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Preventing Urinary Tract Infections

June 30, 2016 | Dr. Ray Bologna

Some women are more susceptible to UTIs than others. If you regularly get UTIs – or just more frequently than you’d like! – taking preventive measures may help to decrease the frequency of your infections. Here a few tips for healthy bladder function that can keep UTIs at bay:

  • Stay hydrated! This is the simplest and most important step.  However, don’t force fluids.  Drink when you are thirsty and avoid dehydration, but excessive fluid intake can change the pH balance of your urine and also lead to an increased susceptibility to infections.
  • Try not to hold your bladder for extended periods of time.
  • Take daily supplements, including…
    • 1000mg of vitamin C to increase the acidity of your urine and reduce the growth of harmful bacteria
    • 36mg of cranberry – the active ingredient Proanthocyanidin helps prevent bacteria from adhering to the bladder lining (make sure you take a supplement made from the inner portion of the berry, not from the skin)
    • 2gm of D-Mannose
  • Use Methiamine (Urex) – a prescription medication that acidifies the urine – for persistent recurring infection prevention.
  • Regulate the balance of bacteria with probiotic lactobacillus. This can be taken intravaginally with Lactin-V for five days a week to treat your UTI, followed by one day per week for prevention. Alternatively, oral probiotics Rhamunosus or L. Reuteri can be taken twice weekly for prevention.
  • Apply vaginal estrogen to restore a normal pre-menopausal vaginal environment. Estrogen cream restores the normal pH of the vagina, increasing the moisture and elasticity to the vaginal tissue, which, in turn, prevents migration of bacteria up into the bladder. Vaginal estrogens come in cream, pills, and an estrogen ring. (Note: oral estrogen replacement is not a substitute for vaginal estrogen.)

If you are unable or prefer not to use estrogen, consider Mona Lisa Touch vaginal laser therapy, which works to restore the vaginal tissues to premenopausal states.

A cranberry a day keeps the doctor away
Well, probably not, but a concentrated dose of cranberry has proven helpful in the prevention of UTIs. The active ingredient is thought to be Proanthocyanidins (PAC), which is found in many products (including red wine!), but the concentration in cranberry is quite high. There are a variety of PACs, but two types – dimers and trimmers – are thought to have the best absorption in the gastrointestinal tract. Cranberries contain 25mgs of PAC dimers per 100gm of edible food. If the recommended dose of PAC’s for urinary tract infection prevention is 36mg per day it would take a minimum of 3600gms of cranberry per day (1 cup = 100gm). That’s a lot of cranberry! This is why supplements are recommended for a concentration of Proanthocyanidins. Read the label on your bottle – you may need to take several pills to get an effective daily dosage.

Special circumstances
There are some circumstances that make women more prone to infections, such as traveling, sexual activity and swimming in pools or soaking in hot tubs.

Travel disrupts the routine, which can lead to bad bladder habits like dehydration and not using the bathroom frequently enough. If you’re prone to UTIs, make an effort to drink plenty of water and empty your bladder. You may also take antibiotics with you as back up.

Some women experience infections related to sexual activity. Drinking water and urinating after sex can help prevent infection and for some patients, a dose of antibiotics after sex can also help.

Everyone loves to soak in a hot tub or go for a dip in the pool, but many women claim a relationship between these activities and UTIs. It can be difficult to make a direct link between UTIs and pools, but if you suspect it’s a problem, the best thing to do is determine if there’s an infection present.

UTIs are not always a straightforward diagnosis. The symptoms are very similar to bladder irritation, which can be treated without antibiotics. Some patients take a dipstick urine check at home, in their primary care doctor’s office or an urgent care setting. These tests can be misleading; a patient may show a trace of blood in the urine and have the symptoms of a bladder infection, but get a negative result on the culture. In these situations, it’s helpful to see a urologist or urogynecologist who can help determine what’s really going on and how best to treat it.

Learn about the latest research on urine cultures and diagnosing urinary tract infections.

Find more articles on Urinary Tract Infections