Urinary tract infections, or cystitis, are an incredibly common reason why women go to the doctor. Approximately one third of all women experience at least one episode of this infection by around 25 years of age, and half of all women will have at least one in their lifetime. Since it’s such a common reason why women go to the doctors, urinary tract infections are always high on the list whenever a woman complains of pelvic pain.

The most common symptoms usually are pain when urinating, pain in the pelvis, cloudy smelling urine, frequency of urination, and getting that sudden urge to have to go. Some patients have all of the symptoms, making the diagnosis very straightforward. Other patients have just a few of the symptoms, making it a little bit more complex.

In fact, one of the main duties for the physician in these cases is to make sure that nothing else is occuring. Pelvic infections, such as sexually transmitted diseases, colitis, vaginal infections, constipation, ovarian pain, and appendix pain can all present with somewhat similar symptoms. The diligent physician will at least consider these other infirmities before leaping to the conclusion of urinary tract infection.

The physician diagnoses a urinary tract infection with a urinalysis. Looking for the presence of bacteria, white blood cells (leukocytes), and a chemical from the bacteria called nitrites, the urinalysis is essential to rule in the diagnosis. It should be noted that ultrasounds, x-rays, and CT scans are not helpful in the diagnosis of urinary tract infections unless a mass or abscess is being considered.

Treatment usually is a three-day course of antibiotics for women. While it in older days seven to ten days would’ve been needed, we now know that three days is usually sufficient. Bactrim, a sulfa drug, is still used in those who are not allergic and where Bactrim does not have a high resistance. Cipro (ciprofloxacin) is also used, and as a third-line drug Macrodantin (nitrofurantoin) is used as a five day course. However, Macrodantin doesn’t actually kill the bacteria, and is usually reserved when other treatments simply don’t work. While other antibiotics not listed here are also often used, they should be used further down the road when these first-line therapies don’t seem to work.

Preventing urinary tract infections can be tricky. Wiping patterns don’t seem to make as much of a difference as we once thought, and underwear fabric choice such as non-cotton underwear doesn’t seem to help either. Tampon use does not seem to play a role in the development of urinary tract infections.

However, it does seem that cranberry juice and cranberry extract can help prevent urinary tract infections. Three to four hundred milligrams of cranberry extract twice daily seems to be an appropriate dose, which corresponds to three 8-ounce glasses of cranberry juice daily.

A small daily dose of preventative antibiotics can also be given to patients who have urinary tract infections over and over again. While this does seem to work while the patient is taking them, this treatment is associated with abdominal pain, nausea, vomiting and diarrhea from the antibiotics themselves. It also only seems to work as long as patients taking the antibiotic. Therefore, this should be done only when absolutely nothing else seems to work.

Kidney function is usually preserved with a urinary tract infection, and the long-term outlook is excellent. Please contact your physician if you have any questions about urinary tract infection, or feel like you need treatment for it. Proper treatment can save a lot of pain and discomfort. Pray for those with serious infections.

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