THIS MONTH'S ARTICLE OF INTEREST -   URINARY TRACT INFECTION IN WOMEN - Medical treatment and prevention of infections
Simple infections are treated with a three day course of antibiotics by your family doctor. Symptoms usually resolve within a few days without damage to the bladder.  Recurrent infections (more than two infections per six months) require a mid stream urine analysis at the local laboratory to determine the type of bacteria and which antibiotic will be the most effective.  The initial treatment course is longer, 14 days, to ensure all bacteria are destroyed.  An extended low dose is then given (prophylactic dose) to prevent bacteria becoming established in the bladder while your natural bladder defences are recovering.  This is continued for three to six months.  If your infections occur following sexual intercourse then the prophylactic dose can be taken only after intercourse. This has been found to be as effective as a daily dose. 
The protective GAG lining of the bladder protects the body from the toxic contents of the urine.  When the lining is damaged by an infection some people find certain foods can cause cystitis symptoms;  coffee, acidic food such as citrus fruits and tomatoes, spices, alcohol or chocolate.  The symptoms continue until the lining has repaired, up to three months.  For women who suffer from allergies, Cimetidine can alleviate the allergic response.
What can I do to Help?
Drink large amounts of water (2 litres/day) to flush out bacteria and diminish burning sensation.   Drinking Bicarbonate of Soda (1tsp/glass of water), Ural and Citravesant sachets provide relief by making the urine less acidic.  Take mild pain relief medications like Paracetamol every four to six hours.
Prevention of infections
*   Ensure you completely empty your bladder by correct posture; leaning forward elbow to knee, use abdominal
     muscles to complete.  If your bladder does not empty completely on the first attempt, it is important to return after
     10 minutes to try again, particularly before going to bed. Discuss with your Doctor if this is a problem.
*   Drink water and empty your bladder immediately after sexual intercourse.
*   Some antibiotics can destroy the natural protective vaginal lactobacillus.  It is important to replace the bacteria which are
     available in acidophilus live yoghurt.  This can be eaten or more effectively applied to the vagina at night.
*   Cranberry Juice (300mls per day) prevents bacteria adhering to the bladder wall.
*   Menopausal women may benefit from hormone replacement, vaginal cream or tablet.
*   The contraceptive diaphragm or cap can be a source for infection, consider an alternative method of contraception.
*   Avoid tight man-made fibres which may irritate the body, trap heat and promote bacterial growth, wear cotton underwear.
Do I need further tests?
Most women with a UTI respond to treatment however if the cystitis symptoms persist it is very important to provide a fresh midstream urine sample to the local laboratory.  A persistent infection is either due to resistant bacteria that will require different antibiotics or a functional abnormality of the urinary system.  There are also other causes for cystitis that require investigation with an ultrasound and sometimes an inspection of the bladder - a cystoscopy.
 (Article written by Tony Beaven - Urologist - ph; 488 6662)