bladder infections

Gary Lum glum at ozemail.com.au
Sat Nov 16 08:13:01 EST 1996


Gary Lum wrote:
> 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. (Infection of the bladder, i.e., UTI).
> 
> 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
> prophylactic 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 fact _S. saprophyticus_ is usually only grown in the urine of
sexually active females, very uncommon in men with UTI.

> 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 community's local antibiogram which
> can be gleaned from your local friendly clinical microbiologist or
> infectious diseases physician who can advise on what's best 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.
> 

Sorry spotted some spelling mistakes in the previous post and just
wanted to correct them.

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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