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What is the reason for recurrent UTI?

Q: I am a 34-year-old married woman with an 8-year-old child. I have been married for 9 years. I have never had any urinary tract infection (UTI) during this time. But earlier this year, I had UTI and was asked to get a routine urine examination done of the first urine. There was no presence of sugar, but there was trace of protein. I was prescribed antibiotics (CEFADUR CA 500) for five days twice a day. Everything was fine and I thought I had recovered. This month again, I suffered from UTI with burning micturition and slight back pain. I again went for a routine urine examination, and the report mentioned that albumin was present, pus cells were 30-32/HPF, and bacteria were present. I was again prescribed the same antibiotic for 5 days. I am worried about recurrent UTI. My physician has asked me to go for an ultrasonography of my lower abdomen. I have no known history of kidney problems in both my paternal and maternal side. What is causing recurrent UTI? I am very particular about personal hygiene and take adequate amount of water. I go for swimming, does that have anything to do with UTI?

A:At the outset let me reassure you that recurrent urinary infection in females of your age is very common, and rarely leads to serious consequences. There are tricks in its effective management and to minimise the chances of its frequent recurrence. This is mainly as the culprit bacteria gets used to the antibiotics and become resistant to these antibiotics. I will give you certain tips, which are well accepted and have helped my patients. Plenty of fluids and maintaining high urinary output will keep bacterial population in the urinary tract low. In females, vagina acts as a good reservoir for the bacteria and hence the perineal and vaginal hygiene is very vital. You should clean your vagina including the entire bottom thoroughly while taking a bath, and subsequently after every time you pass urine or after every intercourse, rinse it thoroughly with plain running water using a flexible shower. You should avoid using any antiseptic as it may cause reaction in skin and the vagina. Using one tablet of Septran 800mg at the time of intercourse (preferably before or else immediately after) helps in preventing acute breakthrough infections. Try taking Cranberry juice 300 ml everyday. Get urine cultures done as and when you have acute symptoms. No doubt your urologist would treat every infection with appropriate medicines. There are no restrictions for you and to play or swim.

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