practice has no support. “There is no study that says that peeing after or before sex reduces infections. But, interestingly, it may work for some women,” says Benjamin Brucker, director of urogynecology at NYU Langone.

According to Gupta, the most common hypothesis about the sex connection is that bacteria on the skin of the perineum are pushed into the urethra during penetration, which can turn into a urinary tract infection. Another is that products like spermicides alter the microbiome of the vagina, creating an environment in which bacteria can flourish and migrate into the urethra. But some women never develop a UTI with increased sexual activity, even if they don’t urinate before or after.

Is it a hygiene problem?

Doctors often tell women that hygiene — such as wiping from front to back, not wearing a wet swimsuit or bikini for long periods, and avoiding tight underwear — can reduce the risk of developing a urinary tract infection. The reasoning is that wiping from front to back reduces the chance that bacteria from fecal matter will be pushed into the urethra, and that a wet swimsuit or tight underwear can irritate the vaginal area.

“These practices are not harmful, but they are also not based on scientific evidence. Giving this type of advice in the context of this infection could end up making women anxious about hygiene. The point is that the risk is not related to the quality of the bath, to a wet swimsuit or choice of clothing,” says Gupta.

Are antibiotics my only option?

Not always. Brucker clarifies: “Imagine that you were scratched by a tree while walking and that the wound turned a little red. You are not necessarily going to take antibiotics, because the body can fight these bacteria. The condition also involves bacteria, and many patients young, healthy people discover that the body can eliminate them on its own. Although antibiotics are part of the standard treatment protocol, it is worth doing a bacterial culture first, which takes time, to discover the best medical intervention.”

He adds that in mild cases, good hydration can help the body rid itself of the infection. Over-the-counter pain relievers, such as acetaminophen and ibuprofen, can help reduce discomfort while the body does its work.

Research published in April found that the old idea that blueberries prevent urinary tract infections may have a grain of truth. In a meta-analysis of 50 randomized clinical trials, fruit products – juice, tablets or capsules – reduced the risk for women with recurrent infections, people susceptible to them and infected children, but not for other groups such as men and older women. old people or pregnant women.

For menopausal women, decreased hormone levels can alter the vaginal environment and increase the risk of infection. According to Brucker, in this situation, vaginal estrogen can be “an excellent way” to prevent infection.