Bladder Infections

Have you had a bladder infection this year? If so, you're not alone: each year, 13% of women (and 2% of men) experience the classic urinary burning and frequency that signal a urinary tract or bladder infection, often called “UTI” or cystitis. Anywhere from 30—50% of all women have at least one UTI in their lifetime. In the United States, there are more than 14 million UTI’s per year, nearly half a million of which require hospitalization. In adults 20-75 years old, these account for more than 8 million doctors office visits and account for direct costs of more than $3.5 billion.

The bladder is one of our most under-appreciated organs. We take it for granted until we have painful, embarrassing or scary problems: symptoms such as urinary frequency, urgency, burning, pain, leakage or bleeding. Despite the pain and disruption bladder symptoms cause, many patients ignore them out of fear or embarrassment. Myths and misinformation too often influence how women handle bladder problems.

The good news is that a little knowledge can go a long way towards restoring bladder health. Speaking up also helps. Your doctor won't know your symptoms if you don't tell him or her. Talking to your doctor is the first and most important step towards a diagnosis and a solution. One of the most common bladder problems are urinary tract infections. UTI’s are generally heralded by classic signs such as urinary burning, urgency, and lower abdominal pain or pressure. There may also be bloody urine. They are usually treated easily and quickly with antibiotics for anywhere from 3 to 10 days.

While UTI's in girls are relatively common due to poor toilet hygiene practices, the most important risk factors for UTI's in young women are a history of previous UTI's and frequent or recent sexual activity. Celibate women rarely have cystitis unless they have another risk factor (e.g. diabetes). While the use of spermicidal agents is very important to prevent unintended pregnancies and transmission of sexually transmitted diseases, it may increase the chances of a UTI by two to three times. Women with frequent recurrences are more likely to have a maternal history of cystitis and to have had cystitis at an early age.

The risk of UTI's also increases in elderly women living in institutional settings or who have conditions associated with impaired urinating or poor toilet hygiene. Estrogen deficiency may also contribute to UTI risk in postmenopausal women. Among generally healthy postmenopausal women, sexual activity is a less important predictor of cystitis than it is in younger women. Recurrent UTI's in this age group are more likely in women who have cystoceles (bladder prolapse) or urinary incontinence or in those who have previously had genitourinary surgery.

Most acute UTI's are uncomplicated and easily treated with a short course of oral antibiotics. However, occasionally, they can spread upwards towards the kidneys and cause an infection called pyelonephritis. Signs of these complicated infections include fever, chills, or lower back pain. Women at greater risk for pyelonephritis include those with diabetes, pregnancy, immunosuppression, previous pyelonephritis, UTI symptoms persisting for more than 14 days, or those who have structural abnormalities of the urinary tract. Although UTI's are generally fairly easy to treat, many women may have sporadic recurrences. Up to one half of women with a UTI may have another UTI within one year.

Antibiotic resistance has also become a significant problem with treating UTI's as well as other infections. Women whose symptoms are not resolved in 2-3 days should discuss this possibility with their physicians. While there is a medicine available over-the-counter without a prescription to treat urinary pain or discomfort (UriStat), this medicine does not treat the actual infection and taking it should not be considered a substitute for seeking medical attention. Another medicine to consider while taking antibiotics for a yeast infection: OTC probiotics will help prevent vaginal yeast infections, which often arise as a complication of antibiotic therapy.

Some women have persistent bladder pain with urgency and frequency without evidence of infection. This may be interstitial cystitis (IC). IC affects approximately 1.3 million Americans; more than 90% are women. Its cause is unknown and it is difficult to diagnose. This contributes to psychological, social, sexual, and hygienic problems for patients with IC. There is one FDA-approved medicine to treat bladder pain associated with IC: Elmiron®.

What should you do if you have any bladder or urinary problems? Drink a full glass of water every hour. . .and talk to your doctor.

Reviewed and Updated June 13, 2009

Created: 9/5/2003  -  Donnica Moore, M.D.