Urinary Tract Infections
The American Urologic Association speaks on UTIs, stating: “UTIs are the most common bacterial infection in women, with approximately 50-60 percent of women experiencing at least one at some point in their lives. UTIs are considered recurrent if they occur two or more times in a six-month period, or three or more times in a year.”
Symptoms of a UTI can vary depending on your age, your immune system, and the severity of the infection. Typically, symptoms include feeling like you need to empty the bladder frequently and severely, small amounts of urine output with a large urge to empty, burning with urination, cloudy urine, or a foul odor of the urine. Symptoms can worsen as the infection worsens and may include lower abdominal pain, low grade fever, fatigue, and flank (lower back) pain. Older adults with a UTI may become confused and disoriented.
If you start to experience these symptoms, first line treatment includes increasing your water intake and Vitamin C intake, practicing good toilet and sexual hygeine (i.e. always wiping front to back and urinating after intercourse), and over the counter bladder pain medication such as Prelief or Azo.
You should call your doctor if your symptoms worsen, or do not respond to home intervention in 24 hours, you should contact your doctor. Other symptoms that indicate you should seek medical care are blood in the urine, bladder cramping or spasms not relieved with OTC pain medications, flank pain, nausea or vomiting, and fever.
f your doctor’s office is closed or unable to quickly see you there are other options for care. Some urology and gynecology offices offer after hours clinics and most urgent care clinics, such as MedExpress, are fully equipped to handle a UTI. The doctor will ask what symptoms you are experiencing, when they began, and will perform a urinalysis to diagnose your UTI. Antibiotics are likely to be prescribed for 3 to 10 days.
There are a lot of myths out there on how to treat a UTI. One of the most common is to drink cranberry juice. While cranberries contain a bladder friendly substance called D-Mannose that has been shown to prevent bacteria from sticking to the bladder wall, the amount of D-Mannose in cranberry juice is not significant enough to reap these benefits. Also, many cranberry juices at the grocery store contain high levels of sugar, which can further irritate the bladder and feed the bacteria causing the infection. D-Mannose can be found in a supplement form over the counter, but this is best used for prevention of UTI, not treatment of an active infection.
Prevention is key when it comes to UTI management, as routine use of antibiotics leads to resistance making future infections harder to treat. Helpful tips include wiping from the front of the vulva towards the rectum, then discarding the toilet tissue. Others include staying hydrated, avoiding bladder irritants like alcohol and caffeine, emptying the bladder on a regular schedule (every 2-4 hours), emptying the bladder after intercourse, and taking probiotics that target the urinary tract.
Although it may seem out of our scope, pelvic health therapists can be the perfect team member for people who suffer with chronic UTIs.
Now of course, we aren’t using prescriptions or bladder scans at the gym, but there are reasons why your pelvic floor is keeping you from clearing that infection.
The pelvic floor is too “tight”
With chronic infection usually comes pain. When there is sustained pain within the pelvis, the muscles respond by guarding - similar to what happens if we sprain our ankle and the muscles spasm around the joint. If our pelvic floor muscles can’t relax, we will have trouble emptying our bladders fully. Urinary retention is a risk factor for UTIs.
The bladder does not have enough support
Some patients have a bladder prolapse - this means the connective tissue and vaginal walls are not supporting the bladder as they used to, and the bladder has shifted down and forward. This makes it more difficult for complete bladder emptying, and increases risk for UTIs.
There are also instances when symptoms of a UTI are present but all urine cultures are negative, meaning there is no active infection. When our pelvic floor muscles get tight and stay that way, they can replicate symptoms of a UTI: bladder and urethral pain, urinary urgency and frequency, painful urination, etc. If your antibiotics aren’t working or your cultures continue to be negative, call a pelvic health therapist for a muscle assessment.