Nothing stresses us more than a breakdown in our body.  A classic case in point is the bladder infection, or cystitis.  While it can happen in men, it is far more likely to happen to women.  In a typical day in my office (or in our walk-in clinics) I will see at least three or four such cases, usually in young healthy women.

While the inherent design of the female body is virtually perfect, the only design “flaw” might be considered the urethra.  With only about an inch of straight tubing separating the bladder from the outside skin, bacteria have an extremely short swim to get into trouble.  No valves exist (other than muscles).  To make matters worse, the act of sexual intercourse will easily massage bacteria up into the bladder; hence the term “honeymoon” cystitis. 

bladder

Here are a few simple steps to avoiding this stressful nuisance:

1.       Always void your bladder after intercourse.

rubber ducks

2.       “Mr. Bubble” (the source of our childhood bubble-baths!) is not your friend. Neither are any of the adult shower gels or bubble baths that contain detergents.   Bacteria are supposed to live all over our skin, including at the outlet of the urethra.  For defense, the body depends on its natural layer of oils to keep the bacteria in normal harmony.  Detergents instantly destroy this layer (visualize a greasy frying pan soaking in water; one drop of detergent instantly cuts through all the floating grease).  So stay away from super-suds.  Stick to Ivory or plain Dove soaps in your shower or bath.

3.       Drink Cranberry juice if you feel any urinary sympoms of burning, frequency, or urgency, or if you see any blood in your urine.  If you hate cranberry juice, vitamin C tablets will also acidify the urine, so the pH is less hospitable to those bacteria.  And make sure to drink lots of water.

4.       See your doctor.  Urine tests will confirm the diagnosis, and cultures can point out (a couple of days later) which antibiotics are most likely to work on this particular organism.  We usually start with a broad spectrum antibiotic, such as Macrobid, but will make a change if the patient is not improving quickly, or if the culture shows resistance to this antibiotic.  Untreated, cystitis can migrate up into the kidneys, and we literally don’t want to go there! Images can also be taken to assess the kidneys, and to measure the size of the bladder when full and empty.  Repeat cases of cystitis usually need cystoscopy, where the doctor can look up into the bladder itself, to rule out any other pathology.

5.       Tone those bladder muscles.  Whilst passing a stream, try sqeezing the muscles to stop the flow of urine.  Then start again, and hold it back.  These are the muscle exercises (called Kegel exercises) that help the bladder empty fully, and offer some resistance to upstream bacterial traffic.  For more on these, see: http://www.mayoclinic.com/health/kegel-exercises/WO00119

6.       For men, bladder infections are less common, but can be more complicated.  Make sure you follow up with a full investigation from your doctor.  Additional attention might be needed to assess prostate and kidneys as well as bladder function. 


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