Urinary tract infections are so common among females that at least one third of women will have at least one UTI in their lifetime.

Some women have RECURRENT UTIS due to a variety of factors. Recurrent UTI is defined as 3 or more attacks in a year or 2 UTIs in 6 months. It warrants investigation for underlying issues and preventive measures.

The term UTI implies that a part of the urinary system that is the bladder , ureter or kidneys is having a bacterial infection.

The commonest UTI in women , is a bladder infection. This is because the women’s urethra is only 3-4 cm long and the urethral opening is more or less enveloped in the vaginal opening. This makes the first third of the urethra open to any bacteria present in the vagina. Uropathogenic bacteria that have the ability to climb up, stick on the bladder wall and multiply will cause a bladder infection

What are the symptoms of a Bladder infection ?

Typical symptoms of a UTI are urinary frequency , urgency , painful urination , incomplete emptying , suprapubic pain and passing visible blood. Less common symptoms are urinary leakage , frequency at night , backache and vaginal discharge. One may have only one or a combination of the above symptoms. The more symptoms occurring , the higher the likelihood that it is a UTI.

Will a UTI go away on its own?
It is estimated by different studies that 20 to 50% of simple UTIs can go away on their own . This largely depends on how virulent the bacteria is , the natural host immunity and what measures were taken to deal with the UTI.

If the symptoms go away and one feels 100% back to normal, carry on with the UTI clearing measures for another week and observe for recurrence. In a third of the time, it truly goes away but often , symptoms recur a few weeks to months down the line.

Therefore its not recommended to leave a UTI untreated as the consequences of a festering UTI include ascending into a kidney infection or chronic bladder oversensitivity.

It is especially not recommended if there are symptoms like fatigue or fever, difficulty in emptying the bladder, flank or abdominal pain or blood seen. One should seek medical attention as soon as possible if such symptoms accompany a UTI.

What can I do to prevent UTIs ?

Starting with the gut - avoid constipation . Make sure to have a good wash after bowel movements followed by a spray with water from the front down.

Avoid spermicide , latex , douches , bubble baths or hot spas as these may affect the natural protective vaginal flora.

Drink adequate amounts to ensure having to pass urine 6 to 8 times a day to flush bacteria out of the urethral opening .
Cranberry and Mannose help prevent the bacteria from sticking to the bladder wall and helps flush away the bacteria with the urinary flow.

Taking vaginal probiotics help as they compete with the bad bacteria for nutrients. These probiotics also make lactic acid, surfactants and hydrogen peroxide among others, making a hostile environment for these bacteria.

At Pearllyn Quek Urology we assess patients with recurrent UTI for bacterial persistence and patient related factors that lead to recurrence. Only after addressing these issues, if any , can true prophylaxis or preventative measures work. We use a step wise approach based on a patient’s ’ risk profile. The mainstay of prevention other then the usual hygiene protocols is to restore vaginal eco disbalance and ensure timely bladder clearance. Prophylactic antibiotics are utilised where appropriate. A sublingual UTI vaccine showing promising results has also just come into the field.