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Urinary tract infections: They are the bane of millions of women, and a new study finds that many people who suffer from them are unhappy that the diagnosis and treatment is still limited for this painful condition.
One of the biggest concerns researchers have is that many women believe that frequent use of antibiotics to treat urinary tract infections, or UTIs, might not be the best solution.
The study also noted frustration among women not getting more prevention help from their doctors. More than half of all women will experience a UTI in their lifetime, while a quarter will experience recurrent infections, the researchers noted.
“That’s really what inspired us to do this study… to dig a little deeper into that and understand,” said lead author Dr. Victoria Scott, urologist at Cedars-Sinai Medical Center in Los Angeles.
Doctors specializing in urogynecology often see the most serious cases of recurrent UTI, after patients have been seen by primary care physicians, Scott said.
The experience of treating women with recurrent UTIs led to the holding of six focus groups where participants were asked what they knew about UTIs, prevention strategies, treatment and impact on their quality of life.
The research team found that the women in the focus groups were frightened and frustrated.
“The problem is waiting for the results… and you are in a lot of pain and you could get worse,” said one study participant.
Another participant said it took her four or five months to get her system and head back to where they were supposed to be after the infection and the antibiotics.
The women in the focus groups were well aware of the risks of developing resistance to antibiotics.
Many believed they had been given antibiotics when they had a different health problem, such as an overactive bladder. Some patients had developed an infection from the antibiotic resistant It’s hard bacteria.
“I also sometimes think that I create a UTI freak that will be resistant to anything,” said one woman.
Women felt that the impact of UTIs on their lives was greater than the medical profession recognized, and they wanted more research into non-antibiotic options.
“I think that today women, as they become more educated and understand much better antibiotics and the pathophysiology of urinary tract infections, are asking for more education and more development of an action plan. from their doctors for when they develop symptoms, ”Scott said.
New strategies are needed to help limit and target antibiotic use, researchers say.
The female urethra is much shorter than the male urethra, which can make it easier for bacteria to enter the bladder, Scott said.
Some women will go through periods in their lives when they will not have UTIs for years, but then recurrent infections could start, which happens for about a quarter of women.
Common periods of recurrent infection include during and after menopause, as well as when a woman becomes sexually active.
“I have to say that for the majority of women, when we assess them, we don’t find specific anatomical or physiological issues that we can fix, which I think is more frustrating for a lot of women than we can. identify a problem, we can actually fix it, ”Scott said.
Although antibiotics are often the most effective treatment option, some studies have shown that about 40% of UTI episodes can be eliminated by using ibuprofen alone to treat symptoms, Scott said.
There is a certain risk of developing a kidney infection if you do not treat the bacteria.
“Our group is excited about hopefully developing faster diagnostics that can tell us what bacteria is growing, if any, and then, very importantly, also antibiotic sensitivities,” Scott said.
“So that when a woman calls us or comes to the clinic with symptoms, we don’t have to guess, number one, is it a urinary tract infection or not? And then, number two, we don’t have to guess which antibiotics are best to treat it, ”Scott said.
The research will appear in the September issue of the Journal of Urology.
A variety of alternative treatments include cranberry supplements, a particular antiseptic drug, probiotics, and vitamin C, but data is mixed on all of these options.
Some topical hormonal treatments may be helpful for postmenopausal women, said Dr Warren Bromberg, urologist at Northern Westchester Hospital in Mount Kisco, NY, who was not involved in the study.
The best prevention tool is hydration, said Bromberg. Reducing both constipation and diarrhea can also reduce the risks.
One solution to getting a faster diagnosis, when a urine culture can take three to five days, is a urinalysis that can be done quickly, Bromberg said.
It won’t confirm a UTI, but it may suggest one because of certain markers that would appear in the urine.
“It’s a bit of a catch-22 because: A. [patients] don’t want to wait because they’re quite uncomfortable, but B., as they mentioned in the article, they’re not really excited about taking the antibiotic in the first place, ”Bromberg said .
The best solution for recurrent UTIs and frustration would be for the doctor to sit down with the patient, consider their specific needs, and develop an individualized plan that the patient is comfortable following, said Bromberg.
“You are trying to solve this problem together,” Bromberg said. “We need a lot more research on this, that’s the other thing they point out, we need a lot of research. [Researchers] looked at the vaccines. It has not yet been a great success. We really need more to help women. “
More information
The United States Centers for Disease Control and Prevention has more information on urinary tract infections.
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