Breaking the silence around UTIs
Concerned you may have a urinary tract infection? You are not alone. About 50-70% of women will experience a UTI at some point in their lifetime. Still, it can be difficult to discuss such a personal subject with others. In the absence of open dialogue, myths and misconceptions about UTIs can take hold, affecting how women relate to their own bodies.
"There is no reason to be embarrassed about a UTI," emphasizes Mary Rieger, M.D., a UT Medicine female pelvic medicine and reconstructive surgeon who provides urogynecology services through Women’s Health, a clinical partnership between UT Medicine and Ascension Seton.
As a urogynecologist, Rieger treats conditions affecting the female genitourinary tract, which includes the reproductive organs as well as the bladder, ureter and urethra. Here, she tackles some of the most common questions women have about UTIs.
What is a UTI?
"A urinary tract infection is a bacterial infection of the urinary tract, most often affecting the bladder or urethra," says Rieger.
Symptoms of a UTI include:
- Bladder pain
- Burning or pain with urination
- Increased urinary frequency or urgency
How are UTIs diagnosed and treated?
"A UTI can be diagnosed and treated by a primary care provider," explains Rieger. "Urine testing that screens for pathological bacteria growth and inflammation is used to diagnose UTIs, and oral antibiotics are the most common treatment method. It is important to take your full course of antibiotics even if your UTI symptoms go away."
Is a UTI a cause for concern?
"Most UTIs are very manageable. However, a more advanced infection of the urinary tract in which it has travelled to the kidneys requires immediate medical attention and should be addressed at an emergency department," warns Rieger.
Signs of an advanced UTI include:
- Fever
- Inability to tolerate the oral antibiotic treatment regimen for UTI
- Severe pain along the side of the abdomen
- Vomiting
How can I prevent a UTI?
"Not only can proper intimate hygiene help you avoid UTIs and infections of the vagina and vulva, but good habits can also help prevent uncomfortable irritation," shares Rieger.
Tips for good intimate hygiene:
- Avoid using douches and wipes; wash the external genitalia only with gentle soap and water
- Avoid undergarments made of tight-fitting or synthetic fabrics; remove wet swimsuits or exercise clothing as soon as possible
- Change tampons or pads regularly; reusable products, such as menstrual cups or period underwear, should be cleaned thoroughly and often
- Drink plenty of water
- Urinate shortly after sexual activity
"While feminine hygiene may help prevent infection, developing a UTI does not imply you have poor hygiene," notes Rieger. "Patients who experience frequent UTIs often feel ashamed of their hygiene habits, but repeated infection can be a sign of an underlying health concern."
"Additionally, when patients feel that they or their partner are doing something wrong to cause their recurrent UTI, this can cause psychological distress and even increased tension in intimate relationships," adds Rieger.
What causes recurrent UTIs?
"Recurrent UTIs may be linked to genetic factors, immune differences or an untreated medical condition," notes Rieger. "Anyone who experiences two infections within six months or three infections within 12 months should seek medical attention to determine the underlying cause of their condition."
Potential causes of recurrent UTIs may include:
- Conditions that cause urinary retention/incomplete bladder emptying
- Neurologic conditions, such as multiple sclerosis or spinal cord injury
- Vaginal prolapse
- Conditions that weaken the immune system
- Kidney stones
- Postmenopausal changes in the genitourinary tract
Explore answers to commonly asked questions about menopause provided by Women’s Health experts.
How are recurrent UTIs treated?
"Treatment for recurrent UTIs depends on the condition’s underlying cause," explains Rieger. "In many cases, the cause of a patient’s recurrent UTIs can be identified and treated by a primary care provider."
"Some causes of recurrent UTI may require care from a specialist," continues Rieger. "As a urogynecologist, I commonly treat patients who develop recurrent UTIs after menopause due to immune system changes in the genitourinary tract. A vaginal estrogen treatment can help restore these immune defense mechanisms."
"For patients with difficulty emptying their bladder due to vaginal prolapse, I can correct their prolapse surgically or with a vaginal pessary, a removable device that supports the pelvic organs while it is in place," adds Rieger.
What other conditions can a urogynecologist treat?
"Urogynecologists are board-certified, fellowship-trained gynecologists who undergo additional training in urogynecology and pelvic reconstructive surgery," explains Rieger. "We specialize in correcting structural abnormalities of the female genitourinary tract, specifically pelvic floor disorders."
Conditions treated by the Urogynecology care team include:
- Anal/fecal incontinence
- Cystocele
- Fistulas
- Frequent urinary tract infection
- Interstitial cystitis
- Labial hypertrophy
- Overactive bladder
- Pelvic organ prolapse
- Perineal descent
- Post-hysterectomy prolapse
- Rectocele
- Urethral diverticulum
- Urinary incontinence
- Uterine prolapse
