Q: I am 23 yrs old. I have been married for 5 months and since then I have been having recurrent UTIs. I pass blood and blood clots in the urine and I have the urge to pass urine every 5 minutes. I have had this 4 times till now. The first and the second time, I took Norflox for 3 days. The third time I had Norflox for 10 days. The fourth time I took Urispas, Cifron and continued with Taxim-o. After taking these tablets, the bleeding stopped in 1 day but the pain and burning sensation while passing urine remained. I am also suffering from a pain in the lower abdomen. The urine routine shows plenty of pus cells. The culture report shows no bacteria (except for once where the report showed Gram negative bacilli in a small number).The ultrasound shows no problem. I haven't got a cystoscopy done yet still.

A:Urinary tract infection (UTI) is common in sexually active women, upto 3% suffering from UTI per year. Such episodes early after marriage are called honeymoon cystitis. Bacteria are often pushed up the urethra and into the bladder during coitus, multiplying later in the bladder to initiate the symptoms. The male urethra, being substantially longer, is not susceptible to the same problem. The term honeymoon was applied because this was traditionally the time of first intercourse when it would be passionate, frequent but not conducted with a great deal of expertise. The predisposing factors are poor vaginal lubrication during a hurried intercourse (inadequate foreplay, anxiety or lack of male expertise) and use of artificial or improper lubricants. The acute infections are treated with a short course of antibiotics as you have been prescribed. The preventive measures recommended are: 1. You have to make a habit of always drinking one extra glass of liquid, and emptying the bladder shortly before and after the intercourse. This will help flush out any bacteria that have been introduced. If you go to sleep without doing so the bacteria have several hours in which to multiply. 2. Fluid intake has to be increased over all. 3. Avoid artificial lubricants, water based lubricants are bettter if used at all. 4. If you have been using condoms, you may have to change the contraception method. 5. As these attacks have been more frequent in your case, you may also take a tablet of Bactrim or Norflox 500 within 2 hours of intercourse for couple of ensuing weeks. 6. If infections continue to bother, you will have to be examined for any anatomical abnormality like any hymenal tags or proximity of urethra to vaginal opening, which may need surgical correction. 7. Blood in urine is not uncommon with infection episodes, but should settle down with above mentioned measures. Normal ultrasound is quite assuring. In case bleeding occus with urine even in absence of infection, a cystourethroscopy may be warranted. It is not a painful procedure since it will be performed under anaesthesia.