Bladder Infections More Likely in Women

Q:  Help! I am 82 years old and have had urinary or bladder infections off-and-on for the past 20 years. I take Sulfatrim tablets that are effective but not for very long.

Doctors have told me that the infections are due to bacteria, but how does that get into my system? I had a hysterectomy 22 years ago and have also had my bladder lifted up (didn't work though). The doctor looked into my bladder through a scope and said nothing was wrong with it.

A:  Bladder infections are caused by bacteria in the urinary tract. Often these are bacteria that exist in the colon and travel the short distance from the anus to the urethra (the opening of the bladder). E. coli, bacteria that is abundant in the stool, is the most common cause of urinary tract infections. Because women have much shorter urethras than men, the bacteria can get into the bladder much more easily, and that's why bladder infections are much more common in women. That's why it's important for women to clean themselves carefully (wiping from front to back) after using the toilet, so that bacteria are not introduced into the bladder.

Many women get more infections after menopause because the tissues are thinner and bacteria can get through more easily. Estrogen has been shown to decrease bladder infections. If the bladder is "fallen" or weak (which appears to be the case with you, in spite of an operation), it does not empty completely and bacteria may invade the urine that is sitting there. That's why women who are prone to frequent infections should remember to empty the bladder every two to four hours and right before and after sex.

There could be several reasons why the Sulfatrim is not working for you anymore. The usual bacteria may have become resistant to it, or you may be infected with a different kind of bacteria and require another antibiotic altogether. To find out, your doctor should send your urine for a culture the next time you have symptoms of burning or pain with urination.

One more tip that may help prevent infections - drink cranberry juice. A study showed that women who drank about one cup a day decreased their number of bladder infections. Apparently cranberry juice contains an ingredient that makes it hard for bacteria to stick to the wall of the bladder.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.