UTIs: Myths vs Facts

Urinary tract infections (UTIs) are more common in women than men. More than 50 percent of all women will experience a symptomatic UTI in their lifetimes. Why? One reason is that the urethra, the tube that carries urine out of the bladder, is shorter in women, so bacteria reach the bladder more easily.

Menopause changes the bacteria of the urogenital tract, which puts women at risk for UTIs. Intercourse may also predispose women to infections. Other causes may be anatomical, kidney stones, or foreign bodies, such as mesh which is sometimes used to treat stress urinary leakage or weakened pelvic muscles.

If you want to prevent or manage your UTI risk, you need to understand the difference between information you may find on the web and accurate medical information, says Laura Martin, M.D., a female pelvic medicine specialist at the University of Miami Health System.

Myth: UTIs are transmitted between sexual partners.

Truth: Sexual partners do not transmit UTIs. In men, infections are generally caused by an obstruction or abnormality in the urinary tract like a kidney stone or enlarged prostate, having recently had a catheter to drain urine, or having a neurological condition like Parkinson’s that might make draining the bladder difficult. Studies have also shown that uncircumcised men are more likely to get a UTI than circumcised men.

Myth: Poor hygiene causes UTIs.

Truth: E.coli, Enterococcus, Staphylococcus, Pseudomonas, or Klebsiella bacteria are the most common causes of UTIs and bladder infections.  Though general hygiene is important, we now know that urine is not sterile and an imbalance in the bladder bacteria or urobiome, the colony of bacteria living in the bladder, is the more likely culprit. When an imbalance occurs, you may experience a UTI.

Myth: My UTI symptoms should go away entirely after treatment.

Truth: After treatment, milk symptoms may linger for several weeks. During a bladder infection, you may experience pain with urination. Burning during urination is just one UTI symptom. You should also watch for frequent or intense urges to urinate, with very little urine, lower abdominal pain; cloudy or bloody urine; foul-smelling urine or feeling tired. However, if moderate to severe symptoms persist, it is important to notify your doctor.

Myth: UTIs are the only condition that causes pain with urination, frequency and urgency to urinate.

Truth: Other conditions such as interstitial cystitis, sexually transmitted diseases and dietary change mimic the symptoms of a UTI. You need a urine culture to ensure a proper diagnosis when you suspect you have a UTI.

Myth: I know when I have a UTI and I do not need to be evaluated by my doctor.

Truth: If you think you have a UTI, it’s important to talk to a healthcare provider. Only a prescription antibiotic can cure a UTI, and without treatment, the infection could get worse – progressing to a kidney or blood infection with more serious consequences like hospitalization, if left untreated. Your doctor will also determine which antibiotic is appropriate for you. “Complete the entire antibiotic course you are given to help prevent future antibiotic resistance,” says Dr. Martin.

Myth: Cranberry juice can prevent a UTI.

Truth: There are varying results in research studies regarding the effectiveness of cranberry juice in preventing UTIs. Most studies do not support drinking it for UTI prevention because it does not contain a high enough concentration of proanthocyanidins (PAC), the substance found in cranberry juice linked to urinary tract health. Juice is also high in sugar. You can use cranberry tablets, which have higher amounts of PAC, along with good hygiene and consultation with your physician.

Myth: If my urinary infection returns, it means my antibiotic didn’t work.

Truth: If your UTI returns after antibiotic treatment, you likely have a recurrence. That does not mean your antibiotic did not work if you completed the entire antibiotic course. However, your doctor will need a culture to determine if you are on the correct medicine. Dr. Martin says, “If you experience two UTIs in six months or three in one year, you have we consider this recurrence and you should ask your doctor to see a specialist to reduce that risk.”

Myth: Wiping front to back, avoiding tight clothes, and urinating after intercourse will prevent UTIs.

Truth: There is no evidence that any of these general hygiene methods help prevent UTIs. However experts still recommend them as they cost nothing and are easy to do. If it works for you, there is no reason to stop these practices.

Myth: There is not much I can do to prevent UTIs.

Truth: There are several things you can do to prevent UTIs in consultation with your physician. These include:

• Initial therapies: probiotics, vitamin C, cranberry tablets with proanthocyanidins
• Intermediate treatments: D-Mannose, vaginal estrogen cream
• Advanced therapies: Methenamine hippurate tablets, antibiotics, antibiotic bladder washes

A simple thing you can do is to drink more water! A study led by the University of Miami Miller School of Medicine has shown drinking more water every day significantly reduced the recurrence of urinary tract infections in women.

“If you feel you have a UTI ask your doctor for a urine culture prior to starting antibiotics,” says Dr. Martin.  “Remember, for women, if you have more than two UTIs in six months or more than three UTIs in a year, this is considered recurrence and you should ask your doctor to see a specialist to reduce that risk.”

Mary Jo Blackwood, RN, MPH, is a contributing writer for UMiami Health News. Based in St. Louis, MO, and Colorado, she has written medical articles and webpages for consumer publications and major university health centers.

Tags: Antibiotic Bladder Washes, antibiotics, cranberry juice, Dr. Laura Martin, Methenamine hippurate, PAC, proanthocyanidins, urinary tract infection, UTI