Can you treat a UTI without antibiotics? 7 home remedies

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Urinary tract infections (UTIs) are caused by bacterial infection, so doctors usually treat them with antibiotics — but is it possible to treat a UTI without antibiotics?

UTIs are among the most common bacterial infections in the United States. They are especially prevalent in women, around 50 percent of whom will have one during their lifetime. UTIs also tend to reoccur.

Increasingly, people want to know whether non-antibiotic treatments can resolve UTIs. We explore this possibility here and provide seven evidence-based home remedies that can help to treat UTIs.

Antibiotics are an effective treatment for UTIs. However, the body can often resolve minor, uncomplicated UTIs on its own without the help of antibiotics.

By some estimates, 25–42 percent of uncomplicated UTI infections clear on their own. In these cases, people can try a range of home remedies to speed up recovery.

Complicated UTIs will require medical treatment. These UTIs involve one or more of the following factors:

• changes in the urinary tract or organs, such as a swollen prostate or a reduced flow of urine
• species of bacteria that are resistant to antibiotics
• conditions that affect the immune system, such as HIV, cardiac disease, or lupus

Antibiotics are the standard treatment for UTIs because they kill the bacteria that cause the infections. Most UTIs develop when bacteria enter the urinary tract from outside the body. The species of bacteria most likely to be responsible for UTIs include:

• Escherichia coli species, which cause up to 90 percent of all bladder infections
• Staphylococcus epidermidis and Staphylococcus aureus
• Klebsiella pneumoniae

While antibiotics can usually treat UTIs quickly and effectively, people can be allergic to them, and their use can carry certain risks.

For instance, an estimated 22 percent of the women receiving treatment for uncomplicated UTIs develop a vaginal Candida infection, which is a type of fungal infection.

Other side effects of antibiotics as UTI treatments include:

More severe risks of using antibiotics include:

Creating stronger strains of bacteria

Over time, some species of bacteria have become resistant to traditional antibiotics. There are several species of E. coli that are showing increasing drug resistance, and these are the primary cause of UTIs.

Every time people use an antibiotic, there is an increased risk of the bacteria developing resistance to it. This is even more likely when people do not follow the doctor’s instructions to complete the full prescribed course of treatment.

As a result, doctors are trying to reduce the use of antibiotics, especially when other treatments may be effective or when illnesses can resolve on their own.

It is essential to continue a course of antibiotics until the end date that the doctor provides. People should also never share antibiotics with others.

Damaging good bacteria

The body contains a community of bacteria, viruses, and fungi that live harmoniously and help with bodily functions. Antibiotics may destroy some of these bacteria, which could increase the likelihood of other infections occurring.

While scientific research supports some at-home or natural UTI remedies, others have been a part of traditional medicine systems for thousands of years.

To treat a UTI without antibiotics, people can try the following home remedies:

1. Stay hydrated

Drinking enough water is one of the easiest ways to help prevent and treat UTIs.

Water helps the urinary tract organs remove waste from the body efficiently while retaining vital nutrients and electrolytes.

Being hydrated also dilutes the urine and speeds its journey through the system, making it harder for bacteria to reach the cells that line urinary organs and to cause an infection.

There is no set recommendation for how much people should drink daily, as each person’s water needs are different. On average though, people should drink at least six to eight 8-ounce (oz) glasses of water each day.

2. Urinate when the need arises

Frequent urination puts pressure on bacteria in the urinary tract, which can help to clear them out.

It also reduces the amount of time that bacteria in the urine are exposed to cells in the urinary tract, reducing the risk of them attaching and forming an infection.

Always urinate as soon as possible when the urge strikes to help prevent and treat UTIs.

3. Drink cranberry juice

Cranberry juice is one of the most well-established natural treatments for UTIs. People have also traditionally used it to help clear general infections and speed up wound recovery time.

Studies on the effectiveness of cranberry juice for UTIs have had mixed results. According to one review, cranberry juice contains compounds that may prevent E. coli cells from attaching to cells in the urinary tract.

Cranberry juice also contains antioxidants, including polyphenols, which have antibacterial and anti-inflammatory properties.

There is no set guideline on how much cranberry juice to drink to treat a UTI, but a common recommendation is to drink around 400 milliliters (mL) of at least 25-percent cranberry juice every day to prevent or treat UTIs.

4. Use probiotics

Beneficial bacteria, known as probiotics, can help keep the urinary tract healthy and free from harmful bacteria.

In particular, a group of probiotics called lactobacilli may help with treating and preventing UTIs. They may do this by:

• preventing harmful bacteria from attaching to urinary tract cells
• producing hydrogen peroxide in urine, which is a strong antibacterial
• lowering urine pH, making conditions less favorable for bacteria

People who take lactobacillus supplements while on antibiotics for UTIs may develop less antibiotic resistance than people not taking them.

Probiotics occur in a variety of fermented and dairy products, including:

• yogurts
• kefir
• some types of cheese
• sauerkraut

People can also take probiotic supplements, which are usually in the form of a capsule or a powder that mixes into water or other beverages.

5. Get enough vitamin C

Vitamin C is an antioxidant that helps to improve immune system function.

Vitamin C also reacts with nitrates in urine to form nitrogen oxides that can kill bacteria. It can lower the pH of urine, making it less likely that bacteria will survive.

As with cranberry juice, people have been using vitamin C in various forms to treat UTIs for thousands of years. But there is a lack of quality research to confirm whether or not increasing vitamin C intake can prevent or treat UTIs.

According to the limited research, taking other supplements alongside vitamin C may maximize its benefits.

In a 2016 study, 38 women with recurrent UTIs took vitamin C, probiotics, and cranberries three times daily for 20 days, then stopped for 10 days. They repeated this cycle for 3 months. The researchers concluded that this could be a safe and effective treatment approach for UTIs.

The National Institutes of Health recommend that for people aged 19 and over, women should get at least 75 mg of vitamin C per day, while men need around 90 mg per day. Adults who smoke should take an additional 35 mg of the vitamin each day.

6. Wipe from front to back

Many UTIs develop when bacteria from the rectum or feces gain access to the urethra, the small channel that allows urine to flow out of the body.

Once bacteria are in the urethra, they can travel up into other urinary tract organs where they can lead to infections.

After urinating, wipe in a way that prevents bacteria from coming into contact with the genitals. Use separate pieces of toilet paper to wipe the genitals and anus.

7. Practice good sexual hygiene

Sexual intercourse introduces bacteria and other microbes from outside the body to the urinary tract. Practicing good sexual hygiene can help to reduce the number of bacteria that people can transfer during intercourse and other sexual acts.

Examples of good sexual hygiene include:

• urinating before and immediately after sex
• using barrier contraception, such as a condom
• washing the genitals, especially the foreskin, before and after engaging in sexual acts or intercourse
• washing the genitals or changing condoms if switching from anal sex to vaginal sex
• ensuring that sexual partners are aware of any current or previous UTIs

Currently, researchers are trying to design vaccines that would prevent many types of bacteria from being able to attach to body cells properly.

They are also working on developing other UTI vaccines that prevent bacteria from being able to grow and cause infection. To date, only one type of UTI vaccine has reached preliminary human trials. Studies on the rest are still using animals and tissue samples.

If a person suspects that they might have a UTI, they should speak to their doctor for advice on the best way to treat the possible infection.

Antibiotics may not always be necessary to treat UTIs, but it is still important to seek medical attention for any infection or suspected infection. This will reduce the risk of a more severe infection developing that is harder to treat.

The signs and symptoms of UTIs include:

• increased frequency and urgency of urination
• pain or burning when urinating
• low-grade fevers (below 101°F)
• pressure or cramping in the area around the lower abdomen and groin
• change in the smell or color of urine
• cloudy, murky, or bloody urine

Most people develop a UTI at some point in their lifetime, especially women.

Many UTIs go away on their own or with primary care. Researchers are increasingly looking for ways to treat and prevent UTIs without the use of antibiotics.

Several longstanding at-home remedies may help to prevent and treat UTIs.

People who think they have a UTI should always talk with a doctor before trying to treat the infection themselves.

Some of the home remedies listed in this article are available for purchase online.

Can you treat a UTI without antibiotics? 7 home remedies

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Here’s our process.

Urinary tract infections (UTIs) are caused by bacterial infection, so doctors usually treat them with antibiotics — but is it possible to treat a UTI without antibiotics?

UTIs are among the most common bacterial infections in the United States. They are especially prevalent in women, around 50 percent of whom will have one during their lifetime. UTIs also tend to reoccur.

Increasingly, people want to know whether non-antibiotic treatments can resolve UTIs. We explore this possibility here and provide seven evidence-based home remedies that can help to treat UTIs.

Antibiotics are an effective treatment for UTIs. However, the body can often resolve minor, uncomplicated UTIs on its own without the help of antibiotics.

By some estimates, 25–42 percent of uncomplicated UTI infections clear on their own. In these cases, people can try a range of home remedies to speed up recovery.

Complicated UTIs will require medical treatment. These UTIs involve one or more of the following factors:

• changes in the urinary tract or organs, such as a swollen prostate or a reduced flow of urine
• species of bacteria that are resistant to antibiotics
• conditions that affect the immune system, such as HIV, cardiac disease, or lupus

Antibiotics are the standard treatment for UTIs because they kill the bacteria that cause the infections. Most UTIs develop when bacteria enter the urinary tract from outside the body. The species of bacteria most likely to be responsible for UTIs include:

• Escherichia coli species, which cause up to 90 percent of all bladder infections
• Staphylococcus epidermidis and Staphylococcus aureus
• Klebsiella pneumoniae

While antibiotics can usually treat UTIs quickly and effectively, people can be allergic to them, and their use can carry certain risks.

For instance, an estimated 22 percent of the women receiving treatment for uncomplicated UTIs develop a vaginal Candida infection, which is a type of fungal infection.

Other side effects of antibiotics as UTI treatments include:

More severe risks of using antibiotics include:

Creating stronger strains of bacteria

Over time, some species of bacteria have become resistant to traditional antibiotics. There are several species of E. coli that are showing increasing drug resistance, and these are the primary cause of UTIs.

Every time people use an antibiotic, there is an increased risk of the bacteria developing resistance to it. This is even more likely when people do not follow the doctor’s instructions to complete the full prescribed course of treatment.

As a result, doctors are trying to reduce the use of antibiotics, especially when other treatments may be effective or when illnesses can resolve on their own.

It is essential to continue a course of antibiotics until the end date that the doctor provides. People should also never share antibiotics with others.

Damaging good bacteria

The body contains a community of bacteria, viruses, and fungi that live harmoniously and help with bodily functions. Antibiotics may destroy some of these bacteria, which could increase the likelihood of other infections occurring.

While scientific research supports some at-home or natural UTI remedies, others have been a part of traditional medicine systems for thousands of years.

To treat a UTI without antibiotics, people can try the following home remedies:

1. Stay hydrated

Drinking enough water is one of the easiest ways to help prevent and treat UTIs.

Water helps the urinary tract organs remove waste from the body efficiently while retaining vital nutrients and electrolytes.

Being hydrated also dilutes the urine and speeds its journey through the system, making it harder for bacteria to reach the cells that line urinary organs and to cause an infection.

There is no set recommendation for how much people should drink daily, as each person’s water needs are different. On average though, people should drink at least six to eight 8-ounce (oz) glasses of water each day.

2. Urinate when the need arises

Frequent urination puts pressure on bacteria in the urinary tract, which can help to clear them out.

It also reduces the amount of time that bacteria in the urine are exposed to cells in the urinary tract, reducing the risk of them attaching and forming an infection.

Always urinate as soon as possible when the urge strikes to help prevent and treat UTIs.

3. Drink cranberry juice

Cranberry juice is one of the most well-established natural treatments for UTIs. People have also traditionally used it to help clear general infections and speed up wound recovery time.

Studies on the effectiveness of cranberry juice for UTIs have had mixed results. According to one review, cranberry juice contains compounds that may prevent E. coli cells from attaching to cells in the urinary tract.

Cranberry juice also contains antioxidants, including polyphenols, which have antibacterial and anti-inflammatory properties.

There is no set guideline on how much cranberry juice to drink to treat a UTI, but a common recommendation is to drink around 400 milliliters (mL) of at least 25-percent cranberry juice every day to prevent or treat UTIs.

4. Use probiotics

Beneficial bacteria, known as probiotics, can help keep the urinary tract healthy and free from harmful bacteria.

In particular, a group of probiotics called lactobacilli may help with treating and preventing UTIs. They may do this by:

• preventing harmful bacteria from attaching to urinary tract cells
• producing hydrogen peroxide in urine, which is a strong antibacterial
• lowering urine pH, making conditions less favorable for bacteria

People who take lactobacillus supplements while on antibiotics for UTIs may develop less antibiotic resistance than people not taking them.

Probiotics occur in a variety of fermented and dairy products, including:

• yogurts
• kefir
• some types of cheese
• sauerkraut

People can also take probiotic supplements, which are usually in the form of a capsule or a powder that mixes into water or other beverages.

5. Get enough vitamin C

Vitamin C is an antioxidant that helps to improve immune system function.

Vitamin C also reacts with nitrates in urine to form nitrogen oxides that can kill bacteria. It can lower the pH of urine, making it less likely that bacteria will survive.

As with cranberry juice, people have been using vitamin C in various forms to treat UTIs for thousands of years. But there is a lack of quality research to confirm whether or not increasing vitamin C intake can prevent or treat UTIs.

According to the limited research, taking other supplements alongside vitamin C may maximize its benefits.

In a 2016 study, 38 women with recurrent UTIs took vitamin C, probiotics, and cranberries three times daily for 20 days, then stopped for 10 days. They repeated this cycle for 3 months. The researchers concluded that this could be a safe and effective treatment approach for UTIs.

The National Institutes of Health recommend that for people aged 19 and over, women should get at least 75 mg of vitamin C per day, while men need around 90 mg per day. Adults who smoke should take an additional 35 mg of the vitamin each day.

6. Wipe from front to back

Many UTIs develop when bacteria from the rectum or feces gain access to the urethra, the small channel that allows urine to flow out of the body.

Once bacteria are in the urethra, they can travel up into other urinary tract organs where they can lead to infections.

After urinating, wipe in a way that prevents bacteria from coming into contact with the genitals. Use separate pieces of toilet paper to wipe the genitals and anus.

7. Practice good sexual hygiene

Sexual intercourse introduces bacteria and other microbes from outside the body to the urinary tract. Practicing good sexual hygiene can help to reduce the number of bacteria that people can transfer during intercourse and other sexual acts.

Examples of good sexual hygiene include:

• urinating before and immediately after sex
• using barrier contraception, such as a condom
• washing the genitals, especially the foreskin, before and after engaging in sexual acts or intercourse
• washing the genitals or changing condoms if switching from anal sex to vaginal sex
• ensuring that sexual partners are aware of any current or previous UTIs

Currently, researchers are trying to design vaccines that would prevent many types of bacteria from being able to attach to body cells properly.

They are also working on developing other UTI vaccines that prevent bacteria from being able to grow and cause infection. To date, only one type of UTI vaccine has reached preliminary human trials. Studies on the rest are still using animals and tissue samples.

If a person suspects that they might have a UTI, they should speak to their doctor for advice on the best way to treat the possible infection.

Antibiotics may not always be necessary to treat UTIs, but it is still important to seek medical attention for any infection or suspected infection. This will reduce the risk of a more severe infection developing that is harder to treat.

The signs and symptoms of UTIs include:

• increased frequency and urgency of urination
• pain or burning when urinating
• low-grade fevers (below 101°F)
• pressure or cramping in the area around the lower abdomen and groin
• change in the smell or color of urine
• cloudy, murky, or bloody urine

Most people develop a UTI at some point in their lifetime, especially women.

Many UTIs go away on their own or with primary care. Researchers are increasingly looking for ways to treat and prevent UTIs without the use of antibiotics.

Several longstanding at-home remedies may help to prevent and treat UTIs.

People who think they have a UTI should always talk with a doctor before trying to treat the infection themselves.

Some of the home remedies listed in this article are available for purchase online.

Can you treat a UTI without antibiotics? 7 home remedies

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Here’s our process.

Urinary tract infections (UTIs) are caused by bacterial infection, so doctors usually treat them with antibiotics — but is it possible to treat a UTI without antibiotics?

UTIs are among the most common bacterial infections in the United States. They are especially prevalent in women, around 50 percent of whom will have one during their lifetime. UTIs also tend to reoccur.

Increasingly, people want to know whether non-antibiotic treatments can resolve UTIs. We explore this possibility here and provide seven evidence-based home remedies that can help to treat UTIs.

Antibiotics are an effective treatment for UTIs. However, the body can often resolve minor, uncomplicated UTIs on its own without the help of antibiotics.

By some estimates, 25–42 percent of uncomplicated UTI infections clear on their own. In these cases, people can try a range of home remedies to speed up recovery.

Complicated UTIs will require medical treatment. These UTIs involve one or more of the following factors:

• changes in the urinary tract or organs, such as a swollen prostate or a reduced flow of urine
• species of bacteria that are resistant to antibiotics
• conditions that affect the immune system, such as HIV, cardiac disease, or lupus

Antibiotics are the standard treatment for UTIs because they kill the bacteria that cause the infections. Most UTIs develop when bacteria enter the urinary tract from outside the body. The species of bacteria most likely to be responsible for UTIs include:

• Escherichia coli species, which cause up to 90 percent of all bladder infections
• Staphylococcus epidermidis and Staphylococcus aureus
• Klebsiella pneumoniae

While antibiotics can usually treat UTIs quickly and effectively, people can be allergic to them, and their use can carry certain risks.

For instance, an estimated 22 percent of the women receiving treatment for uncomplicated UTIs develop a vaginal Candida infection, which is a type of fungal infection.

Other side effects of antibiotics as UTI treatments include:

More severe risks of using antibiotics include:

Creating stronger strains of bacteria

Over time, some species of bacteria have become resistant to traditional antibiotics. There are several species of E. coli that are showing increasing drug resistance, and these are the primary cause of UTIs.

Every time people use an antibiotic, there is an increased risk of the bacteria developing resistance to it. This is even more likely when people do not follow the doctor’s instructions to complete the full prescribed course of treatment.

As a result, doctors are trying to reduce the use of antibiotics, especially when other treatments may be effective or when illnesses can resolve on their own.

It is essential to continue a course of antibiotics until the end date that the doctor provides. People should also never share antibiotics with others.

Damaging good bacteria

The body contains a community of bacteria, viruses, and fungi that live harmoniously and help with bodily functions. Antibiotics may destroy some of these bacteria, which could increase the likelihood of other infections occurring.

While scientific research supports some at-home or natural UTI remedies, others have been a part of traditional medicine systems for thousands of years.

To treat a UTI without antibiotics, people can try the following home remedies:

1. Stay hydrated

Drinking enough water is one of the easiest ways to help prevent and treat UTIs.

Water helps the urinary tract organs remove waste from the body efficiently while retaining vital nutrients and electrolytes.

Being hydrated also dilutes the urine and speeds its journey through the system, making it harder for bacteria to reach the cells that line urinary organs and to cause an infection.

There is no set recommendation for how much people should drink daily, as each person’s water needs are different. On average though, people should drink at least six to eight 8-ounce (oz) glasses of water each day.

2. Urinate when the need arises

Frequent urination puts pressure on bacteria in the urinary tract, which can help to clear them out.

It also reduces the amount of time that bacteria in the urine are exposed to cells in the urinary tract, reducing the risk of them attaching and forming an infection.

Always urinate as soon as possible when the urge strikes to help prevent and treat UTIs.

3. Drink cranberry juice

Cranberry juice is one of the most well-established natural treatments for UTIs. People have also traditionally used it to help clear general infections and speed up wound recovery time.

Studies on the effectiveness of cranberry juice for UTIs have had mixed results. According to one review, cranberry juice contains compounds that may prevent E. coli cells from attaching to cells in the urinary tract.

Cranberry juice also contains antioxidants, including polyphenols, which have antibacterial and anti-inflammatory properties.

There is no set guideline on how much cranberry juice to drink to treat a UTI, but a common recommendation is to drink around 400 milliliters (mL) of at least 25-percent cranberry juice every day to prevent or treat UTIs.

4. Use probiotics

Beneficial bacteria, known as probiotics, can help keep the urinary tract healthy and free from harmful bacteria.

In particular, a group of probiotics called lactobacilli may help with treating and preventing UTIs. They may do this by:

• preventing harmful bacteria from attaching to urinary tract cells
• producing hydrogen peroxide in urine, which is a strong antibacterial
• lowering urine pH, making conditions less favorable for bacteria

People who take lactobacillus supplements while on antibiotics for UTIs may develop less antibiotic resistance than people not taking them.

Probiotics occur in a variety of fermented and dairy products, including:

• yogurts
• kefir
• some types of cheese
• sauerkraut

People can also take probiotic supplements, which are usually in the form of a capsule or a powder that mixes into water or other beverages.

5. Get enough vitamin C

Vitamin C is an antioxidant that helps to improve immune system function.

Vitamin C also reacts with nitrates in urine to form nitrogen oxides that can kill bacteria. It can lower the pH of urine, making it less likely that bacteria will survive.

As with cranberry juice, people have been using vitamin C in various forms to treat UTIs for thousands of years. But there is a lack of quality research to confirm whether or not increasing vitamin C intake can prevent or treat UTIs.

According to the limited research, taking other supplements alongside vitamin C may maximize its benefits.

In a 2016 study, 38 women with recurrent UTIs took vitamin C, probiotics, and cranberries three times daily for 20 days, then stopped for 10 days. They repeated this cycle for 3 months. The researchers concluded that this could be a safe and effective treatment approach for UTIs.

The National Institutes of Health recommend that for people aged 19 and over, women should get at least 75 mg of vitamin C per day, while men need around 90 mg per day. Adults who smoke should take an additional 35 mg of the vitamin each day.

6. Wipe from front to back

Many UTIs develop when bacteria from the rectum or feces gain access to the urethra, the small channel that allows urine to flow out of the body.

Once bacteria are in the urethra, they can travel up into other urinary tract organs where they can lead to infections.

After urinating, wipe in a way that prevents bacteria from coming into contact with the genitals. Use separate pieces of toilet paper to wipe the genitals and anus.

7. Practice good sexual hygiene

Sexual intercourse introduces bacteria and other microbes from outside the body to the urinary tract. Practicing good sexual hygiene can help to reduce the number of bacteria that people can transfer during intercourse and other sexual acts.

Examples of good sexual hygiene include:

• urinating before and immediately after sex
• using barrier contraception, such as a condom
• washing the genitals, especially the foreskin, before and after engaging in sexual acts or intercourse
• washing the genitals or changing condoms if switching from anal sex to vaginal sex
• ensuring that sexual partners are aware of any current or previous UTIs

Currently, researchers are trying to design vaccines that would prevent many types of bacteria from being able to attach to body cells properly.

They are also working on developing other UTI vaccines that prevent bacteria from being able to grow and cause infection. To date, only one type of UTI vaccine has reached preliminary human trials. Studies on the rest are still using animals and tissue samples.

If a person suspects that they might have a UTI, they should speak to their doctor for advice on the best way to treat the possible infection.

Antibiotics may not always be necessary to treat UTIs, but it is still important to seek medical attention for any infection or suspected infection. This will reduce the risk of a more severe infection developing that is harder to treat.

The signs and symptoms of UTIs include:

• increased frequency and urgency of urination
• pain or burning when urinating
• low-grade fevers (below 101°F)
• pressure or cramping in the area around the lower abdomen and groin
• change in the smell or color of urine
• cloudy, murky, or bloody urine

Most people develop a UTI at some point in their lifetime, especially women.

Many UTIs go away on their own or with primary care. Researchers are increasingly looking for ways to treat and prevent UTIs without the use of antibiotics.

Several longstanding at-home remedies may help to prevent and treat UTIs.

People who think they have a UTI should always talk with a doctor before trying to treat the infection themselves.

Some of the home remedies listed in this article are available for purchase online.

Signs You Have Bladder Infection: Symptoms, Diagnosis, & Treatment

By your 10th trip to the bathroom in 2 hours, you might wonder if you have a bladder infection. And you may be right, especially if it hurts, burns, or stings when you pee.

Bladder infections are the most common type of urinary tract infection (UTI). They’re caused by bacteria and lead to problems like pain in your lower belly and having to pee way more often than usual.

Your doctor can do some simple tests to find out if you have one, and they’re usually easy to treat. If you get bladder infections often, your doctor may want to do more advanced tests to find the cause.

Basic Tests

Your doctor will first do a physical exam and talk to you about your symptoms. That may be enough to find out whether you have one.

If not, you’ll get a urine analysis. This is a test that checks for bacteria, blood, or pus in a sample of your pee. Your doctor may also run a urine culture to find out which bacteria are causing your infection.

Advanced Tests

Getting a bladder infection once in a while may be a bother, but it’s not usually a serious health concern. Sometimes, though, it’s important to know the cause of the infection, because medicine alone may not be enough to treat it.

You may get more advanced tests if you belong to one of these groups:

• Children
• Men (Because they tend not to get bladder infections, it could be a sign of something else.)
• People who have kidney damage
• Women who get three or more bladder infections in a year or have blood in their urine

To find the cause of a bladder infection, your doctor can use:

• Cystoscopy. Your doctor inserts a cystoscope – a thin tube with a camera — into your urethra to look for problems or to get a tissue sample for more testing (biopsy).
• Imaging. An ultrasound, CT scan, and MRI can show tumors, kidney stones, and other issues.
• Intravenous urogram (IVU). This is an X-ray that uses contrast dye to take images of the kidneys, ureters, and bladder.
• Voiding cystourethrography. Your doctor puts a dye into your bladder to see if any urine flows backward from the bladder toward the kidneys.
• Retrograde urethrography. This test uses contrast dye to find problems in the urethra.

Treatment

A mild bladder infection may go away on its own within a few days. If it doesn’t, it’s usually treated with antibiotics. You usually start to feel better in a day or so, but be sure to take all the medicine as directed.

Women with a basic infection usually take antibiotics for 3 to 7 days, though some doctors may give you an antibiotic you can take just once. For stronger infections, or if you get them often, you may take antibiotics for 7 to 10 days. And, if you have another health condition, such as diabetes, you may get a stronger antibiotic to take over a longer time.

For women past menopause, your doctor may also suggest a vaginal cream with estrogen, if it’s safe for you.

For men who have a bladder infection caused by a prostate infection, you may be on antibiotics for several weeks.

Your doctor may also give you medicine to help with symptoms such as pain or the constant urge to pee.

Self-Care

Here are some things you can do at home to get relief:

• Avoid having sex.
• Drink lots of water, but avoid alcohol, caffeine, and spicy foods. They can all make your symptoms worse.
• Take a pain reliever.
• Try a 15- to 20-minute soak in a warm bath.
• Use a heating pad on your lower belly.

Home Remedies for UTI Symptoms: Natural Treatment for Urinary Tract Infections

1. Get Your Fill of Water and Water-Based Foods

One of the first things to do when you have a urinary tract infection is drink plenty of water. That’s because drinking water can help flush away the bacteria that’s causing your infection, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (3) It puts you on the right track for recovery.

Most people can be assured they’re getting the water they need by simply drinking water when thirsty, according to the health and medicine division of the National Academies of Sciences, Engineering, and Medicine. (4) But to be safe, you may want to make sure you’re drinking at least six to eight 8-ounce (oz) glasses of water each day. (3) General recommendations have suggested that women get about 91 oz of water daily and men get about 125 oz each day, including water from food, as also noted in that group’s report. (4)

2. Load Up on Vitamin C for a Healthy Urinary Tract

Getting plenty of foods high in vitamin C is important because large amounts of vitamin C make urine more acidic. This inhibits the growth of bacteria in your urinary tract, according to Johns Hopkins Medicine’s health library. (5) However, if you have an active UTI, you may want to avoid citrus or other acidic foods. These foods are known to irritate the bladder, which is the last thing you need when you’re having pain urinating.

3. Soothe UTI Pain With Heat

Inflammation and irritation from UTIs cause burning, pressure, and pain around your pubic area, says Kandis Rivers, MD, a urologist in the Henry Ford Health System in Wast Bloomfield, Michigan. Applying a heating pad can help soothe the area. (3) Keep the heat setting low, don’t apply it directly to the skin, and limit your use to 15 minutes at a time to avoid burns.

4. Cut Bladder Irritants From Your Diet

When you have a UTI, caffeine, alcohol, spicy food, nicotine, carbonated drinks, and artificial sweeteners can irritate your bladder further, making it harder for your body to heal, according to the Cleveland Clinic. (6) Focus on healthy foods, such as high-fiber carbohydrates (including oatmeal or lentil soup), that are good for your digestive health, says Holly Lucille, ND, RN, a naturopathic doctor in private practice in West Hollywood, California, and the author of Creating and Maintaining Balance: A Woman’s Guide to Safe, Natural Hormone Health.

5. Go Ahead, Empty Your Bladder Again

Every time you empty your bladder — even if it’s just a small amount — you rid it of some of the bacteria causing the infection. (3) Keep making those bathroom runs, advises Dr. Rivers.

6. Consider Herbal Remedies

You may find some relief from taking the herb uva ursi (bearberry leaf), which is sometimes used as an herbal remedy for lower urinary tract infections. (7) But Rivers cautions that it should be taken only for short periods of time — five days or less — as it could cause liver damage.

It’s important to note that even though bearberry leaf may help some, there have been no large randomized controlled trials (the gold standard when it comes to proving the effectiveness of a drug or treatment in medicine) testing it as a remedy for UTIs. (7)

Some preliminary research, including as a study published in 2016 in the European Review for Medical and Pharmacological Sciences, also suggests that D-mannose supplements may help to prevent and treat UTIs. (8,9) Researchers think it might keep bacteria from attaching to the walls of the urinary tract. D-mannose is a simple sugar found naturally in fruits, including oranges, apples, and cranberries.

Always be sure to check with your doctor before an herbal supplement. Supplements, herbs, and other medication you might be taking can cause side effects or may interact with one another. The effects can sometimes be serious.

7. Change to Healthier Daily Habits

Lifestyle changes matter because they can help you recover from a UTI and might prevent another infection, according to the NIDDK. (3)

• Quit smoking.
• Wear loose cotton clothing and underwear.
• Wipe yourself clean from front to back.
• Choose only fragrance-free personal hygiene products.

8. Cut Back on Meat and Poultry

Some studies, such as one published in August 2018 in the journal mBio, have linked contaminated poultry and meat to E. coli bacteria strains that can cause UTIs. (10) These studies haven’t proven that eating meat or poultry causes UTIs. In fact, some E.coli can live in the intestines without causing any problems. However, bacteria from the gut can enter the urinary tract and cause infection. This risk is greater in women than men, because women have shorter urethras than men, meaning the bacteria has less distance to travel to reach the bladder.

Cutting back on meat and focusing on fruits and veggies may slightly cut your risk of UTIs. According to a study of Buddhists in Taiwan, published in January 2020 in Scientific Reports, compared with nonvegetarians, vegetarians had a 16 percent lower risk of UTI. (11)

Related: Vegetarian Diet Linked to Lowered Risk Of Urinary Tract Infection

A Note About Cranberry Juice and UTIs

Cranberry juice or cranberry extract in supplemental form has long been used as a home remedy for UTIs.

The thought is that “the proanthocyanidins in cranberries may help prevent bladder infections by keeping the bacteria from clinging to the bladder wall,” says Sonya Angelone, MS, RDN, a nutrition consultant based in San Francisco, and spokesperson for the Academy of Nutrition and Dietetics.

Yet there’s scientific controversy over how effective cranberry juice is at preventing UTIs due to conflicting conclusions in studies on the topic, according to an article published in May 2016 in Advances in Nutrition. (12) Some studies have found it might work, while others have found no effect.

“Bottom line, there is some evidence it may help, and it doesn’t hurt to try it,” says Angelone. Just be sure to chose unsweetened cranberry juice (the sugar in sweetened cranberry juices can actually feed a bacterial infection). Mix this with sparkling water or plain yogurt, she recommends.

Another low-calorie option — choose a cranberry pill that contains d-mannose, she says.

Are Bananas Good for UTIs?

The American Urological Association calls bananas a bladder-friendly food. (13) That’s because bananas aren’t likely to irritate the bladder in most people. Other bladder-friendly fruits and veggies include: pears, green beans, winter squash, and potatoes. While eating bananas may help to lessen bladder irritation, eating bananas alone won’t make a UTI go away.

Can Onions Help UTIs?

Onions, especially raw ones, may cause bladder irritation in some people. (6) If you have an active UTI, eating foods that further irritate the already inflamed tissues of the urinary tract could make UTI symptoms worse.

Can Drinking Apple Cider Vinegar Treat UTIs?

Studies, such as one published in January 2018 in Scientific Reports, have shown that apple cider vinegar has some antibacterial and antifungal properties, but there’s no scientific or medical evidence that drinking apple cider vinegar cures UTIs. (14) Drinking large amounts of apple cider vinegar could lead to throat irritation and tooth decay.

Is Coconut Oil Effective at Alleviating UTI Symptoms?

Some studies have suggested that coconut oil may have antimicrobial properties. (15) However, there’s no research looking specifically at the effect of coconut oil on UTIs.

Additional reporting by Marie Suszynski.

How To Get Rid Of A Bladder Infection Fast

If you’re reading this post, you’re likely in the midst of a bladder infection or urinary tract infection (UTI) and are in some serious need of relief now!  We get it – UTIs are no fun – they can be really painful, leave you rushing to the bathroom nonstop, and can even lead to leaks. So it’s no wonder you’re researching quick cures for bladder infections. 

The best thing you can do for fast relief from a bladder infection is to is see your doctor, and get an antibiotic. 

Antibiotics kill the bacteria that causes bladder infections and are the best way to stop a UTI in its tracks. They typically work pretty quickly, although be sure to take your medication for the full course, even if you’re feeling better sooner than that.  So, if you’ve been experiencing a UTI for more than a couple of days, make an appointment with your doctor now to get treatment.

In the meantime, there are a few things you can do for a little relief.

1. Drink water – lots of it. Getting in the recommended eight glasses of water per day can help flush the bacteria out of your bladder and make you heal a bit faster. Limit your caffeine or sugary drinks though, as they can irritate you bladder.

2. When you gotta go, go. Holding your urine when you really have to go gives time for the bacteria in your system to multiply, making it harder to get rid of.

3. Talk to your doctor about over the counter pain relievers. While these won’t cure a UTI, they may help give you a bit of relief while you’re waiting for the antibiotics to treat the infection.

4. Rest. Getting enough rest gives your body the energy it needs to be able to fight off an infection. Make sure you are getting the recommended 7-8 hours of sleep each night.

5. Wear loose clothing. Not only will this be more comfortable for you during this time, but it might also prevent bacteria growth. Bacteria grow the quickest in moist, warm environments so ditch the skinny jeans for a week or so and opt for loose trousers, skirts or dresses.

Follow the steps above for quick relief from UTIs.  

How to Get Rid of a UTI in 24 Hours: 7 Effective Home Remedies

You’ve heard of E. Coli before, but did you know it causes 90% of urinary tract infections?

The bacteria could get picked up in several ways, but the result is the same — pain! Are you experiencing painful urination, bloody urination, and abdominal pain? If so, then it’s likely you’ve got a urinary tract infection.

The discomfort is unbearable. So, you’re likely wondering how to get rid of a UTI in 24 hours. Read on to learn the top seven ways to treat your condition at home.

1. Water is Your Best Friend

When you first notice burning when you use the restroom, it’s tempting to reduce your water intake. After all, that will prevent the pain, right?

Wrong.

It seems counter-intuitive, but you need to flush out your system. You should drink plenty of water to help your body remove the E. Coli. Don’t overdo it, but drink as much water as possible in those crucial first 24 hours.

2. Cranberries

Cranberries can help when you have a UTI. Here’s how:

• UTIs happen when E. Coli attaches to your bladder
• Cranberries contain A-type proanthocyanids (PACs)
• PACs stop the bacteria from sticking to your bladder

Keep in mind that cranberries won’t cure an infection. They can help your body flush bacteria out. But, you’d have to ingest a strong concentration to eradicate them all.

3. Take a Sick Day

If you’re putting your focus on drinking more, then you’ll be urinating — A LOT.

It’s advised that you take a sick day for the first 24-hours. That way, you can stay close to the restroom and relieve yourself when you need to.

4. Consider Probiotics

Once E. Coli gets into your bladder, it’ll begin reproducing. It will start to invade and replace the ‘good’ bacteria that live in your gut and urinary tract.

Probiotics can help your body restore itself. It will increase the ‘good’ bacteria and prevent the ‘bad’ ones from taking over.

5. Eat Vitamin C

Vitamin C can help destroy bad bacteria due to its acidity. It will also help protect you from future infections, so start increasing your intake now.

6. Consume Garlic

Garlic doesn’t only ward off vampires. It also fights off bacteria like E. Coli. Increasing your garlic consumption can help you combat bladder infections.

It’s also effective with antibiotic-resistant UTIs.

7. Practice Good Hygiene

More than half of all women will experience at least one UTI. Many are unaware of their poor hygiene habits until they’ve experienced one.

Always wipe from front to back to prevent E. Coli from nearing your private space. Also, empty your bladder after having sex. If you’re prone to UTIs, then you should also avoid bubble baths and spermicide.

How to Get Rid of a UTI in 24 Hours

Are you experiencing painful urination and a constant need to run to the bathroom? If so, then you’re already wondering how to get rid of a UTI in 24 hours. The seven home remedies in this article can help.

If you’re still experiencing symptoms after 24 hours, then you need antibiotics. To get your hands on them, you’ll need to visit the doctor.

The doctors at Oxford Urgent Care will provide you with prompt treatment and relief. Check out our contact information and visit our office as soon as possible to remedy your UTI.

90,000 Urinary tract infections: symptoms and treatment

Urinary tract infections (UTIs) account for more than 8 million doctor visits each year and about five percent of all doctor visits. 40 percent of women and 12 percent of men will have at least one episode of symptomatic urinary tract infection during their lifetime. A bladder infection is called cystitis, and a kidney infection is called pyelonephritis. Kidney infections are much less common but more serious.

A few words about the urinary system of a healthy person

In the organs of the urinary system, urine is formed and accumulates, which is one of the waste products of our body. Urine is produced in the kidneys and travels down the ureters to the bladder. The bladder serves as a storage reservoir for urine, which is then emptied through the urethra. The urethra ends at the penis in men and the area above the vagina in women.

The kidneys are a pair of fist-sized organs located in the lumbar region and serve as a filter for the body, removing waste from the blood in the form of urine.The kidneys also regulate the balance of various chemicals in the body (sodium, potassium, calcium, phosphorus, etc.) and control the acidity of the blood. The kidneys produce some hormones that are involved in regulating blood pressure, stimulating the production of red blood cells, and promoting the development of strong bones.

The ureters are two muscular tubes that transport urine to the bladder.

Normal urine is sterile and free of bacteria.However, bacteria can enter the urine from the urethra and then travel to the bladder.

Symptoms of urinary tract infection

If you have a urinary tract infection (UTI), the lining of your bladder and urethra becomes inflamed and irritated, just like your throat during a cold. Possible pain in the lower abdomen and pelvic region, frequent urination with burning sensation in the urethra. While urinating, only a few drops of urine may pass out despite a distinct urge.You may also find that your urine has an unpleasant odor and is cloudy.

Kidney infections are often associated with fever and back pain. These infections need to be treated promptly because a kidney infection can quickly spread through the bloodstream and lead to life-threatening conditions.

UTIs are often classified as simple (uncomplicated) or complicated. Complicated UTIs can be considered when the urinary tract is abnormal or when the bacteria causing the infection are resistant to most antibiotics.

What are the causes of urinary tract infections?

A large number of bacteria live in the rectal area as well as on our skin. Bacteria can enter the urine from the urethra, from there into the bladder and even end up in the kidneys.

Just as some people are more prone to colds, many of us are prone to UTIs. Women who have gone through menopause have changes in the vaginal mucosa and a decrease in estrogen, which increases the likelihood of UTIs. Postmenopausal women with UTI may benefit from hormone therapy.Some women are genetically predisposed to urinary tract infections.

Sexual intercourse increases the incidence of urinary tract infections.

Women who use coils have an increased risk compared to those who use other forms of contraception. The use of spermicidal condoms also leads to an increase in urinary tract infections in women. In general, women are more prone to urinary tract infections because they have a shorter urethra than men, so the bacteria travel a short distance to the bladder.

Most likely to get a urinary tract infection in the case of anomalies of the urinary tract or in the case of instrumental manipulations (for example, a urethral catheter).

Endocrine diseases such as diabetes increase the risk of UTIs by weakening the immune system and therefore reducing the body’s resistance to infection.

Anatomical abnormalities in the urinary tract can also lead to UTIs. These disorders are common in young children, but are also possible in adults.

So how do you identify a urinary tract infection?

If you are concerned about this issue, then you should see your doctor.

The main types of UTI diagnostics are laboratory tests of blood and urine. A urine sample is examined under a microscope to look for signs of infection – bacteria or white blood cells in the urine. A urine culture is recommended to determine microflora and antibiotic susceptibility.

If you find blood in your urine, you should see a doctor immediately.Blood in the urine can be associated with an infection, but it can also be a manifestation of other formidable diseases such as urolithiasis or tumors of the bladder or kidneys.

How are urinary tract infections treated?

Simple UTIs are usually treated with a short course of oral antibiotics. A three-day course of antibiotics may be sufficient; however, some infections require longer therapy, up to several weeks. Depending on the type of antibiotic used, take one dose of the medication a day or up to four daily doses.Several doses of the medication can relieve you of pain or frequent urination, but you should still complete the full course of treatment prescribed by your doctor, even if all symptoms have already disappeared. If UTIs are not completely treated, they may return more than once. You should also remember to drink plenty of fluids.

If you have a complicated UTI, you need to take longer antibiotics and medications to improve your condition. Renal infections are generally considered complicated by UTIs.

What to expect after treatment for urinary tract infections?

An uncomplicated UTI usually resolves after a few days of antibiotic therapy and you do not need to have a urine culture to prove it is gone. If you have a complicated UTI, urine culture is required both before and after treatment.

Frequently Asked Questions:

What about my kidneys if I have a UTI?
If UTIs are treated in the early stages, then there will be no problems.Recurrent or untreated UTIs can lead to kidney changes if not addressed promptly.

Why do I have a UTI?
Most UTIs are carried once and never recur. Some patients have anatomical and genetic predispositions, which tend to make one person more susceptible than another.

How to avoid urinary tract infections?
There are some simple steps women can take to avoid urinary tract infections:

• Certain forms of birth control, such as spermicidal gels and coils, are known to increase the risk of UTIs in women who use them as contraception.
• You need to drink plenty of fluids – at least 2 liters per day.
• You should not endure the urge for a long time and you should not interrupt urination.
• Women are advised to wipe from front to back after using the toilet to prevent bacteria from entering the vagina or urethra from the anus.
• Urination after intercourse may reduce the risk of developing a UTI. Sometimes, taking a single dose of an antibiotic after unprotected intercourse can help prevent recurrence of UTIs.

When to worry?
If you have UTI symptoms that persist after treatment, or have UTI symptoms with nausea and vomiting, you should see your doctor right away. If you ever see blood in your urine, you should also see your doctor.

What if I am pregnant?
If you are pregnant and have symptoms of a UTI, you should see your doctor urgently. A UTI during pregnancy can put the health of the mother and baby at risk if the problem is not addressed quickly and correctly.

If UTIs keep repeating, can I ever get rid of them?
If you have recurrent urinary tract infections (three or more per year), then you should consult a doctor for further in-depth diagnosis. Additional imaging tests may be needed to rule out any urinary tract abnormalities.

Also, you may need a longer course of antibiotics in lower doses or taking antibiotics after intercourse.

Urologist’s advice: help with bladder inflammation

A persistent urge to urinate can be a sign of chronic bladder inflammation that needs to be treated urgently. But at the same time, there are a number of other reasons for the overactive bladder.

Frequent urination may indicate an inflammatory process called cystitis. Typical symptoms are burning or pain when urinating. This is often accompanied by an unpleasant feeling of heaviness in the lower abdomen.“Women are more likely than men to suffer from this ailment because their urethra is shorter and the bacteria that cause inflammation can more easily enter the bladder,” says Dr. med. Arndt Katzenwadel, Senior Physician, Department of Urology, University Hospital Freiburg.

In most cases, the acute form of this infectious disease is successfully treated with antibiotics recommended by a doctor.

In case of a sudden rise in temperature, chills, acute pain in the kidney area, nausea and general malaise, immediate medical examination is necessary.These symptoms may indicate pyelonephritis – an inflammatory process in the renal pelvis, which in its advanced form can lead to serious consequences in the form of renal failure.

Do not suppress pain, but treat it

In acute inflammation of the bladder, antibiotic therapy is a fairly reliable method of treatment. If the inflammatory process flows into a chronic form, and inflammation occurs very often, then therapy is more difficult. “Chronic bladder inflammation is often preceded by multiple urinary tract infections that have not been fully cured,” says Dr. Katzenwadel.The doctor can identify the causative agents of the disease and prescribe the appropriate therapy for the patient with the appropriate antibiotics based on the results of the urinalysis.

Violation of urination with incomplete emptying of the bladder contributes to the development of infections of the genitourinary system and may be associated with old age, menopause, and estrogen deficiency. In some women, infections enter the urinary tract almost regularly within a short time after intercourse. To avoid inflammation, it is recommended that you empty your bladder regularly, drink plenty of fluids, and avoid hypothermia.Frequent intercourse, especially in young women, increases the likelihood of urinary tract infection, so the doctor advises to visit the toilet as soon as possible after intercourse so that when the bladder is emptied, microbes that may have entered the urethra are mechanically excreted along with urine.

Irritated bladder

The urge to urinate is not always caused by an infection of the bladder. Dr Katzenwadel explains that a much more common condition is bladder irritation, also called “overactive bladder” or “irritable bladder syndrome.”It manifests itself in particularly frequent urination. Desires for it can be sharp and sudden, and uncontrolled urination can occur. “The combination of urge and involuntary urination, which cannot be controlled by volitional effort, gives a person great inconvenience, both physically and psychologically,” explains Dr. Katzenwadel. In some cases, overactive bladder develops with pathological processes in the peripheral nervous system, which is responsible for controlling urination.

The reasons for the overactive bladder are often not subject to precise explanation. Nevertheless, diseases such as acute inflammation, urolithiasis, tumors in the urinary tract area must be excluded here, and meanwhile, the problem of the intervertebral discs of the lumbar spine can also cause an overactive bladder.

Simple therapy for an irritated bladder

Simple measures such as stress relief, smoking cessation, alcohol and coffee can help reduce the symptoms of an irritated bladder.In addition, pelvic muscle training is recommended, as exercise to tension and relax the pelvic floor muscles often has a positive effect on the bladder.

If these measures do not give a positive result, the disease can be treated with drugs that suppress the activity of the bladder – the so-called anticholinergics. “Unfortunately, this can have side effects such as dry mouth or constipation. Now there are drugs of the latest generation that are better tolerated, ”says the doctor.

If conservative treatment is unsuccessful, endoscopic surgery is recommended. For this, botulinum toxin is injected into the muscle tissue of the bladder. This procedure does not give a permanent effect, therefore, the treatment must be repeated after 6-9 months. And an acute urinary tract infection can usually be effectively treated with antibiotic therapy prescribed by a doctor.

Urinary tract infection and the role of phytopreparations in its complex therapy | # 03/15

Urinary tract infection (UTI; synonyms: urinary tract infection, urinary tract infection) is a collective term denoting an infectious and inflammatory process in the urinary system without specifying its location and nature of the course.By localization, infection of the lower urinary tract (cystitis, urethritis) and upper urinary tract (pyelonephritis, abscess and kidney carbuncle, apostematous pyelonephritis) is isolated.

By the nature of the course, UTIs are divided into uncomplicated and complicated. Uncomplicated UTI usually develops in people without obstructive uropathy and structural changes in the kidneys and urinary tract, in the absence of underlying diseases. Complicated infections occur in patients with obstructive uropathies, urolithiasis, polycystic kidney disease, benign prostatic hyperplasia (BPH), against the background of bladder catheterization and / or with instrumental (invasive) research methods, as well as in patients with concomitant diseases such as sugar diabetes, gout, other metabolic disorders.

On occurrence, outpatient (occurring on an outpatient basis) and nosocomial (developing after 48 hours of hospital stay) UTI are isolated. At least 40% of all nosocomial infections are caused by UTI, caused in most cases by bladder catheterization [1-3].

Depending on the severity of clinical manifestations, UTIs are often subdivided into afebrile (mainly lower urinary tract infection), febrile (mainly upper urinary tract infection), and asymptomatic bacteriuria (BB).BB is a bacteriological diagnosis, which is established by examining urine collected with the maximum observance of sterility and delivered to the laboratory as soon as possible. According to the Infectious Diseases Society of America (IDSA), BB is isolated bacteriuria in a urine sample obtained under conditions that exclude contamination and in the absence of symptoms of urinary infection [4]. The diagnosis of BB can be established:

• if in two consecutive urinalysis in women without clinical signs of UTI, the same strain of microorganisms is isolated in an amount of ≥ 10 ⁵ CFU / ml;
• if in the analysis of urine in men without symptoms of UTI, a bacterial strain is isolated once in an amount of ≥ 10 ⁵ CFU / ml;
• if in the analysis of urine obtained during catheterization, both in men and women, a bacterial strain is isolated in an amount of ≥ 10 ² CFU / ml.

In the structure of infectious morbidity, UTI ranks second, second only to respiratory infections. Among the adult population, women are 30-50 times more likely than men to suffer from UTI, and during their lifetime up to 60% of women experience an episode of UTI. In every fourth patient of this age group, UTI recurs within a year [5]. In old and senile age, the frequency of UTI in women and men is gradually compared, which is due to the development of almost 100% of BPH, which disrupts urodynamics.In general, UTIs, including pyelonephritis, are significantly more common in women than in men. The prevalence of UTI in the pediatric population is 20–22 cases per 1000 children, and over the age of one year of life, girls are ten times more likely than boys.

In the structure of nosocomial infections, the share of UTIs can reach 40%.

Etiology

The main causative agents of UTIs are gram-negative bacteria from the family Enterobacteriaceae , of which mainly Escherichia coli (E.coli) . In uncomplicated UTIs, E. coli and other members of the family of Enterobacteriaceae account for up to 90–95% of all cases, while in complicated UTIs, the share of E. coli in the etiological structure decreases to 30–50% and Proteus spp. ., Pseudomonas spp., Klebsiella spp. , mushrooms (mainly Candida albicans ). A feature of complicated UTIs is a large proportion of microbial associations in the etiological structure (Table 1). one).

UTI treatment

The mainstay of UTI therapy is antibiotic therapy. As with other bacterial infections, the sensitivity of pathogens to antibiotics is critical when choosing a drug for empiric treatment of UTIs. An uncomplicated UTI is best treated.

Some of the most commonly used drugs for the treatment of UTIs are fluoroquinolones (levofloxacin, norfloxacin, ofloxacin, pefloxacin, etc.), which are indicated in many international guidelines as drugs of choice in the treatment of UTIs.However, at present, there is a rapid increase in the resistance of the uropathogenic E. coli to the drugs of this group. It is believed that when the level of resistance in the population is more than 10%, restrictions are imposed on the use of drugs. In Russia, the level of resistance of uropathogenic E. coli to fluoroquinolones, according to various studies, ranges from 4.3% to 12.9%, averaging about 7–8% [1, 2, 6, 7].

For the treatment of UTI in pregnant women and children, as well as in other categories of patients with intolerance to fluoroquinolones, the drugs of choice are amoxicillin / clavulanate, cephalosporins of II – III generations, fosfomycin trometamol, nitrofurantoin [8].The advantage of using amoxicillin / clavulanate is not only its high activity against E. coli (the level of resistance is lower than to fluoroquinolones), but also the absence of teratogenic effects, which makes it possible to use it in the first trimester of pregnancy [9, 10].

The efficacy and safety of the use of third-generation cephalosporins in children and pregnant women in the treatment of uncomplicated and complicated UTI has been proven [7]. A distinctive feature of the third generation cephalosporins is their high activity against microorganisms of the family Enterobacteriaceae , resistance to beta-lactamase action, and a long half-life [11].

The use of nalidixic acid and nitrofurantoins has certain disadvantages due to the need to use these drugs 3-4 times a day, as well as the weak activity of nitrofurantoin against Proteus spp. , And nalidixic acid against S. saprophyticus [12].

The duration of antibiotic therapy depends on the characteristics of the UTI. As a rule, in the absence of risk factors, antibiotic therapy is prescribed for 3-5 days for acute lower urinary tract infection, for 10-14 days – for upper urinary tract infections.In acute complicated UTI or in the presence of risk factors, the same antimicrobial drugs are used as in uncomplicated UTI, but the duration of therapy is increased to 7-14 days or more [13].

A feature of the treatment of UTI in childhood is a longer, compared with adults, antibiotic therapy with a mandatory course of anti-relapse treatment.

Antibiotic resistance is an important problem in the treatment of both complicated and uncomplicated UTIs.Thus, there is a high frequency of resistance of community-acquired strains E. coli to ampicillin (uncomplicated infections – 37%, complicated – 46%) and co-trimoxazole (uncomplicated infections – 21%, complicated – 30%), therefore, these drugs are not recommended as drugs of choice for the treatment of UTIs [8]. In addition, microorganisms colonizing the uroepithelium are capable of producing polymeric substances, creating a biofilm, inside which it is difficult for antibiotics and mucosal protective factors to enter.This allows them to “escape” the immune response and largely determines the resistance to antibacterial drugs [14, 15].

Therefore, despite the successes in the creation of new antibacterial drugs, the treatment of UTI, especially complicated and recurrent, remains an urgent task, often requiring in its decision the appointment of a combination of drugs or their successive change, long-term anti-relapse courses. This inevitably leads to an increase in the incidence of adverse drug reactions to therapy, and also forms a vicious circle, i.e.because frequent and prolonged use of antibiotics leads to an increase in the population of microflora resistant to them.

In recent decades, there has been a resurgence of significant interest in herbal medicine as a component of the treatment of UTIs. The medicinal properties of plants were well known to doctors of antiquity, traditional medicine of almost all peoples and countries uses them to treat various diseases. The action of phytopreparations within the framework of modern research appears to us in a new light, primarily from the point of view of overcoming antibiotic resistance and the ability to destroy the microbial biofilm on the urinary tract mucosa.

In the complex therapy of UTI, phytopreparations are used that have anti-inflammatory, diuretic, and hemostatic effects, which is important in the development of hematuria.

Herbal preparations can be used as separate infusions or herbal preparations. Components of various plants are also included in the composition of factory medicines.

The most widely used medicinal plants for UTI are presented in table. 2 and are also described below [16, 17].

Goldenrod (life-giving herb, core) – is widely used in folk medicine in various countries. In Germany, goldenrod infusion is recommended, first of all, for chronic inflammatory diseases of the kidneys and urinary tract, crystalluria and urolithiasis, as a diuretic. Goldenrod herb preparations have a hypoazotemic effect. Goldenrod herb contains flavonoids, saponins, organic acids and essential oil, which contribute to the destruction of bacterial cell membranes, carotene, ascorbic and nicotinic acids.

Bearberry (bear ears) – contains arbutin, which is broken down in the body into hydroquinone (an antiseptic that has an antibacterial effect in the urinary tract) and glucose. It is used in the form of decoctions (30 g per 500 ml), 2 tablespoons 5-6 times a day. Bearberry has an effect in an alkaline environment, therefore, taking a decoction must be combined with the ingestion of alkaline mineral waters (“Borjomi”), soda solutions. Apples, pears, and raspberries are used to alkalinize urine.

Field horsetail – has anti-inflammatory, diuretic and hemostatic effect.It is used for UTI, crystalluria and urolithiasis. Due to the high content of silicon compounds, decoctions, infusions and extracts of horsetail have a pronounced healing and vaso-strengthening effect, promote the dissolution of salt crystals in the urine, and accelerate the elimination of lead from the body.

Lingonberry leaves – have antimicrobial and diuretic effects. The latter is due to the presence of hydroquinone in lingonberry leaves. It is used as a decoction (2 tablespoons per 1.5 cups of water).It is prescribed 2 tablespoons 5-6 times a day. Also, like bearberry, it works better in an alkaline environment.

Knotweed (knotweed) – contains avicularin glycoside, tannins, essential oil, carotene, ascorbic acid. It is used as a diuretic, styptic and astringent. It has an antispasmodic effect on the urinary tract. It is widely used in folk medicine and is part of various fees.

Garden parsley is rich in flavonoids and essential oils.Has a direct effect on the renal tubules, thereby achieving a diuretic effect. It has an antispasmodic effect on the smooth muscles of the urinary tract and blood vessels.

Medicinal lovage (love potion) – mainly the roots of the plant are used for medical purposes. Contains essential oils, organic acids, coumarin, tannins. It has a pronounced diuretic and antibacterial effect. It is used for inflammation of the urinary tract, disorders of the gastrointestinal tract.As a rule, it is included in the combination of drugs and fees.

Wheatgrass creeping – contains essential oils, saponins, inulin, ascorbic acid, carotene. It has a diuretic effect thanks to inulin, the essential oil provides an antiseptic and anti-inflammatory effect.

Cranberry juice, fruit drink (contains sodium benzoate) – has an antiseptic effect (synthesis in the liver from hippuric acid benzoate increases, which, excreted in the urine, causes a bacteriostatic effect).Take 2-4 glasses a day.

Forest pine – the essential (turpentine) oil of pine has a pronounced bactericidal, anti-inflammatory and diuretic effect.

For chronic and recurrent urinary tract infections, various herbal preparations are used. They are prescribed, as a rule, for a long period, with an alternation of mainly bactericidal and diuretic charges. However, self-treatment with medicinal plants is fraught with some dangers.Components of many medicinal plants in large doses can be potentially poisonous and have a pathological effect on the functioning of certain organs. Therefore, from the point of view of safety in the complex treatment of UTI, preference is given to factory-made drugs, the correct dosage of which ensures high efficiency while maintaining complete safety.

One of the most widely used herbal remedies for the treatment of UTI is Fitolysin.Phytolysin contains an extract of a mixture of plants (goldenrod, horsetail, wheatgrass, knotweed, birch leaves, lovage, wheatgrass, parsley, sage, mint, pine and orange seeds, fenugreek seeds), due to which it has a diuretic, anti-inflammatory, antispasmodic effect, reduces crystal formation , promotes the dissolution of crystals and calculi and their excretion in the urine.

The drug is in the form of a paste for preparing a suspension, which makes it easy to dose and use.Adults are prescribed orally 1 teaspoon of paste, dissolved in 1/2 cup of warm sweet water, 3-4 times a day after meals. Phytolysin can be used in the complex treatment of UTIs together with antibiotics or after their use at the stage of anti-relapse therapy. The drug is widely used as a prophylactic agent for chronic inflammation of the urinary tract. The course of therapy with Phytolysin is 2–6 weeks and, if necessary, can be extended.

The effectiveness of medicinal plants in the treatment of UTI has been proven by centuries of experience of the peoples of the world.Modern combined phytopreparations, such as Fitolizin, occupy an important place in the complex therapy of UTIs and make it possible to increase the effectiveness of antibacterial therapy by overcoming the resistance of the pathogen to antibiotics, shorten the courses of antibiotic therapy, and reduce the frequency of unwanted drug reactions of their use.

Literature

1. Gales A. C., Jones R. N., Gordon K. A. et al. Activity and spectrum of 22 antimicrobial agents tested against urinary tract infection pathogens in hospitalized patients in Latin America: report from the second year of the SENTRY antimicrobial surveillance program (1998) // J Antimicrob Chemother.2000; 45: 295-303.
2. Mazzuli T. Resistance trends in urinary tract pathogens and impact on management // J Urol. 2002; 168: 1720-1722.
3. Ruden H., Gastmeier P., Dascher F. D., Schumacher M. Nosocomial and community-acquired infections in Germany. Summary of the results of the First National Prevalence Study (NIDEP) // Infection. 1997; 25: 199-202.
4. Nicolle L. E., Bradley S., Colgan R. et al. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults // Clin Infect Dis.2005; 40: 643-654.
5. Lindsay E. N. Managing recurrent urinary tract infections in women // Women’s Health. 2005; Jul, 1: 39-50.
6. Gridnev OV Clinical and pharmacological aspects of rational antibiotic therapy of urinary tract infections (clinical and economic multicenter study). M., 2006.S. 124.
7. Rafalsky V.V., Dovgan E.V., Ostroumova M.V. et al. Cefixime: clinical pharmacology and place in the treatment of urinary tract infections and gonococcal infections in women // Obstetrics and gynecology.2008, No. 6, p. 70-74.
8. A practical guide to antimicrobial chemotherapy. Ed. L. S. Strachunsky, Yu. B. Belousova, S. N. Kozlova M .: Borges, 2002; from. 384.
9. Sweet R. L. Bacteriuria and pyelonephritis during pregnancy // Semin. Perinatol. 1977. No. 1. P. 25–40.
10. Pasechnikov S.P., Ventskovskaya I.B., Nikitin O.D., Zagorodnyaya A.S. Modern approaches to the treatment of urinary tract infections in pregnant women // Medical aspects of women’s health.2012, No. 2 (53), p. 13-18.
11. Forti I. N. Medicina (B. Aires). 1994. P. 439-458.
12. Moiseev S.V. Practical recommendations for antibiotic therapy and prevention of urinary tract infections from the standpoint of evidence-based medicine // Infections and Antimicrobial Therapy. 2003, vol. 5, no. 3.
13. Maringhini S., Corrado C., Leone F., Pavone G. Controversies in the antimicrobial treatment of urinary tract infections // J Chemother.2006, May; 18 Spec no 3: 16–20.
14. Bondarenko VM The role of opportunistic bacteria in chronic inflammatory processes of various localization. Tver: Triada, 2011.
15. Erman MV Phytotherapy in the treatment of urinary tract infections in children // Effective pharmacotherapy. 2014, No. 2 (16), p. 18-22.
16. Okorokov A. N. Treatment of diseases of internal organs: a Practical guide. Volume 2. Minsk, 1997, 360 p.
17. Lavrenova G.V., Lavrenov V.K., Onipko V.D. From all diseases (medicinal plants of fields and forests). Directory. Donetsk: MP “Fatherland”, 1994, 523 p.

A.V. Malkoch ¹ , Candidate of Medical Sciences
N.N. Filatova, Candidate of Medical Sciences

GBOU DPO RMAPO MZ RF, Moscow

¹ Contact information: malkoch @ mail.ru

90,000 Antimicrobials for the prevention of urinary tract infections in adults undergoing cystoscopy

Review question

We reviewed the evidence for the benefits and harms of using antibiotics for cystoscopy (examination of the interior of the bladder) to prevent urinary tract infections (UTIs).

Relevance

Cystoscopy can cause urinary tract infections (UTIs).This intervention can cause unpleasant symptoms, such as a burning sensation when urinating from an infection confined to the bladder, or fever and chills from a more serious infection entering the bloodstream, or a combination of burning while urinating, fever, and chills. Antibiotics can prevent infection and reduce these symptoms, but they can also cause unwanted effects. It is unclear if people should take antibiotics before this procedure.

Characteristics of research

We found 22 studies with 7711 participants.These studies were published from 1971 to 2017. In these studies, participants had an equal chance of receiving an antibiotic or placebo / no treatment. The evidence is current to 4 February 2019.

Main results

Antibiotics given before cystoscopy to prevent UTIs may have little or no effect on the risk of a more serious infection spreading into the bloodstream.

They may reduce the risk of infection if both types of infections (serious infections with infiltration into the bloodstream and infections limited to the bladder) are considered together.

None of the participants included in the trial experienced serious adverse effects. Thus, we concluded that antibiotics used to prevent UTIs may not cause serious adverse effects, but we are very uncertain about this conclusion.

Antibiotics may also have little or no effect on minor adverse effects. They may also have little or no effect on infections limited only to the bladder, but we are very uncertain about this conclusion.Participants who received antibiotics were more likely to have bacteria that were more resistant to antibiotics, but we are very uncertain about this conclusion.

Quality of evidence

We rated the quality of the evidence as low or very low, which means that our confidence in the results was limited or very limited. The true effect of antibiotics on the prevention of cystoscopy-associated UTIs may differ significantly from what was found in this review.

Treatment of chronic cystitis in a clinic in Moscow

How to forget about pain forever

We publish the expert opinion of the Candidate of Medical Sciences, doctor of the highest category of urologist, urogynecologist Khalafyants Eduard Alexandrovich.

For your convenience, we have divided the article into subsections so that you can easily find answers to your questions.

How to understand that cystitis is chronic , What is cystoscopy , Modern methods of treatment , Causes and symptoms , Prevention , Cost of examination and treatment

Can chronic cystitis be cured?

Yes, I say recovery is possible.

I solve the problem of chronic cystitis that is resistant to antibiotics and all previous treatments.

Correctly established diagnosis, modern protocols of evidence-based medicine and effective drugs of the latest generation allow obtaining results even in the most advanced cases.

Usually they come to me after several unsuccessful courses of therapy, when it seems that nothing is helping. The story is roughly always the same:

• I have been suffering from cystitis for more than 3 years.In the last months, life can be compared to hell when you drink the best antibiotics on the advice of your doctor, but nothing helps!
• A few days of respite – and in a maximum of a week everything starts all over again! Constant terrible discomfort and pains such that I’m ready to scream. If you suffer, you go to the doctor again, to another. Prescribes other antibiotics. Injecting injections. You think – well, several courses should definitely work, these are not iron bacteria.
• And so these often recurring cystitis tortured me, I have no strength.I run to the toilet every 15 minutes, it’s uncomfortable in front of my colleagues, I go home with stops near every McDonald’s, because there are toilets. I won’t even stutter about my personal life …
• I don’t understand why cystitis often recurs: the legs are always dry, the coat is long. Why do these seizures occur? Maybe it’s psychosomatics? What to do, what to take so that this nightmare does not happen again? How to live if it is impossible to live like that ???

The fact is that acute and chronic cystitis are inherently different diseases.If in the acute form it is enough to get rid of the bacteria, and “everything will pass”, then with the chronic form, for many reasons, this number does not work. There are no pills for chronic cystitis.

You need to mentally prepare yourself for the fact that effective treatment of chronic cystitis is a complex, not quick and painstaking process that will require trust, patience, your assistance and self-discipline.

But the result, believe me, is worth it! Subject to certain rules, cystitis very often leaves my patients forever.

How to understand that cystitis is chronic

Before diving into the question, I propose to clarify the terminology. In the modern International Classification of Diseases (ICD 10), we find the only mention of chronic cystitis – a diagnosis under the code N30.2 – “other chronic cystitis”. Why alone? After all, there are many cystitis? The point is that the term “chronic” is outdated. Now the term “recurrent” is used instead. The old name is used by doctors and patients out of habit.And below I will also allow myself to use it loosely.

The problem of chronic cystitis is very serious. During a lifetime, every second woman encounters the disease, and in about 60% it becomes chronic. We can say that any cystitis is an inflammation of the bladder. This is where the similarities of cystitis end. And if an acute one can be cured with antibiotics, then with a chronic one it is useless and even sometimes harmful.

If inflammation of the bladder occurs no more than once every six months or twice a year, then each of the relapses is treated in the same way as the first acute attack.More frequent relapses – three or more cases per year – are already considered a chronic condition. In this case, the symptoms are usually persistent or disappear for a very short period. They acquire a “worn out” character – the urge to urinate ceases to be painfully intrusive, pains are often less pronounced and more like “discomfort”.

And now, about everything in order.

In case of illness, bacteria settle in the bladder, most often Escherichia coli. Due to the anatomical features of a woman, the intestinal flora, under certain conditions, through the urethra can enter the bladder and cause inflammation in it.The task of the bacteria is to gain a foothold and multiply. But normally, the epithelium of the bladder (urothelium) is covered with a protective layer against bacteria and toxic urine components – irritants. To survive, they need to neutralize the protective layer. Its destruction is one of the main causes of chronic cystitis.

Bacteria multiply at a tremendous rate – a whole generation grows in 45 minutes. Consequently, one, entrenched in a suitable environment for her, turns into a colony of millions of individuals in a few hours.

Of course, immunity is on guard – and if a person is healthy, then most likely there will be no cystitis. But colds, fatigue, hormonal imbalances, any chronic diseases, and even just wet feet and hypothermia – and bacteria begin to build their colony.

In order to protect against our immunity (and at the same time antibiotics), a colony of microorganisms creates an “invisibility cloak” – a biofilm, or biofilm from mucus. It is impervious to drugs, and under it, without knowing fear, they multiply until they are ready to invade new areas of the urothelium.Therefore, even after shock doses of antibiotics, recovery does not occur.

Theoretically, they can be destroyed, but the protective layer of the urothelium is restored very slowly. Aggressive components of urine continue to “eat away” the walls of the bladder, provoking pain. And literally every new bacterial attack on a defenseless urothelium can result in a new inflammation.

This is how the chronic form of cystitis develops, in which any remedy for the acute form stops working.At the same time, there may not be terrible exacerbations, but the woman feels the sluggish process constantly – with perhaps insignificant periods of relief. At this stage, women go to the doctor for YEARS, receive more and more antibiotics, treat exacerbations on their own, but the problem is not solved. However, urine tests may not show any infection. In parallel, a process is going on in our body that resembles a horror movie. On the one hand, incessant inflammation begins to change the very structure of the bladder, turning the mucous tissue into scar tissue.In this case, all the protective functions of the urothelium disappear with it. The regeneration necessary for recovery does not occur. At this stage, the chronic process, if not dealt with, begins to reproduce itself in an endless cycle.

Similar changes occur under the influence of genital infections (if cystitis was provoked by these pathogens). They also destroy the structure of the mucous membrane. Trying to protect itself from the toxic effects of pathogens, the body builds a “wall” of cells of stratified squamous epithelium.This condition is called squamous metaplasia (degeneration) of the epithelium of the mucous membrane of the bladder. As a result, the so-called leukoplakia of the bladder develops. An independent disease, which is often mistaken for cystitis, it also manifests itself in a variety of pains and urinary disorders.

On the other hand, the use of antibiotics makes bacteria resistant – that is, insensitivity to them. Bacteria inherit their ability to synthesize antibiotic breakdown enzymes.Therefore, if it is necessary to treat the infection, more and more powerful drugs have to be used. But this is a road to nowhere.

At recent conferences, all pharmaceutical companies unanimously declare that there will be NO NEW ANTIBIOTICS in the next 20 years.

I repeat: if you want to cure chronic cystitis and forget it like a bad dream, you cannot do with pills. We will need to restore the urothelium and the protective properties of the bladder in full, and this requires a number of procedures.

That’s what I’m doing. First, I make a precise diagnosis. Then I restore the mucous membrane of the bladder. If necessary, I treat the infection.

Cystoscopy, finding out what we are dealing with

Before you understand how to treat this or that type of cystitis, it is necessary to conduct a very thorough examination. The disease can have a very different nature and manifestation. Therefore, before starting, we need to understand who the enemy is and with what we will fight.

At the reception I will ask you:

• Describe your complaints – tell if any symptoms persist between exacerbations.Recall the frequency of urge to urinate, the intensity of pain in the urethra and vagina.
• Talk about hygiene practices (this is extremely important!) And your sexual habits.
• Recall the time of the first episodes of cystitis.
• Tell about past infectious diseases, including genital infections.
• Describe, if possible, what therapy was given earlier.

Perform the following surveys:

• General urinalysis with culture for flora and determination of sensitivity to antibiotics.
• Examination “on the chair” with the O’Donnel test – it allows you to exclude the anatomical cause of the disease.
• Get examined by a gynecologist.
• Study of urine and blood sediment for sexually transmitted infections (STIs).
• Ultrasound of the urinary and reproductive system.
• Tests for hormones.
• Uroflowmetry – according to indications.
• Cystoscopy with targeted bladder biopsy and biopsy examination.

Why is cystoscopy needed?

It allows you to accurately establish the diagnosis.Without cystoscopy, a woman can undergo many ineffective treatments for years. After a series of unsuccessful attempts, doctors shrug their shoulders and are often inclined to assume mental illness in such patients.

I think this cry from the forum will be more convincing than any of my words:

• Recommend a competent, experienced urologist who can help treat chronic cystitis.
• It is good if the doctor is a surgeon and does a cystoscopy with a biopsy. That is, you need a serious doctor who deals specifically with the problem of cystitis.
• Unfortunately, I did not find such a thing, everything is sent only for ultrasound of the kidneys (CT has already been done) and for urine analysis (it is also normal). But the problem has not been resolved, constant exacerbations with hematuria. The area is not important.

Cystoscopy is an obligatory stage in the diagnosis of chronic cystitis. It is better if it is performed by the same doctor who will carry out the treatment.

With its help, the doctor gets the opportunity to visually assess the state of the urothelium and, taking into account the results of the biopsy, to prescribe a competent treatment.Knowing the initial state of the mucous membrane, after the end of treatment, it will be easier for a specialist to assess the effectiveness of therapy. Conventional diagnostic methods are not enough for chronic cystitis. And that’s why. For example, in the vast majority of cases, if there are problems with the mucous membrane and bacterial biofilms, there are no signs of inflammation in urine tests. And ultrasound of the bladder, even against the background of leukoplakia, does not show any signs of changes in its walls. The fact is that in a chronic process, pathogenic organisms are not detected in urine tests.These are the so-called adherent microorganisms, which means that they coexist with the urothelium cell already at the membrane level. If, at the same time, you do not conduct an endoscopic examination, that is, you do not see the changes in the mucous membrane with your own eyes, but rely only on the test results, then there is a great risk of missing the true picture of the disease and making the wrong diagnosis.

There is another very important reason. The symptoms of chronic cystitis are not specific, and with the help of cystoscopy, we can identify other diseases, which means that we can prescribe competent effective therapy.

For my research I use a rigid cystoscope with the finest tip. A rigid mechanism has many advantages – it is stable, makes the procedure manageable and allows selective (targeted) biopsy to be taken accurately from suspicious areas.

I perform cystoscopy as delicately and accurately as possible, without pain. I will not be cunning: after the procedure, you will experience discomfort, which, however, goes away within a few hours. My patients never complain of acute pains during urination – everything is quite tolerable.

What is visible on cystoscopy?

My task is to investigate the urothelium in detail. By the nature of its changes, one can understand whether the protective functions of the bladder mucosa are preserved.

Normally, the mucous membrane should be pink or pink-yellowish, smooth and glossy. In chronic cystitis, the picture is different: the mucous membrane of the bladder is changed and can be whitish, villous, bullous – covered with pimples and balls, like pebbled skin. “Simple” inflammation is also different in appearance from squamous cell metaplasia.

Cystoscopy allows you to take a targeted biopsy – a piece of tissue from an altered part of the urothelium – for histological examination. In the laboratory, the doctor will study the features of the diseased area and help to accurately diagnose for signs of squamous metaplasia of the bladder mucosa. Also, the procedure allows you to take material contaminated with bacteria for analysis (I have already said that microflora from biofilms is not determined in a simple urine analysis).

Chronic cystitis – treatment.

I have already spoken about this above, but I consider it necessary to repeat it. The trouble is that many doctors organize the treatment of recurrent cystitis as well as the acute form of the disease. Unfortunately, antibiotics, pain relievers and physical therapy bring only temporary relief, since they do not affect the CAUSE of the disease. Only more or less prolonged remission is possible, which after each new course will be shorter and shorter.

With this approach, a woman’s life turns into hell and is built exclusively within the reach of the toilet – without any hope for personal life, companionship and career.Endless restrictions leave an imprint on the character – it is difficult to be an agreeable, kind and gentle cat when every day is against you, and even the night does not bring relief. Meanwhile, chronic cystitis is successfully treated if correct diagnosis is carried out before starting.

So, let’s get down to the main thing. If the chronic process has not passed into an advanced stage, I always give preference to non-surgical methods. I prescribe preparations from weakened strains of E. coli. Also called the urologic vaccine, it works the same way as the flu shot.These are tablet preparations that are absorbed in the intestine and are incorporated into the mucous membrane of the entire urinary system with blood currents. The necessary immune response is formed, the defense mechanisms of the bladder mucosa are restored. Now, as soon as E. coli tries to attach to the wall, it will receive a reliable rebuff.

Along with the vaccine for three months, I prescribe an antibiotic with an interval of 10 days. Thus, infectious agents that can enter the bladder are destroyed by a targeted blow.When using such a scheme, the intestinal and vaginal microflora does not suffer, since the balance of the intimate and intestinal flora is disturbed only against the background of a long, continuous course of antibiotic therapy. This is a tactic recommended by the European Urological Association and works well.

If, as a result of culture of a portion of urine taken during cystoscopy, pathogenic bacteria are found, I prescribe a course of antibacterial drugs, which I inject directly into the bladder cavity by instillation.This therapy has an effective effect on biofilms and restores the urothelium of the bladder.

By attacking on all fronts, we take control of the disease – and in the vast majority of cases, recovery occurs. Painful urination and burning sensation, pulling pains in the lower abdomen, pain during sexual intercourse disappear from your life. Compliance in the future with fairly simple recommendations regarding the way of life allows us to talk about a lifelong recovery. Three months after treatment, it will be necessary to pass tests again and perform a second cystoscopy.

Treatment of chronic cystitis in women after 50

Chronic cystitis occurs more often in women after 50 years than in young women. The reason is that the health of the bladder lining, its thickness, and the ability to resist infection are inextricably linked to estrogen levels. After 40-50 years, the production of estrogen decreases. The so-called hypoestrogenism develops – a chronic estrogen deficiency. As a result, tissue elasticity decreases, mucous membranes become thinner.The bladder becomes more vulnerable to pathogenic microorganisms. Immune defenses are also weakened, and literally “any little thing” can provoke a relapse.

Therefore, I try to prescribe at least topical estrogen preparations. This approach allows you to improve the structure of the mucous membrane and restore its ability to resist invasions of pathogenic bacteria.

The role of hormones in women for the preservation of the barrier function of the urothelium is today considered one of the key ones.Even a whole line of study of chronic cystitis is developing at the junction of urogynecology and gender endocrinology.

Reasons

Neither hypothermia nor wet feet by themselves lead to cystitis, no matter what our grandmothers say about this. This disease is initially bacterial in nature, and any weakening of the body (due to wet feet as well) simply gives it additional chances. Here is an incomplete list of factors that contribute to its development:

• Pol.Cystitis is more common in women – this is due to the peculiarities of the anatomy. The short and wide urethra is an open door for pathogenic microorganisms, and their natural reservoirs – the anus and vagina – are very close.
• Stagnation of blood in the small pelvis during sedentary work.
• Tendency to constipation.
• Consumption of significant doses of alcohol, salty and spicy foods, addiction to junk food.
• Attempts to self-medicate genital infections. Their particular danger is that inflammation against their background is asymptomatic for years.In doing so, they cause damage and degeneration of the mucous membrane, which persists even after successfully getting rid of STIs.
• Any other chronic infections (caries, tonsillitis, pyelonephritis, gastrointestinal problems …).
• Violation of hygiene rules: from wearing tight underwear made of artificial fibers to improper washing.
• Hormonal changes: pregnancy, menopause, menstruation.
• Endocrine diseases – diseases of the adrenal glands and thyroid gland.
• Stress, lack of sleep, chronic fatigue syndrome and other situations that weaken the immune system.
• Early onset of sexual activity, frequent change of sexual partners.
• Gynecological diseases: inflammatory processes, vaginal dysbiosis, etc.
• Older age, although recently cystitis has clearly “rejuvenated”.
• Genetic predisposition and anatomical features.
• Diseases of the stomach, intestines and liver, affecting the ability to absorb antibiotics and leading to a decrease in immunity.
• Taking antibiotics without sufficient reason and using substandard generic drugs (analogues).
• Emergence of pathogens resistant to a wide group of antibiotics.

Any of these factors can cause exacerbation of a chronic “sluggish” disease.

Symptoms

The disease is insidious in that it has many “masks”. It is difficult for a woman to understand that the symptoms are caused by cystitis, and not urethritis, cervicitis, vaginitis or leukoplakia, so at the first suspicion it is worth contacting a urologist.In order to develop effective treatment tactics, it is very important to exclude diseases that are similar in terms of symptoms and to make the correct diagnosis. In the acute stage, the signs of chronic cystitis do not differ from the symptoms of acute:

• Frequent urination.
• Difficult intermittent outflow of urine, which is accompanied by pain and burning, and ends with a feeling of incomplete emptying.
• Inability to urinate with a full bladder.
• Urinary incontinence.The outflow of fluid occurs involuntarily. Moreover, the urge can either arise unexpectedly or be absent altogether.
• Soreness and cramps when urinating in the lower abdomen, in the urethra or in the bladder, during sexual intercourse.
• Pelvic pain, discomfort in the pubic region.
• Aching and drawing pains when filling the bladder.
• Blood at the end of the act of urination.
• Sometimes the temperature rises, there are other indirect manifestations of cystitis.
• Appearance of night urge to use the toilet.
• Burning pains after urination.

These symptoms occur individually or in different combinations, if one of them appears, I recommend that you see a doctor immediately.

Based on patient complaints, chronic cystitis is divided into:

• Chronic latent. This form has very different manifestations. In one case, the inflammatory process is present, but it is detected only during cystoscopy, and does not manifest itself in any way with unpleasant sensations or in analyzes.In other cases, this form is occasionally exacerbated with manifestations of the type of acute.
• If laboratory tests, all symptoms and examination results indicate cystitis, but the reservoir function (that is, the function of filling and retaining fluid) of the bladder is not impaired, they speak of persistent.
• If there is a violation of the reservoir function on the face: the bladder fills with sharp pain, it is impossible to endure, which is why a woman goes to the toilet “often and a little bit” – this is interstitial cystitis.

How to avoid relapse

After treatment, we always give the most detailed recommendations on how to behave, what to eat, what to drink and what to take.

• Hygiene: shower twice a day, washing after defecation – strictly from front to back with previously washed hands.
• Change your synthetic underwear for breathable models – they can also be very beautiful and seductive.
• Don’t sit all day. A healthy bladder requires walking and adequate physical activity.
• Don’t overcool, dress for the weather.
• Treat all infectious and viral diseases in time – from ARVI and agnin to caries.
• After any antibiotic treatment, take care of the restoration of the intestinal microflora and “feed” her regularly – she loves white yoghurts without sugar, fruits, vegetables and whole grains.
• The same applies to the microflora of the vagina – the gynecologist will suggest drugs.
• Observe the mode of urination – you need to urinate regularly, every two hours, at least.Take this recommendation literally: even if your bladder does not seem to be full enough, go to the toilet literally “by the hour.”
• Observe the drinking regime: in the morning – 2 glasses of clean water (not carbonated or sweet). Then every hour you need to drink literally a few, in order to collect about 2 liters of water per day.
• Frequent, fractional and balanced diet. Hunger strikes are strictly prohibited: dieting is stress for the body. Refusal from proteins / fats / carbohydrates leads to a violation of the biochemistry and protective properties of the urothelium.If you need to fast, all restrictions must be introduced and monitored by a doctor.
• It is worth swimming only in a clean reservoir with warm enough water.

It is very important that the flora of the vagina and intestines is also stable and healthy. Therefore, against the background of the treatment of cystitis, we recommend visiting a gastroenterologist and gynecologist.

Are there any dietary restrictions?

A special diet is not needed, but I strongly recommend adjusting the nutrition. “Thank you” will tell you not only the bladder:

• Observe your drinking regime: two liters of water a day helps to eliminate uric acid and bacteria.
• Limit alcohol and eliminate colored sodas.
• Give up processed products and everything canned – chips, canned food, sausages. Products must be natural. These are foods that can be eaten raw and those that need to be cooked.
• And what can you do? Dairy products without sugar, white poultry meat, cereals, legumes and vegetables, fish, leafy vegetables.

How to have sex to avoid relapse?

The following paragraphs are excerpts from the official recommendation of the European Association of Urology.Some of them seem strange at first glance, but each point is justified.

• With a new partner, you need to get tested for STDs. Before obtaining results and 6 months after it is necessary, it is recommended to use condoms with intimacy (6 months is the incubation period of HIV infection).
• In addition to general hygiene procedures, it is recommended to brush your teeth well and use a mouthwash: the microflora of the mouth can cause inflammation of the urethra.
• Do not use saliva as a lubricant.
• If you want to continue having sex after anal penetration, you need to change the condom, wash your hands and genitals well.
• Be sure to urinate immediately after intercourse: nature has endowed us with a powerful defense mechanism. “I do not want”? Drink some water.
• Avoid hard sex.

Proper treatment, lifestyle changes and nutritional adjustments often allow you to completely get rid of recurrences of cystitis and never remember about it.

Cost

• Appointment (examination, consultation) at a urologist, consultative, primary, including drawing up a treatment plan 2 500 90 735
• Appointment (examination, consultation) at a urologist, advisory, repeated, including drawing up a treatment plan2 300
• Cystoscopy, category I (excluding the cost of anesthesia) 7 200 90 735 90 075
• Cystoscopy, II category (excluding the cost of anesthesia) 8 200 90 735 90 075
• Cystoscopy, category III (excluding the cost of anesthesia) 9 600
• Bladder biopsy.One locus (excluding the cost of morphological research) 1,500

90,000 Urinary Tract Infections vs Pregnancy: Treatment and Prevention | Medicinal chronograph

Summary. Urinary tract infections are one of the most common complications in pregnant women, which can lead to serious consequences not only in the expectant mother, but also in the child. When managing pregnant women with diseases of the urinary system, it is extremely important to choose the correct and, most importantly, safe therapeutic tactics.What drugs are safe during pregnancy? What obstetric and therapeutic tactics are most effective for kidney disease in pregnant women? What diagnostic methods are best used for asymptomatic bacteriuria, acute cystitis and pyelonephritis? Professor Olga Grishchenko , Head of the Department of Perinatology, Obstetrics and Gynecology, Kharkiv Medical Academy of Postgraduate Education, spoke about this in her speech during a training workshop for gynecologists “Actual Guidelines of Gynecology, Reproductology, Obstetrics”, which took place on March 29, 2019.in Kharkov. The event was organized by the MedExpert Group of Companies together with the A.A. Bogomolets and the National Medical Academy of Postgraduate Education named after P.L. Shupika.

Actuality of the problem

Urinary tract infections (UTIs) are the most common bacterial infections in outpatient practice; they rank second, second only to respiratory tract infections. According to statistics, 50% of women in the world have an episode of UTI at least once in their life, of which 25–40% relapse within 6–12 months.Every year, about 10% of women develop acute cystitis, and pyelonephritis remains the main reason for hospitalization during pregnancy for non-obstetric indications.

In the presence of a UTI in pregnant women, the risk of premature birth and rupture of amniotic fluid, chorioamnionitis increases, premature or functionally immature babies are born, and the level of perinatal mortality increases.

In the structure of UTI, asymptomatic bacteriuria is observed in 4-9.5% of pregnant women, acute pyelonephritis – in 12-25%, chronic pyelonephritis – in 33%, glomerulonephritis, urolithiasis – in 0.1-0.2%.

Risk factors and pregnancy

As a rule, infections, self-medication or improper treatment, asymptomatic bacteriuria, frequent UTI combined with inflammatory diseases (colpitis), lifestyle and nutrition can affect the occurrence of pathology of the urinary system.

Pregnant women have an increased risk of urogenital tract diseases. A high level of progesterone leads to the development of hypotension, hypokinesia, dyskinesia of the ureters and the calyx-pelvic system.In turn, the uterus compresses the ureter, there is a high intra-abdominal pressure, especially in primiparous. During pregnancy, the renal pelvis enlarge, the growing uterus squeezes the ureter more and more, the outflow of urine from the kidneys becomes difficult, urine stagnates, bacteria multiply in it and inflammation easily occurs.

Pathogens of infection can enter the bladder ascending (in inflammatory diseases of the urethra), descending (most often in tuberculous kidney damage), hematogenous (in the presence of a purulent focus in other parts of the body) and lymphogenous (in diseases of the genital organs) by way.

Classification of UTI in pregnant women

Among UTIs in pregnant women, asymptomatic bacteriuria, lower urinary tract infections (acute and recurrent cystitis) and upper urinary tract infections (acute pyelonephritis, chronic pyelonephritis in remission, exacerbation, latent course) are distinguished.

Cystitis in pregnant women: course, diagnosis

Cystitis is an inflammation of the bladder wall, one of the most common urological diseases, usually caused by an infection.Symptoms of cystitis in women are manifested in the form of increased urination, cramps and pain during urination, pulling sensations in the lower abdomen, weakness, fatigue, irritability, blood in the urine, cloudy urine, discharge of pus or yellow spots on underwear.

Normally, urination is not accompanied by pain. In women, painful urination can be caused by diseases of the bladder, urethra, or vagina. So, pain in the bladder, as a rule, is felt in the bosom, it can increase with urination or, conversely, decrease with emptying of the bladder.Urethral pain associated with urination is felt by the patient directly in the urethra and is usually aggravated by urination. If urine gets into the vaginal opening, it can cause pain if it is inflamed. Inflammation of the urethra is most often characterized by a bacterial nature and requires additional examination and treatment.

Primary diagnosis of cystitis involves examination by specialized specialists (urologist, nephrologist, gynecologist), as well as taking anamnesis and establishing possible causes of the disease (hypothermia, unprotected intercourse, taking medications, the presence of concomitant diseases).

Laboratory tests include urine analysis for cultures according to Nechiporenko (helps to identify the pathogen), general urine analysis (allows to detect erythrocytes, leukocytes, protein in urine; urine itself may be cloudy with an admixture of blood or pus), general blood test (reveals a picture of inflammatory process, it is possible to increase the erythrocyte sedimentation rate (ESR), leukocytosis). Among the instrumental methods, ultrasound examination (ultrasound) of the bladder, urethroscopy and cystoscopy (in case of violation of the passage of urine) are used.

Asymptomatic bacteriuria during pregnancy

Asymptomatic bacteriuria during pregnancy is dangerous for both the mother and the fetus; against its background, 25% of women develop acute pyelonephritis. According to the World Health Organization, about 8% of women have asymptomatic bacteriuria, and 15–57% of women with untreated asymptomatic bacteriuria develop symptoms of UTI (acute cystitis or pyelonephritis). Treatment of this disease during pregnancy reduces the risk of developing acute UTIs, premature birth, and low birth weight.

The diagnosis of asymptomatic bacteriuria can be established by detecting 10 ⁵ CFU / ml of one bacterial strain or 10 ² CFU / ml of uropathogen Escherichia coli in 2 urine samples taken> 4 hours apart and containing> 10 leukocytes in the field vision in the absence of clinical manifestations of UTI.

It should be remembered that the risk of this pathology is most real from the 9th to the 17th week of pregnancy. The only reliable method for diagnosing asymptomatic bacteriuria is the urinoculture method.

In accordance with Ukrainian and international recommendations for asymptomatic bacteriuria, it is recommended to conduct antibacterial therapy orally with a single dose of fosfomycin trometamol.

Pyelonephritis: diagnosis

Pyelonephritis is an infectious and inflammatory kidney disease of bacterial etiology with a primary and predominant lesion of the interstitium and tubular apparatus. The frequency of detection of pyelonephritis during pregnancy reaches 33%, mortality is 3.5%, maternal mortality from kidney disease in the structure of extragenital pathology is 8-10%, the frequency of gestational pyelonephritis is 11.5%.

Primary pyelonephritis in pregnant women is difficult to treat, may be accompanied by fever, chills, nausea, vomiting, pain in the lumbar region, pyuria, bacteriuria. As a rule, the right kidney is affected more often than the left, with the expansion of the calyx-pelvic system (according to ultrasound).

In acute pyelonephritis, mandatory research methods are general urine analysis (in 2 portions) once every 7 days, urine analysis according to Nechiporenko, general and biochemical blood analysis, bacteriological urine analysis, ultrasound of the kidneys and bladder, daily proteinuria, biochemical blood test, blood pressure monitoring, consultation with a urologist.Additional research methods – computed tomography without contrast or excretory urogram, nuclear magnetic resonance imaging – are carried out exclusively according to strict, sometimes vital, indications.

It should be remembered that dysuria in primary acute cystitis with a body temperature of 38 ^° C and chills may indicate acute ascending pyelonephritis. A sharp dysuric syndrome is characteristic of joined cystitis with exacerbation of chronic pyelonephritis.Urinary syndrome (proteinuria, leukocyturia, hematuria, etc.) can periodically disappear with a unilateral process and ureteral occlusion, in this regard, serial urine tests are necessary. The degree of leukocyturia does not always correspond to the severity of the inflammatory process. A single urine culture produces at least 20% false positives. Bacteriuria appears and can be detected 2 days earlier than pyuria.

Choice of drugs for the treatment of pregnant women with UTI

There are specific requirements for antibiotics for the treatment of UTIs in pregnant women.In particular, they should be effective against most pathogenic pathogens, be able to create a high concentration in organs – foci of infection, have a long half-life sufficient to maintain a high concentration of antibiotic in the blood, not have toxic and allergic effects, be well tolerated by patients, be harmless to mother and fetus.

It has been shown that for the treatment of pregnant women with acute cystitis, asymptomatic bacteriuria, acute pyelonephritis, it is advisable to use antibacterial uroseptics.In particular, fosfomycin trometamol has a bactericidal effect associated with blocking the bacterial enzyme involved in the synthesis of the cell wall, as well as an antiadhesive effect (destroys the fimbria of Escherichia coli, preventing it from fixing on the wall of the urothelium and promoting leaching from the urinary tract). After a single dose of the drug, the therapeutic concentration is observed for 48 hours (this is enough for urine sterilization and recovery).

An alternative to antibiotics are phytoneering drugs with antiadhesive and antibacterial activity, as well as anti-inflammatory, antispasmodic, nephroprotective properties.

Organization of care for pregnant women with UTI and prevention

Delivery of pregnant women with UTI (without obstetric pathology) is carried out through the vaginal birth canal, taking into account the obstetric situation.

Distinguish the degree of risk of pyelonephritis:

• I degree – uncomplicated pyelonephritis that occurs during pregnancy;
• II degree – chronic uncomplicated pyelonephritis, noted before pregnancy;
• III degree – pyelonephritis with hypertension, azotemia, pyelonephritis of a single kidney.

They must be taken into account when managing pregnant women. So, with I – II degree of risk, pregnancy can be prolonged, but with III degree (creatinine> 265 μmol / l, glomerular filtration rate <30 ml / min), pregnancy should be terminated.

Prevention of UTI in pregnant women should include sanitation of the vagina in violation of its microflora and other sources of infection (teeth, pharynx, etc.), normalization of bowel function, optimal water regime.

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Marina Kolesnik,
photo by author

90,000 symptoms, treatment, prevention we discuss with obstetrician-gynecologist

The weekend was great. You went on a hike with headscarves or went to the beach, where you swam to your heart’s content, and then sat in a cold wet swimsuit, or you went to a picnic, where everything was fine, except that on a cool evening you sat on the cold ground for too long … as a result, you feel a sharp pain when urinating, a feeling of inability to go to the toilet, you have to squeeze out the liquid literally drop by drop? Sadly, most likely, you have started cystitis.

Our consultant: obstetrician-gynecologist “EuroMed Clinic” Alina Vladimirovna CHAPLOUTSKAYA.

Cystitis is an inflammation of the bladder. This term is often used to refer to a urinary infection associated with inflammation of the bladder mucosa and impairment of its function.

The appearance of cystitis can be provoked by trauma to the mucous membrane of the bladder, problems with urination, diseases of the bladder and nearby organs (prostate, urethra, genitals), intestinal bacteria, stagnation of blood in the veins of the pelvis, hormonal disorders, vitamin deficiencies, hypothermia, etc.

Women are more likely to suffer from cystitis than men – approximately 20 to 40% of the female population have experienced this disease.

Cystitis is primary and secondary, acute and chronic, infectious and non-infectious. The symptoms of cystitis depend on the type of cystitis.

Symptoms

Acute cystitis is characterized by frequent urination, accompanied by “cutting” pain, hematuria (blood in the urine), discomfort in the lower abdomen, aggravated by urination, clouding of urine, fever, general malaise.

In chronic cystitis, symptoms may be virtually absent. The only thing that you can pay attention to is the increased urge to urinate.

Acute cystitis is diagnosed by the clinical picture – pronounced symptoms make it easy to identify this disease. Chronic cystitis is determined by characteristic symptoms, urinalysis results, bacteriological data, cystoscopy, functional studies of the lower urinary tract.

Treatment

Do not delay seeking medical attention! Only a doctor will be able to assess your condition and prescribe effective treatment, thanks to which you will forget about discomfort very quickly. With cystitis, antibacterial drugs are usually prescribed, as well as drugs that relieve spasm of the muscles of the bladder, which reduces pain.