Global Health Asia-Pacific May 2020 | Page 61

ALL YOUR QUESTIONS ABOUT UTI ANSWERED Q: What is Recurrent Urinary Tract Infection (UTI)? Are they common? A: Recurrent UTI is defined as at least two (2) infections in six months or three (3) infections in a year. The episode of UTI must be confirmed with positive urine culture. Recurrent UTI is one of the most common conditions affecting mainly women. It is estimated that about 50 – 60% of women will develop UTI in their lifetime. A: Generally, the treatment for recurrent UTI are “prevention” and use of “antibiotics”. Q: What are the different types of UTI? What are the causes to recurrent UTI? A: UTI can be divided into two (2) broad categories; uncomplicated and complicated. Prevention is always better than cure! An uncomplicated UTI occurs when the patient suffers from an isolated episode of UTI which has no structural or functional abnormalities of the urinary tract. A complicated UTI is usually presented with existing structural or functional abnormalities of the urinary tract. (e.g. urinary obstruction). Possible Causes Young and Pre-Menopausal Women Post-menopausal and Elderly Women Sexual intercourse Use of spermicide A new sexual partner A mother with a history of UTI History of UTI during childhood Blood group antigen secretory status Q: What is the treatment for recurrent UTI? History of UTI before menopause Urinary incontinence Atrophic vaginitis due to oestrogen deficiency Increased post-void urine volume Blood group antigen secretory Table adapted from EUA Q: Am I genetically at risk of getting recurrent UTI? A: Yes, there is a possibility. The antigens secreted by various blood groups may influence the response specifically on urothelial cells (cells on the surface of the bladder) thereby causing bacteria and lead to developing UTI. The frequencies of secretor status in different ABO blood groups are as follows: Drink plenty of fluids (at least 2 to 3 liters per day) Do not hold urine for a long time as this allows bacteria to multiply within the urinary tract resulting in UTI. Urinate regularly. Pass urine after sexual intercourse. Avoid using spermicidal contraceptives. Use diaphragms and vaginal douching with shower cream, soap or lotions instead. To wipe from front to back, which will reduce the spread of E. coli from the perigential area to the urethra. Avoid multiple sexual partners which will reduce risk of both UTIs and sexually transmitted disease. Take cranberries and probiotics products which have proven effective in preventing recurrent UTI in small studies. Use vaginal estrogen creams or rings which may reduce the risk of UTI in post-menopausal women. Antibiotics Before the UTI symptom begins (Self-start regime) After sexual intercourse (Self-start regime) Long-term low dose antibiotic regime If you are familiar with the symptoms and it has proven with a urine culture before, the urologist may advise you to self-start antibiotic treatment whenever you are experiencing the start of the UTI symptoms. If the UTI happens mostly after sexual intercourse, the urologist may advise you to self-start a 3-day prophylactic course of antibiotics after sexual intercourse. The urologist may advise you to take 3 to 6 months daily course of low dose antibiotics to prevent recurring UTI. This is usually advised when all conservative measurements fail. Blood Type Percentage Shirley Bang Shieh Ling (Dr) A 70.1% B 67.8% Senior Female Urologist at Advanced Urology Associates, the largest group of urology specialists in private practice in Singapore. AB 67.9% O 88.3% www.urology.com.sg For enquiries and appointments, please contact our Advanced Urology Associates clinics at Gleneagles Medical Centre 6 Napier Road, Suite #04-16,Singapore 258499 T: +65 6475 3668 F: +65 6475 7086 Appt: +65 6475 3668 Mt Elizabeth Medical Centre 3 Mt Elizabeth, Suite #17-14,Singapore 228510 T: +65 6735 0369 F: +65 6735 1317 Appt: +65 6735 0369 Excellence Mt Elizabeth Novena Specialist Centre 38 Irrawaddy Road, Suite #07-04, Singapore 329563 T: +65 6694 1838 F: +65 6694 1828 Appt: +65 6694 1838 | Professionalism Parkway East Medical Centre 319 Joo Chiat Place, Suite #02-05, Singapore 427989 T: +65 6881 0048 F: +65 6881 0049 Appt: +65 6881 0048 | Integrity Farrer Park Medical Centre 1 Farrer Park Station Road, #14-11, Singapore 217562 T: +65 6694 9722 F: +65 6694 9622 Appt: +65 6694 9722 | Compassion