One of the most common reasons that patients visit us is for repeated urinary tract infections. For most patients this is the same as a ‘bladder infection’ but it can also refer to kidney infections or prostate infections. Both men and women can suffer from this condition but the causes can be different.
UTIs can present with blood in the urine, pain with urination, frequent or urgent urination, back pain, fever or generalized weakness. Older individuals, in particular, may become confused or very tired without any urinary symptoms. Some patients, especially those with a catheter or neurologic disease, may be found to have bacteria in their urine without any symptoms at all.
Many times, patients will feel that they have a urinary tract infection but no bacteria is found. Such patients are often treated with various antibiotics and can even feel better for a short period of time before the symptoms return. Interstitial cystitis is a chronic inflamatory bladder condition that can seem like recurrent bladder infections.
In men, frequent bladder infections can be a sign of an enlarged prostate or urethral stricture disease as they both can lead to incomplete emptying of the bladder. Treatment is then geared towards the underlying condition.
Women are more often referred for frequent UTI’s and we rely heavily on the labs from the primary care doctor’s office to understand what bacteria are found in the urine. More than 2 infections in six months or 3 infections in a year are considered abnomal.
In younger women, our evaluation is focused on possible anatomic causes including: vesico-ureteral reflux, kidney blockage and kidney stones. In older women, we will look for incomplete bladder emptying, chronic constipation, bladder prolapse and poor vaginal tissues from a lack of estrogen. All women will be advised to follow our Strategies to Reduce UTI’s.
A full evaluation may include radiologic studies and possibly a cystoscopy.
In patients where no reversible cause for UTI’s are found, we will work to reduce the burden of infections by making testing and treatment easy to access.