Archive for the ‘urinary tract infections’ Category

Urinary Tract Infections-Help Without Medication

February 5, 2013

Urinary Tract Infections Are One of the Most Common Maladies affecting women and is a source of pain, discomfort, and inconvenience. There are several action steps that most women can take to help reduce the frequency of these infections.
There are several simple, do-it-yourself techniques that may prevent a urinary tract infection. Some may work some of the time, or only in some women. But, because they carry no side effects, they certainly are worth trying to prevent the often painful and bothersome symptoms the infection can bring.
Here are some steps you might consider if you have more than 3-4 infections a year.

• Drink plenty of fluids – the equivalent of six to eight 8-ounce glasses of liquids – every day to flush bacteria out of your urinary system.
• Make sure you’re getting vitamin C in your diet, either through food or supplements. Vitamin C, or ascorbic acid, makes your urine acidic, which discourages the growth of bacteria.
• Drinking cranberry juice may also produce the same effect. Cranberry tablets are a more concentrated form of cranberry juice without the sugar content.
• Urinate every two to three hours whether you have the urge or not. Keeping urine in your bladder for long periods gives bacteria an opportunity to grow.
• Avoid using feminine hygiene sprays and scented douches. They also may irritate the urethra.
If you suffer from urinary tract infections more than three times a year, your health care professional may suggest one of the following therapies to try to prevent another recurrence:
• See you doctor about a low dosage of an antibiotic medication, such as trimethoprim/sulfamethoxazole or nitrofurantoin, taken daily for six months or longer
• If you infections occur after sexual intimacy, a single dose of an antibiotic medication taken after sexual intercourse.
Bottom Line: Recurrent urinary tract infections impact millions of American women. A few of these steps can probably reduce the frequency of these infections. If you have any questions, check with your doctor.

Deciding Upon the Prime Cut- The Circumcision Decision

December 28, 2012

No descriptor required!

No descriptor required!


Parents often ruminate about the decision to circumcise their young baby boys. Certainly if you are of the Jewish faith, there is no question that you will consider cicrcumcision for your new baby boy. For non-Jews, and non-Moslems, the decision is much more difficult.

New evidence is out that circumcision reduces the risk of sexually transmitted diseases. A review of current medical research points out that the medical benefits of circumcision outweigh the risk of the procedure. Circumcised infants are 90
% less liekly than uncircumcised infants to develop urinary tract infections. Later in life, the circumcised boys are at a lower risk of contracting HIV, herpes, penile cancer, and human papilomavirus, which when passed to female partners, can cause cervical cancer. The serious complicaitons occur in only about 0.2 percent of baby boys who under the operation.

Bottom Line: The circumcision decision is often difficult for most parents to make. I suggest you speak to your pediatrician and obstetrician about the “prime cut.”

A Burn In the Urine-Managing Urinary Tract Infections (UTI)

June 15, 2012

One of the most common afflictions affecting most women and many men are urinary tract infections. UTIs are eight times more common in women than men. Initial symptoms typically include burning at the time of urination, frequent and intense urge to urinate, with discoloration of the urine ranging from cloudy to even bloody.

A bacteria, E. Coli, is responsible for 75% to 90% cases of acute uncomplicated cystitis. UTIs can also be caused by sexually transmitted disease (STD) such as Chlamydia and Mycoplasma. Other possibilities of painful urination include pelvic inflammatory disease, radiation cystitis, and hemorrhagic cystitis.

Bacteria causing urinary tract infections

E. Coli bacteria – common cause of urinary tract infections

Your doctor can make a presumptive UTI diagnosis in symptomatic women if there is either burning with urination and frequency without vaginal symptoms. The diagnosis can be confirmed with urinalysis showing positive nitrite or positive leukocyte esterase. The ultimate diagnosis is based on urine culture which grows out the bacteria and tells the doctor the best drug or antibiotic for treating the infection.

Uncomplicated cystitis does not cause fever. If a patient has a fever the UTI may have spread to the kidneys. A bacterial infection of the kidney is referred to as pyelonephritis and the symptoms often include pain in the back or side below the ribs, nausea and vomiting.

Urinary tract infections in men are often the result of an obstruction or blockage of the urinary tract — for example, a urinary stone or enlarged prostate — or from a catheter used during a medical procedure.

Optimal empiric therapy for nonpregnant women with uncomplicated UTI is with trimethoprim-sulfamethoxazole (TMP-SMZ, Bactrim, Septra) 160 mg/800 mg orally b.i.d. for three days. Other antibiotic options include ciprofloxacin (Cipro), levofloxacin Levaquin), or nitrofurantoin (Macrodantin).

Cranbeery juice and supplements are thought to be a good alternative preventive treatment for recurrent UTIs. Rich in vitamins C and E, antioxidants and anthocyanins, cranberry may help prevent E. coli from attaching to the bladder wall as well as bladder stone formation, and provide symptom relief for cystitis.

Bottom Line: UTIs are common in both men and women and can be easily diagnosed with a history, physical exam, and examinatioin of the urine. Treatment is effective with antibiotics. If it burns when you urine, call your doctor.

When Thongs May Be Wrong

August 18, 2011

The underwear de jure for many women is a thong. However, thongs may lead to unwanted urinary tract infections. Let me explain why. Bladder infections in many women are caused by the movement of bacteria from the rectum to the vagina and then they can’t easily gain access to the urinary tract through the short urethra which is the tube that transports urine from the bladder to the outside of the body. Wearing thongs can contribute the spread of bacteria. Thong panties can cause bladder infections and may even be a cause of very dangerous kidney infections. These conditions can be very painful for women and worsen if not treated. Thongs can also aid in the distribution of bacteria from one area to another. The small string on a thong allows the anus and vagina to be connected with each other through the small cloth the bridge on the thong. There is no separation between the two orifices which will allow fecal bacteria to get into the vagina and subsequently gain access to the lower urinary tract.
If you are at risk or have recurrent urinary tract infections, I recommend not wearing a thong. However if you insist in wearing a thong, I suggest you purchase a thong made of 100% cotton and avoid purchasing a thong made of nylon or made from spandex. Another advice for women who have urinary tract infections is not to wear the thong for prolonged periods of time and certainly do not where the thong overnight. Sleeping in a thong provides bacteria ample time for bacteria to migrate from the rectum on the string- like material to the vagina.
Bottom line: Care and attention must be practice when choosing to wear a thong. You might also consider going “commando” and going buff and not wear any panties at all. Britney Spears did!

Frequent Urinary Tract Infections? Pee Your Way to Fewer Infections!

August 16, 2011

UTIs (urinary tract infections) are one of the most common infections in women. Women with UTIs complain of frequency of urination, burning on urination, and getting up at night to urinate. These are the hallmark symptoms of UTIs. That’s the bad news. The good news that UTIs are one of the easiest to prevent. These infections usually occur as bacteria from the rectum migrate to the vagina and then enter the urethra or the tube that transports urine from the bladder to the outside of the body. This is why your doctor will advise you to wipe from the front of your vagina towards the rectum as this will decrease the bacteria that may enter your urethra.

If you are affected with recurrent UTIs, 3 or more per year, then you will want to drink lots of water to flush out your kidneys and bladder to help keep them clear of bacteria. Since bacteria can be massaged into the urethra from the vagina during sexual intimacy, it is important to urinate immediately after sex. Urination after intercourse washes out those unwanted bacteria that enter the urethra during intimacy.
Some women are able to control their frequency of infections by taking a low dose antibiotic such as Macrodantin or a half a tablet of Bactrim right after sexual intimacy. The use of antibiotics after sexual intimacy is especially helpful for those women who develop urinary symptoms shortly after engaging in sexual intimacy.

Bottom Line: UTIs affect millions of women. These infections impact a women’s quality of life. However, a few simple steps like urinating after sexual intimacy is an example of good vaginal hygiene that can reduce the frequency of those bothersome infections.

Blueberries Beat Back Urinary Tract Infections Plus Other Medical Benefits

June 19, 2011

Recent studies have shown that blueberries have compounds similar to those of cranberries and can also be used to treat and prevent urinary tract infections (UTIs). Epicatechin is a bioflavonoid (antioxidant) found both in cranberries and blueberries.

Epicatechin works to prevent bacteria from attaching to the lining of the bladder tissue. This causes the bacteria to be eliminated thru your urine rather than attaching to the bladder wall, where they start multiplying and ultimately causing infection.

Not just for urinary infections-Other benefits of blueberries

Antioxidants consist of a group of vitamins, minerals and enzymes that have health enhancing effects for our bodies. Antioxidants work to neutralize free radicals before they do harm to our bodies. Free radicals are atoms that cause damage to our cells. They harm our immune system leading to many degenerative diseases. Free radicals are formed by our cells being exposed to a variety of substances such as radiation, chemicals, pollution, smoke, drugs, alcohol, pesticides and sun and through various metabolic processes such as when our bodies utilize stored fat for energy. A poor diet also aids in the formation of free radicals.

Antioxidants work by donating an electron to free radicals to convert them to harmless molecules. This protects cells from oxidative damage that leads to aging and various diseases.

Besides tasting great and looking good, blueberries can also lower your cholesterol levels. This is due to the antioxidant compound found in blueberries called pterostilbene. Its effect is similar to a commercial medication, Ciprofibrate (sold under the name of “Modalim”) that is used to reduce “bad” or LDL cholesterol.

The simple conclusion is that blueberries lower cholesterol as effectively as drugs, but without the negative side effects.

Blueberries have been shown to have a positive effect on aging. Blueberries appear to reverse some aspects of brain aging. This has given the blueberry a nickname, the ‘brain berry’. The antioxidant and anti-inflammatory properties of blueberries build a protective coat around the brain to fight signs of aging and deterioration. There is also evidence that blueberries may help to prevent Alzheimer’s disease and other neurological disorders.

The anti-inflammatory properties of blueberries appear to prevent and relieve arthritic symptoms, while the nutrients in blueberries may help strengthen blood vessels, leading to healthier blood pressure levels and heart health. The manganese in blueberries supports strong bones and its vitamin C supports the immune system.

Bottom Line:  Blueberries have great medicinal value and can be a boon against the common urinary tract infections.  They also can lower your cholesterol levels and may be an anti-aging agent.

Pay attention to the color and smell of your urine

May 26, 2011
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by Neil Baum, MD

Most of us are uncomfortable talking about our waste products, urine and feces. However, changes in the color and odor may signify disease that can be treated or prevented. This article will review causes of discoloration of urine and when there is a change in the odor of urine.

For hundreds of years doctors have looked at urine as a barometer of what is happening in the body. The urine can tell what you have been eating, how much fluid you are consuming, and what diseases you may have. Early doctors even tasted the urine of their patients in order to diagnose their medical conditions. Fortunately, we have made progress and a simple urinalysis can make this determination in seconds.

Urine is an important part of the body’s regulation process. Its job is to remove the extra water and wastes that the kidneys filter out of the blood. The urine is there primarily to get rid of toxins or things that would otherwise build up in the body that would be bad for the body.

When you notice that your urine has changed color, or there’s a strange odor emanating from the toilet, the cause might be something as harmless as what you had for dinner such as asparagus. It also might be a sign of a more serious condition, such as an infection or cancer.

Color changes

Urine normally varies from pale yellow to deep amber, depending on the concentration of the urine, which is determined by the amount of fluid you consume. Darker urine is usually a sign that you’re not drinking enough water. Correction is as simple as consuming more liquids, especially water.

The opposite is also true. If your urine is very pale, it means that you’re either drinking a lot of fluid, or you’re taking a diuretic or water pill which is a drug that forces the body to eliminate excess water.

Urine can turn a rainbow of colors, and an unusual hue isn’t necessarily cause for alarm. Certain medications can turn the urine fluorescent green or blue, the carotene in carrots can tint it orange, and vitamins can give it a yellow hue. Pyridium, a medication, which is used to treat burning on urination, will turn the urine orange-red.

Seeing red is typically a sign that there is blood in the urine, but before you panic, know that a little blood can produce a dramatic color change. Just like a drop of food coloring will add color to a large volume of food or fluids, it only takes one drop of blood to turn an entire toilet bowl red.

Red urine is usually an ominous sign and can indicate an infection or maybe even cancer. Red blood is a real warning sign and should prompt you to see your doctor or urologist, a doctor who specializes in disease of the kidneys and bladder.

Odor changes

Urine normally doesn’t have a very strong smell. If your urine has a foul odor, you could have an infection or urinary stones, which can create an ammonia-like odor. Diabetics might notice that their urine smells sweet, because of excess sugar.

Some foods can also change urine odor. Asparagus is among the most notorious. What people are smelling when they eat asparagus is the breakdown of a sulfur compound called methyl mercaptan (the same compound found in garlic).

How often do you need to go?

How often you need to go can be as important an indicator of your health as the color or smell of your urine. Most people take bathroom breaks about six to eight times a day, but you might go more or less depending on how much fluid you drink. If you’re constantly feeling the urge to go and it’s not because you’re not drinking extra fluid, causes can include:

  • overactive bladder (when you gotta go, you gotta go!)
  • urinary tract infection
  • interstitial cystitis (painful urination without an infection)
  • prostate gland enlargement
  • diabetes

The opposite problem, not going to the bathroom enough, can occur when there is a blockage or infection. Or, it can be the result of bad bathroom habits. Some people — especially teachers, surgeons, and anyone else who doesn’t have time for regular bathroom breaks throughout the day — tend to hold it in.

Delaying urination can also cause problems. The bladder can develop a chronic over-distension and will not empty completely. As a result urine is left in the bladder and can be a source for developing a urinary tract infection.

Develop good bathroom habits. Drink whenever you’re thirsty, but certainly increase your fluids before going outside in the hot summer sun or before exercising.

If you’re getting up during the night to use the bathroom, stop drinking three to four hours before bedtime. Limit caffeine, which can irritate the lining of the bladder. Also watch your intake of alcohol, which can have an effect similar to a diuretic.

Finally, don’t hold it in. Don’t delay answering the call of the rest room. Your bladder will thank you.

Bottom Line: Pay attention to the color and odor of your urine. If there is a change, contact your physician.

Neil Baum is a urologist at Touro Infirmary and can be reached at his self-titled site, Neil Baum, MD, or on Facebook and Twitter.

When Things Aren’t Right “Down There”-When Women Should Call Their Doctor*

April 21, 2011

For most women, a couple of irregular menstrual cycles or an occasional yeast infection are just a part of life — nothing that time or simple treatment won’t cure.  However, there are a few symptoms that warrant a call to the doctor.  This article will cover when you should call your doctor for problems “down there”?
1. Pelvic Pain
Pain at the time of ovulation, is referred to as Mittelschmerz.  However, if you have pelvic pain that persists or doesn’t ease with simple home treatment, call your doctor.
When a woman has chronic pelvic pain, doctors will check for benign uterine fibroids and endometriosis. They will also look for pelvic inflammatory disease, which usually appears as a triad of pelvic pain, vaginal discharge, and fever.
In addition, abdominal pain and vaginal bleeding may signal an ectopic pregnancy, in which a fertilized egg implants outside of the uterus.  This is a medical emergency and you need to visit an emergency room if you can’t reach your doctor.
Ovarian cancer is another condition that can cause pelvic pain.  The symptoms of bloating, pelvic pressure and frequency of urination for more than two weeks is a potential sign that you should be checked for a possible ovarian cancer.
2. Irregular Bleeding
If you’re not on any kind of birth control and you have irregular bleeding that lasts for more than a month or two, you should always be checked.  Irregular bleeding includes: periods that last longer than normal, bleeding mid-month, having two periods per month, bleeding after sex, and other unusual patterns.  Abnormal bleeding may stem from multiple causes that aren’t serious, among them, perimenopause or uterine fibroids or polyps.
If you bleed every time after sex, that may indicate that the cervix is being easily irritated especially if there’s some infection of the cervix.  Sexually transmitted diseases, such as gonorrhea or chlamydia, can cause cervical lesions that bleed with sex.
If you’re postmenopausal, be especially vigilant about any vaginal bleeding; it’s a potential sign of uterine cancer. Uterine cancer, compared to ovarian cancer, is extremely treatable. It’s very curable because it’s generally found in an early stage and it has an early warning sign, which is postmenopausal bleeding.
3. Abnormal Vaginal Discharge
Abnormal symptoms include a strong odor; an unusually large amount of discharge; accompanying itching, burning, or irritation; unusual color; or blood in the discharge.
4. Vaginal Dryness
Vaginal dryness in postmenopausal women or vaginal atrophy can cause spotting after intercourse. Because older women have less estrogen, their vaginal tissue thins or atrophies and becomes dry and irritated.  Not only does vaginal dryness make sex painful, but vaginal thinning also leaves women more susceptible to infections and can contribute to urinary incontinence.
Most women can find relief with estrogen creams, rings, or tablets that are applied or inserted directly into the vagina.
5. Sores or Lumps
Sores in the genital area may point to herpes, a sexually transmitted disease, or cancer. Symptoms of cancer of the vulva include unusual lumps, wart-like bumps, or red, flat sores that don’t heal. Sometimes, the flat sores turn scaly or discolored.
Bottom Line: Most problems “down there” are innocuous but you should know when to call your doctor.  These are the five most common symptoms that need your attention and that of your doctor. 

*Modified from WebMD, 4-20-11

Cranberry Juice Does Not Prevent Urinary Tract Infections-Another Medical Myth Bites The Dust

March 29, 2011

According to a report in Clinical Infection Diseases (2011;52:23-30), a placebo beverage fared better than cranberry juice in protecting against repeat urinary tract infections (UTIs) in 319 female college students presenting with acute UTI. The women were assigned to drink either eight ounces of cranberry juice or a placebo juice twice a day for six months or until another UTI developed. Although the investigators expected to see a 30% recurrence rate in the placebo group, the actual overall recurrence rate was 17%, with the cranberry-juice group experiencing a slightly higher recurrence rate than the those girls taking the placebo drink. according to a report in Clinical Infection Diseases (2011;52:23-30).

 

Urinary Tract Infections in Men

May 4, 2010

Urinary tract infections (UTI) indicate inflammation anywhere within the urinary system.  In men it can occur in the kidneys, bladder, prostate or urethra.  UTIs are more common in women, but they also affect men, especially in men more than 50 years of age.  If UTIs are left untreated, they can result in spread of the infection and cause permanent kidney damage.

Prostate infections are the most common infections in men.  Acute prostatitis occurs when bacteria lodge in the prostate and produce symptoms such as fever, chills, difficulty with urination, back pain, or blood in the urine.  The treatment is antibiotics for 7-10 days.

Chronic bacterial prostatitis is similar to the acute infection but without the fever or chills.  These men also may have painful ejaculation and low back pain.  The treatment is also antibiotics but often the medication has to be taken several weeks or even months.  Men with chronic prostatitis also may be advised to avoid caffeine, alcohol, spicy foods and chocolate.

In many men, prostatitis occurs without identifying any bacterial culprit.  This is called abacterial prostatitis or prostadynia.  The symptoms are the same a chronic bacterial prostatitis.  The pain and vague urinary problems are a result of spasm or congestion of the pelvic floor muscles or congestion within the prostate gland itself.  In most instances, antibiotics are not helpful in treating this condition.  The treatment consists of anti-inflammatory medication, muscle relaxants or alpha blockers.

UTIs can also occur after instruments are inserted into the urinary tract such as catheters or tubes as they may transport bacteria from outside of the body to the bladder and prostate gland.

Previous infections such as some of the sexually transmitted diseases may leave scars in the urethra and cause it narrow or stricture.  This disrupts the normal flow of urine and may result in infections of the urinary tract.

The diagnosis of a UTI is made with a history, physical examination and a urinalysis and a urine culture.  The latter is a test that identifies the offending bacterial and the best antibiotic to treat the infection.  Occasionally, additional tests such as a CAT scan and cystoscopy are required.

General measures for treating UTIs in men include increasing the consumption of water. Alkaline substances, such as citrates, taken in water might improve symptoms. By making the urine more alkaline, they make the environment more hostile to bacterial growth and improve the results of antibiotic therapy.

Antibiotics are the mainstay of treatment. Trimethoprim (Trimpex) is currently the first choice for lower UTI , because it is cost-effective, well tolerated and works in 80 per cent of infections. Cephalosporins and quinolones are reserved as second line drugs in patients with lower UTI, but are first choices in patients with signs of kidney infection.

You can prevent UTIs by drinking lots of fluids every day, empty your bladder often and completely, practice safe sex, always use latex or polyurethane condoms, urinate after sex to flush out bacteria, if you are uncircumcised, and wash under the foreskin each time you take a bath or shower.

Although UTIs are aggravating and affect the quality of life of those with the condition, they do not cause prostate cancer, benign enlargement of the prostate, or perhaps more importantly, impotence.

Bottom Line: With an accurate diagnosis and the correct treatment, most cases of UTIs in men can be cured, treated or certainly controlled.


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