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.


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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