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bladder infections

Gary Lum glum at ozemail.com.au
Fri Nov 15 22:40:17 EST 1996


amcfarla at mustang.uwo.ca wrote:
> 
> I remember some weeks ago when one of the guest speakers was talking
> about sexually transmitted diseases and I distinctly remember him
> mentioning something about urinary infections being caused by having
> intercourse.  One of my friends was complaining about this yesterday and
> since she is sexually active (one partner), I was wondering what the
> possibilities of this being caused by a STD are.  Also I would
> appreciate some advice on what she can do to ease the pain.  If this
> persists is it a matter that should be taken to health services?
>         If I am way off base and urinary infections have nothing to do having
> intercourse please clue me in and tell me what they are caused from.


Greetings.

Urinary tract infections (UTI) are associated with sexual intercourse in
sexually active women.  The main reason being the skin flora of the
perineum and the enteric flora from your anus are so close to the
introitus which contains the outlet for the female urethra.

The actions of intercourse lead to friction, epidermal break down etc.
which facilitate the entrance of pathogens which ascend up the urethra
into the bladder causing cystitis.

Many women suffer post-coital UTI.  The best advice is often to
encourage the female partner to void urine straight after intercourse. 
Some women have been advised by the medical officers to take a
prophylactice antimicrobial agent after intercourse.  For some women,
the symptoms are such that they limit the amount of intercourse they
partake in.

Condom use with a good amount of lubricant may also help your friend.

Of the microorganisms involved, common ones are _Escherichia coli_,
_Klebsiella pneumoniae_, _K. oxytoca_, _Proteus mirabilis_,
_Staphylococcus saprophyticus_, and many others.

In terms of management once a person has developed a UTI.  I usually
recommend a three day course of Trimethoprim, or co-trimoxazole. 
Occasionally I'll suggest norfloxacin depending on the history.  The
management really depends on your communities local antibiogram which
can be gleaned from your local friendly clinical microbiologist or
infectious diseases physician who can advise on what's bets for your
area.

As far as Sexually transmitted diseases microorganisms causing UTI, well
they can, but usually it's the perineal and/or enteric flora that are
the culprits.

One thing I really advise against is anal sex followed by vaginal
intercourse without washing.  I know many people practice this and have
no problems, but I've seen a few patients where it has caused major
problems.  The simple rule is don't put in your vagina what has been in
your rectum.

If you have further concerns or questions please contact me by E-mail.

All the best, hope this helps.

Gary


-- 
******************************************************************
Dr Gary Lum
Director of Microbiology
Royal Darwin Hospital

Microbiologists do it with Culture and Sensitivity
Meet me at my Home page http://www.ozemail.com.au/~glum/index.html



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