Signs of a possible urinary tract infection are burning, pain when urinating, wanting to go to the toilet all the time, low volume, and strong odor or blood in the urine. According to the Brazilian Society of Nephrology, women are more affected, but children, especially newborns, and the elderly are also at risk of having this problem.

Infectious scientist Thaís Guimarães, from Hospital das Clínicas, Faculty of Medicine, University of São Paulo (USP), says that it is very common for the urethra to be colonized by bacteria from the gastrointestinal tract.

“This is because, in both women and men, the urethra is very close to the anus, from which the stool comes out. When these bacteria get into the urethra and reach the bladder, they cause a urinary tract infection, also called cystitis. If, through the bladder, it manages to reach the kidneys, they will cause pyelonephritis, a kidney infection, which tends to progress to more serious cases and requires hospitalization, ”he explains.

Using intimate soaps can help minimize the problem. “Because they have an acidic pH, it can cause a change in the microbiota around the urethra, especially in women who have recurrent UTIs, because they reduce the amount of bacteria present in the area. “

Gynecologist and obstetrician Fernanda Torras agrees with her colleague, but stresses that the analysis must be done on a case-by-case basis. “The vaginal flora has a naturally acidic pH, with bacteria that help prevent infections. Some soaps, including intimate ones, contain chemicals that change vaginal pH, eliminating bacteria that help defend the area and interfering with the functioning of the vaginal immune system.

However, Fernanda points out, in cases of urinary tract infection (UTI), the ideal is to follow the doctor’s recommendations, which may include the use of a specific soap or even a suspension of it, using only water to wash the area.

Diagnosis
The diagnosis of urinary tract infection is made by physical examination, depending on the condition and physical and laboratory tests. An examination ordered by a doctor can confirm the suspicion and proceed with the indicated treatment. “The diagnosis of certainty is given by urine culture. The only treatment for UTI is an antibiotic, the only medicine that kills the bacteria that cause the disease. There are other types of pain medication or prevention, but not treatment, ”adds the gynecologist.

It is estimated that UTIs occur in up to 30% of women at some point in their lives. There is a peak in incidence early in sexual life, during pregnancy and a gradual increase after menopause, Fernanda explains. “In the event of recurrent urinary tract infection, it is necessary to consult a specialist to assess whether there is a predisposing factor and to indicate the best prevention method to use. Urinary tract infections of the bladder or urethra, if left untreated, can rise and progress to pyelonephritis [infecção do rim]. Although in most cases it is a reversible disease, if left untreated it can progress to chronic kidney disease, even sepsis and death ”

A recurrent UTI occurs when a person has more than three UTIs in six months, or more than six in a year. In this case, a medical investigation is necessary to verify that there is nothing obstructing the urinary system.

Prevention
The most common cause of obstructive pathology of the urinary system is the presence of stones, commonly called stones, explains infectologist Thaís Guimarães. “When stones are small, they can be expelled naturally, but sometimes very large stones have to be removed surgically. “

Good intimate hygiene of the genital area after a bowel movement or sex is the best way to prevent infections. Controlling diabetes is also very important to minimize the problem. Avoiding the use of tight clothing and wet panties also helps in prevention, in addition to hindering the proliferation of fungi and vulvovaginitis.

The gynecologist also has other recommendations to prevent the problem: “Have sex with a relatively full bladder and urinate soon after sex.” Drink plenty of fluids and avoid long periods without urinating ”,

Thais also recommends the use of cranberries. “Cranberry extracts reduce the ability of uropathogenic E. coli to adhere to the urinary tract epithelium. Escherichia coli is the bacteria responsible for around 80% of urinary tract infections and is a normal microorganism of our intestinal flora. Some strains are virulent and often responsible for urinary tract infections.

Women should also be careful when choosing contraceptive methods. “The use of diaphragms, cervical caps and spermicides increases the risk of recurrent urinary tract infection and can alter the vaginal flora. The doctor also advises the use of topical estrogen in postmenopausal women, especially if they have recurrent UTIs.

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