Frequent UTIs, possible urethral syndrome
I have been getting urinary tract infections on and off for about three years. The most recent one that I had, I was urinating blood (only about 5-6 drops).
The doctors always just put my on some antibiotic, and then it comes back within the next month. It usually occurs while I'm sexually active, but I do urinate right after sex. The last infection came with greater abdominal pains than any of the other times.
What can I do so I won't get these infections any more, and I am going to the wrong doctors? (I go to the campus health center.)
This can be recurrent infection of the bladder or urethra, recurrent trauma to the urethra (from sexual relations) or an entity called urethral syndrome which probably is a very low grade infection of the tiny glands in the outer portion of the urethra.
If they are doing urinary cultures and they are always positive, you are having recurrent infection of the bladder. If you have some blood but no bacteria, then it's trauma with or without urethral syndrome.
The treatment is an active 7 day course of antibiotics (sulfa like Bactrim DS® or Septra DS® if not sulfa allergic) then, if symptoms all gone, one tablet of sulfa immediately before or right after sexual relations.
Occasionally I've had to put women on one a day with an extra tablet after relations. This almost always works. See if your doctor will let you try this.
I've included some abstracts. Some primary care physicians may not be aware of this. Usually permanent college health service physicians are quite aware of this entity but sometimes if there are just moonlighting MDs, they may not be attuned to this.
Abstracts
Managing urinary tract infection in women
Drug Ther Bull 1998 Apr;36(4):30-32
Each year, around 5% of women present to their GPs with dysuria and frequency. About half have a urinary tract infection, as confirmed by the presence of a threshold ('significant') number of bacteria in their urine (usually defined as > or = 10(5)/mL). In the remaining women, symptoms occur in the absence of bacterial infection: this condition is referred to as urethral syndrome. In this article, we discuss the diagnosis and treatment of urinary tract infection in women.
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