How to manage repeated urinary tract infection?
Senior Consultant,
Department of Urology,
Sir Ganga Ram Hospital,
New Delhi
Q: I have been married for 7 years and have a history of repeated urinary tract infection. Initially, the infection used to surface only once a year but in the past one year I have already had 4 episodes. Each time I get the infection, it would be after an intercourse with my husband. I was under the impression that I was contacting it from him but my husband has no symptoms of any infection. However, his urine culture once revealed the presence of E. coli, for which he too had medication. However, even during that time he had no symptoms. When I consulted a urologist for the first time last week (earlier I was treated by my gynecologist), he said my repeated infection has nothing to do with my partner and that it is an infection present in me that is getting triggered everytime an intercourse takes place. He also said that URINARY INFECTIONS ARE NOT TRANSMITTED SEXUALLY. So there is no way that I could have contacted from him. Kindly confirm this fact. For your information, abdominal scans were done twice to look out for the presence of any stone. Thankfully, the scans were normal and also my random sugar was normal. The doctor has now given me an antibiotic course of strength 200 mgs (twice daily) for 7 days and reduced it to 100mgs strength (once daily) for the following week, after which a repeat culture test is to be taken. He also further added that I should be on a mild dose of antibiotics for 3 months to completely eradicate this problem. Is it advisable to do this since I’m planning on having a baby through IVF after a couple of months. (since I had not been able to conceive and an IUI done recently gave rise to an ectopic pregnancy due to which one tube had to be taken). Also I have severe gastritis problems for which I take OMEZ. So by taking a prolonged course of mild antibiotics, will my gastritis problem get worse? Does this repeated UTI have anything to do with not conceiving, as we both belong to the category of unexplained infertility? Kindly answer all my questions as this would help me in getting a second opinion on this matter.
A:It is right that UTI is not sexually transmitted but intercourse does have relation - it may actually facilitate migration of bacteria up in urethra. Secondly, low dose, single tab. at night has no significant side effects and it is ok to take it this way. This treatment is given when no cause of recurrent or persistent UTI is found on various tests. Other causes which you have not mentioned are - white vaginal discharge which could be infection of vagina, usually fungal, some residual urine in bladder after you pass urine also is an important cause.Small measures like keeping pubic hair short will help better hygiene, backward cleaning movement after passing motion also may help as this is the area from where infection is generally acquired. If all these measures fail, then you can take long course of antibiotics as suggested.