When should we prescribe prophylactic antibiotics? Does cranberry work? An expert's answers to these and other questions about recurrent UTI.
Clinical Assistant Professor, Department of Medicine, Perelman School of Medicine at University of Pennsylvania ; Internist, Department of Medicine, Hospital Medicine Section, Pennsylvania Hospital, Philadelphia, Pennsylvania Associate Professor of Clinical Medicine, Department of General Internal Medicine, Lewis Katz School of Medicine; Staff Physician, Department of General InternalThe CurbsidersWe are going to talk about recurrent urinary tract infection .
It can be a challenge to differentiate between a true UTI and other syndromes that can cause this urinary discomfort, such as pelvic floor dysfunction, pelvic organ prolapse, overactive bladder, and other conditions we see fairly commonly in primary care. We need to make the distinction between those things and what is a true UTI. This was my favorite pearl of the episode.
Methenamine hippurate has also been studied for UTI, with similarly mixed results. It requires a low vaginal pH, and a treatment that actually lowers the vaginal pH is vaginal estrogen. This can be used by women with genitourinary syndrome of menopause — typically, postmenopausal women who have signs of vaginal atrophy on exam. Vaginal estrogen is one of our workhorse medications for this condition.
UTI - Urinary Tract Infection UTI Recurrent Urinary Tract Infection Recurrent Uti Vaginal Prolapse Female Genital Prolapse Pelvic Organ Prolapse Antibiotics Vaginal Atrophic Vaginitis Vaginal Atrophy Pennsylvania Fellowship Fellows Residency Residents Clinical Guidelines Guidelines Estrogen Estrogen Therapy Pelvic Floor Disorder Primary Care Prophylaxis
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