8/13/2016

PreventionofUrinaryTractInfectionsinWomen:GeneralGuidelinesandSuggestions,SterilizingWashclothsforHomeUse,SummaryofTips

PreventionofUrinaryTractInfectionsinWomen
Author:JohnLBrusch,MD,FACPChiefEditor:MichaelStuartBronze,MDmore...
Updated:Aug17,2015

GeneralGuidelinesandSuggestions
Thereareanumberofgeneralguidelinesandsuggestionsthatwillhelpwomen
avoidurinarytractinfections(UTIs)inmostinstances.Thesemaybeconveniently
dividedintothecategoriesofhygiene,clothing,diet,activities,andmedications.
MostUTIsareascendinginfectionsofbacteriathatcolonizethevaginalwalland
eventuallytheurethra.Fromtheurethra,thebacteriacantravelupwardsandinfect
thebladder(lowertractinfection)orcontinuefromthebladderuptheuretersand
infectthekidneysthemselves(uppertractinfection).Theeffectivepreventive
measuresareabletoblockthisbacterialmigration.
GotoUrinaryTractInfectioninFemalesforcompleteinformationonthistopic.

Hygiene
Wipefronttoback.Alwayswipefromthefronttothebackafterusingthe
bathroom.Donottrytoreachfrombehindbecausegermsfromtherectumcanbe
transferredtothehandandtissue.Afterbowelmovements,cleantheareaaround
theanusgently,wipingfromfronttoback.Neverwipetwicewiththesametissue.
Anywipingmotionthatstartsnearertotherectumandthenapproachesthe
bladderopeningareamovespotentiallypathogenicbacteriaclosertothebladder.
Takeshowersandavoidprolongedbaths.Bathwatermayfairlyquicklybecome
contaminatedbythebather'sownskinflorae.Sittinginatuballowsbacteriato
reachthebladderopeningarea.
Washproperly,fronttoback,intheshowerorbath.Rinsewellandrememberto
wipecorrectlyfromfronttoback.Doucheshavenoprovenbenefitinpreventing
ladderinfections.
Usetamponsforperiods.Tamponsareadvisedduringthemenstrualperiodrather
thansanitarynapkinsorpadsbecausetheykeepthebladderopeningareadrier
thanasanitarypad,therebylimitingbacterialovergrowth.
Extremelyeffectiveisavoidinglongintervalsbetweenurinating.Trytoemptythe
bladderatleastevery4hoursduringthedaywhileawake,eveniftheneedorurge
tovoidisabsent.Whenfeelingtheneedtoemptythebladder,donottrytoholdit
untilamoreconvenienttimeorplace.

Clothing
Donotweartightfittingundergarmentsmadeofnonbreathingmaterials.Withsuch
fabrics,accumulatingmoisturebuildsup.Thisleadstomacerationoftheskinand
bacterialovergrowthadjacenttotheopeningofthebladderCottonunderwearfor
generaluseissuggested.

Diet
Drinkmorewater.Startwith1extraglasswitheachmeal.Iftheurineappearsany
darkerthanaverypaleyellow,thismeansnotenoughliquidisbeingingested
increasethefluidintake.
Cranberryjuiceandcranberrypillshaveunprovenbenefitinreducingurinary
infections.Theyappeartobemosteffectiveinyoungerwomen.

Activities
Whenengaginginphysicalactivityandexercise,makesuretoemptythebladder
frequentlyanddrinkplentyofwaterandotherfluids.
Takespecialprecautionsaftersexualactivitysuchactivitymayalsoincreaserisk
becauseitcanintroducebacteriaintothebladderarea.Thebladdershouldbe
emptiedafterintercoursedrink2extraglassesofwater.Somepatientsareadvised
bytheirphysiciantotakeaurinaryantisepticorantibioticaftersexualactivity.Make
suretotakethemedicationaccordingtothephysiciansrecommendation.
Avoidtheuseofspermicidaljelly.Thiskillsspermaswellasnormalvaginalflorae,
whichareextremelyimportantinsuppressingcolonizationwithpathogenicbacteria.

Medications
Anestrogenvaginalcreammayhelpincreaseresistancetobladderinfections.An
estrogencreamforthevaginamaybesuggestedforwomenaftermenopauseeven

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PreventionofUrinaryTractInfectionsinWomen:GeneralGuidelinesandSuggestions,SterilizingWashclothsforHomeUse,SummaryofTips

ifanoralestrogensupplementorpatchhasalreadybeenprescribed.Thecream
helpskeepthetissuesaroundthebladderhealthyandmoreresistanttoinfection.
Takeantibioticsonlyasprescribedbyadoctor.Ifamedicationhasbeenprescribed
aspreventivetherapy,followthephysiciansinstructionscarefully.Beawarethat
medicationsmaybenecessaryforuptoayearormoredependingonthenature
andseverityoftheurinaryinfectionproblem.
Forsomepatients,asmallamountofurinaryantibioticorantiseptictakendaily
preventsmosturinaryinfectionsandallowsthebladdertohealandrestoreits
naturalresistance.Otherpatientsmaybetoldtotakeanantibioticonlywhenthey
thinktheyaregettinganinfection.Takeanyprescribedmedicationexactly
accordingtothephysiciansadvice.Contactthephysicianorpharmacistifnoclear
instructionsareonthebottleofmedicine.

Furthersteps
Theguidelinesandsuggestionslistedabovehelpmostwomenavoidbladder
infectionsmostofthetime.Ifaninfectiondevelopsinspiteoftheseprecautions,
promptlyseekmedicalhelp.Aurinespecimenforexaminationshouldbeprovided.
Seekpromptattentionforexcessivevaginaldischargeorothersignsofvaginal
inflammationandinfection.Ifanantibiotichasbeenprescribedforthispurpose,
begintakingit.Insomecases,thephysicianmayrequestadditionaltests(eg,
kidneyradiographsorexaminationofthebladder).

SterilizingWashclothsforHomeUse
Sterilizingwashclothsforwashingandpersonalhygienetohelppreventrecurrent
UTIsmayberecommended.Thisextrastepisprobablyunnecessaryformost
patientswithrecurrentinfections,butforthemoreresistantorseverecases,itmay
beveryhelpful.Homesterilizationofwashclothsisonlyonepartofanongoing
programtohelppreventtheseinfections.Useonlythosewashclothspurchasedfor
thispurposeandremembertowipecorrectly,fronttoback.
1.Washthewashclothswithhotwaterandsoapinaclotheswasher.Ifa
clotheswasherisunavailable,usesoapandhotwaterinthesink.
2.Boilthewashclothsinwaterforatleast20minutes(optional).
3.Takethewashclothsoutofthewaterandallowtodryoruseaclothesdryer.
4.Whendry,placeeachwashclothinaseparatesealableplasticbag,suchas
aziplockbag.Leavethebagsopendonotsealthemyet.
5.Placethebagscontainingwashclothsinamicrowaveoven.Putalargeglass
ofcoldwaterinthecenterofthemicrowaveoven.Donotplacethebags
withthewashclothsinthewater.
6.Putthemicrowaveovenonhighpower,setthetimerfor5minutes,andturn
iton.Replacetheglass(whichisveryhot)withanewglassofcoldwater,
andrunthemicrowaveovenonhighpowerforanadditional5minutes.
7.Letthebagscool,thenclosethebags.Thesterilewashclothisnowinsidea
sterilebag.
Thistechniquekillsthegermsandbacteriabyusingmicrowaveradiationtosterilize
thewashcloths.Withouttheglassofcoldwatertoabsorbtheheat,thebagswould
meltandthewashclothswouldburn.

SummaryofTips
TipsforUTIpreventionmaybesummarizedasfollows:
Wipeinthecorrectdirection,fromfronttoback,afterusingthebathroom
Cleanthebladderareafirstwhenwashingtopreventcontaminationwith
bacteriafromotherpartsofyouthebody.
Emptythebladderatleastevery4hours
Avoidtheuseofspermicidaljelly.
Drinkextrawaterandconsiderdrinkingcranberryjuice(ortakingcranberry
pills).Itcannotharm.
Useanestrogencreamifpostmenopausal.
Takeanymedicationasprescribedbyaphysician.

ContributorInformationandDisclosures
Author
JohnLBrusch,MD,FACPAssistantProfessorofMedicine,HarvardMedicalSchoolConsultingStaff,
DepartmentofMedicineandInfectiousDiseaseService,CambridgeHealthAlliance
JohnLBrusch,MD,FACPisamemberofthefollowingmedicalsocieties:AmericanCollegeofPhysicians,
InfectiousDiseasesSocietyofAmerica
Disclosure:Nothingtodisclose.
ChiefEditor
MichaelStuartBronze,MDDavidRossBoydProfessorandChairman,DepartmentofMedicine,StewartG
WolfEndowedChairinInternalMedicine,DepartmentofMedicine,UniversityofOklahomaHealthScience
CenterMasteroftheAmericanCollegeofPhysiciansFellow,InfectiousDiseasesSocietyofAmerica
MichaelStuartBronze,MDisamemberofthefollowingmedicalsocieties:AlphaOmegaAlpha,American
MedicalAssociation,OklahomaStateMedicalAssociation,SouthernSocietyforClinicalInvestigation,

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PreventionofUrinaryTractInfectionsinWomen:GeneralGuidelinesandSuggestions,SterilizingWashclothsforHomeUse,SummaryofTips

AssociationofProfessorsofMedicine,AmericanCollegeofPhysicians,InfectiousDiseasesSocietyofAmerica
Disclosure:Nothingtodisclose.
Acknowledgements
MaryFBavaro,MDChief,DivisionofInfectiousDisease,NavyMedicalCenter,SanDiego
MaryFBavaro,MDisamemberofthefollowingmedicalsocieties:AmericanCollegeofPhysiciansand
InfectiousDiseasesSocietyofAmerica
Disclosure:Nothingtodisclose.
BurkeACunha,MDProfessorofMedicine,StateUniversityofNewYorkSchoolofMedicineatStonyBrook
Chief,InfectiousDiseaseDivision,WinthropUniversityHospital
BurkeACunha,MDisamemberofthefollowingmedicalsocieties:AmericanCollegeofChestPhysicians,
AmericanCollegeofPhysicians,andInfectiousDiseasesSocietyofAmerica
Disclosure:Nothingtodisclose.
KlausDieterLessnau,MD,FCCPClinicalAssociateProfessorofMedicine,NewYorkUniversitySchoolof
MedicineMedicalDirector,PulmonaryPhysiologyLaboratoryDirectorofResearchinPulmonaryMedicine,
DepartmentofMedicine,SectionofPulmonaryMedicine,LenoxHillHospital
KlausDieterLessnau,MD,FCCPisamemberofthefollowingmedicalsocieties:AmericanCollegeofChest
Physicians,AmericanCollegeofPhysicians,AmericanMedicalAssociation,AmericanThoracicSociety,and
SocietyofCriticalCareMedicine
Disclosure:Nothingtodisclose.
MarkJeffreyNoble,MDConsultingStaff,UrologicInstitute,ClevelandClinicFoundation
MarkJeffreyNoble,MDisamemberofthefollowingmedicalsocieties:AmericanCollegeofSurgeons,
AmericanMedicalAssociation,AmericanUrologicalAssociation,KansasMedicalSociety,SigmaXi,Societyof
UniversityUrologists,andSouthwestOncologyGroup
Disclosure:Nothingtodisclose.
FranciscoTalavera,PharmD,PhDAdjunctAssistantProfessor,UniversityofNebraskaMedicalCenterCollege
ofPharmacyEditorinChief,MedscapeDrugReference
Disclosure:MedscapeSalaryEmployment
JeffreyMTessier,MDAssistantProfessor,DivisionofInfectiousDiseases,DepartmentofInternalMedicine,
VirginiaCommonwealthUniversitySchoolofMedicine
JeffreyMTessier,MDisamemberofthefollowingmedicalsocieties:AmericanCollegeofPhysiciansAmerican
SocietyofInternalMedicine
Disclosure:Nothingtodisclose.

References
1.MedscapeReference.Availableathttp://medscape.com.
MedscapeReference2011WebMD,LLC

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