MYTHS COMPLICATE PROBLEM OF URINARY TRACT INFECTIONS, EXPERT SAYS
COLUMBUS, Ohio -- The myths and folklore surrounding urinary tract infections can needlessly confuse those suffering from this common medical condition, according to an Ohio State University expert.
There are many misconceptions about how urinary tract infections arise, how they might be prevented and cured, said Calvin M. Kunin, Pomerene Professor of internal medicine at Ohio State and author of the new book Urinary Tract Infections: Detection, Prevention, and Management (Williams and Wilkins, 5th Edition, 1997).
There is, for example, little evidence that personal hygiene is responsible for causing urinary tract infections or that cranberry juice can treat the infections, he said.
Urinary tract infections, in which the urine and structures of the urinary tract become colonized with bacteria or other microbes, are especially common among women, Kunin said. Plus, he said, some women are much more susceptible than others.
There is considerable speculation about the factors that predispose certain women to urinary tract infection, he said.
Some believe that cold feet, the weather, diet, personal hygiene, bathing, frequency or patterns of urination, failure to void after intercourse or the direction of wiping after defecation increase susceptibility to infection, he said. There is weak or nonexistent clinical evidence to support most of these notions, he said. There is, however, evidence that sexual intercourse can be a factor in urinary tract infections in a small minority of women.
Most women do not develop urinary tract infections in association with sexual intercourse, he said. However, there is a special group of women in whom sexual intercourse appears to be related to recurrent urinary tract infection. These women benefit from a dose of antibiotics after intercourse, he said.
For women who are susceptible to recurrent infection, Kunin said, the best course of action is to develop a relationship over time with a physician and have a small supply of the appropriate antibiotics on hand for emergencies.
Its probably best to have the drug at home so that you can take it right away, as soon as you develop symptoms, Kunin said. Short courses of antimicrobial therapy -- three days -- are excellent for treating these infections. If you have many recurrences, there are several really good drugs that can be used to prevent infections. If we use them intelligently, we can make the resistance issue less of a problem.
Drinking large amounts of water or cranberry juice have not been shown to be reliable measures for treating urinary tract infections, Kunin said.
The best thing to do is just take an effective drug, he said. If you drink a lot of water or juice, youre washing out your bladder. But youre also diluting the drug, and its the drug thats important.
Urinary Tract Infections: Detection, Prevention, and Management covers topics such as dysuria (painful urination) syndromes, kidney infections and urinary tract infections in children, including the problem of vesico-ureteral reflux, a congenital defect in which urine flows back from the bladder, through the ureter to the kidneys. Also included in the book are chapters on how microorganisms cause urinary tract infections and how the bodys immune system responds. In addition, the book includes chapters on care of the urinary catheter and management of urinary tract infections.
This book was primarily written for physicians and nurses, but the information should be readily understood by the general public, Kunin said. It addresses many problems and concerns.
EDITORS NOTE: Review copies of Urinary Tract Infections: Detection, Prevention, and Management are available to reporters from Williams and Wilkins. To receive a copy, call Danielle T. Griffin at (410) 528-4181 or e-mail her at dgriffin@wwilkins.com.
Contact: Calvin M. Kunin, (614) 293-8976; Kunin.1@osu.edu
Written by Kelly McConaghy Kershner, (614) 292-8308; Kershner.4@osu.edu