| From the foregoing information on UTI, one | | | | has shown promising results. . |
| should realize that the best course is to follow, | | | | The above step for the prevention of UTI is very |
| strictly, the preventive measures, which are very | | | | important and calls for an urgent need to impart |
| simple, mostly relating to routine hygiene, rather | | | | sex education at the appropria te age. Physicians |
| than being on long-term prophylactic antibiotks; or, | | | | obstetricians / gynaecologists / paediatricians can |
| in neglected cases, developing terminal kidney | | | | also guide their patients as and when an |
| disease, i.e. kidney failure, which may, require | | | | opportunity arises. Mothers can also advise their |
| repeated dialysis, or even kidney transplant, | | | | children in this matter. |
| depending on the case. | | | | (iii) Passing of urine frequently |
| Various guidelines are mentioned below, and all | | | | All persons, and especially those who are more |
| individuals, irrespective of age and sex, are | | | | prone to UTI, should pass urine frequently, say |
| required to carefully follow them in their everyday | | | | every 3-4 hours, so that the urinary bladder is |
| life. | | | | constantly washed out, and the bacteria, if any, |
| (i) Perineal hygiene | | | | are pushed out in the urine. If the bladder is not |
| The perineum is the area where the openings of | | | | evacuated frequently, the bacteria will get more |
| the anus, the urethra and the vagina are situated | | | | time to increase in number in the urine collected in |
| (of course, the scrotum and the penis in the | | | | the urinary bladder. Hence, frequent urination is an |
| male). It is the most dangerous area, especially in | | | | esseI)tial step towards the prevention of UTI, |
| females, as all the three openings are lying close | | | | which should be observed by everyone. |
| together (Fig. 21), and there is always a threat of | | | | In any case, urination should not be postponed, as |
| infection to the urinary tract from anal-faecal | | | | this will increase the rise of UTI. |
| organisms, which invade the urinary tract through | | | | (iv) Passing of urine at bedtime |
| the urethral opening. Hence if proper hygiene is | | | | Similarly, urine must be passed at bedtime, so |
| maintained after each defecation, the infection | | | | that the minimum quantity of urine remains in the |
| from the anus to the urethra can be stopped | | | | urinary bladder during the night. Since the duration |
| prevented since UTI is caused mostly by E. coli | | | | of the night is long, there should be as little urine |
| organisms present in the faeces. Of course, the | | | | as possible in the bladder, and one should pass |
| various predisposing/associated factors | | | | urine even during the night, if he or she happens |
| responsible for UTI, if present, have to be | | | | to wake up. |
| simultaneously investigated and treated. | | | | (v) Plenty of fluids |
| A simple cleansing with water, and preferably with | | | | It is obvious that the intake of plenty of fluids is |
| soap and water after passing stools, and urine in | | | | required, so that there is frequent urination, and |
| the case of females, is strongly recommended at | | | | the bladder is constantly kept clean. At least |
| all ages, more so in children, girls, both married | | | | about three litres of water/fluids must be taken |
| and unmarried women. However, those using | | | | daily to achieve the desired results. |
| toilet-paper, after passing stools, should be more | | | | Ideally, the habit of frequent urination or bladder |
| careful, and see that the area has been | | | | training, including cleanliness, should be instilled right |
| thoroughly cleaned, especially in the case of | | | | from childhood, especially in the case of female |
| females. Hence, it is of the utmost importance to | | | | children. Above all, once the subject is made clear |
| always keep the perineal area clean, and thus it | | | | to the sufferers/others, it becomes routine. |
| has been rightly said that 'cleanliness is next to | | | | (vi) Immediate treatment of predisposing factors |
| godliness.' | | | | As soon as some predisposing/ obstructive lesions |
| (ii) Passing of ur'ine after sexual intercourse | | | | happen to occur, e.g. urinary stones, benign |
| (postcoital voiding) Since during sexual activity, the | | | | enlargement of prostate, etc., immediate attention |
| organisms may gain entry through the urethral | | | | should be paid, and surgery, if required, should not |
| opening into the urinary bladder, it is advisable for | | | | be delayed, so that UTI does not develop at all, |
| all women to pass urine after each sexual | | | | and there is absolute prevention. |
| intercourse, so that the bacteria, in case they | | | | (vii) Control of high blood pressure and diabetes |
| have entered the urinary bladder, are washed out. | | | | Control of high blood pressure and diabetes is an |
| It is safer if urine is also passed before sexual | | | | essential requirement to prevent the kidneys |
| intercourse. | | | | from contracting an infection, since a damaged |
| Further, women who are more prone to UTI, or | | | | kidney, as a result of high blood pressure and/or |
| get recurrences of UTI as a result of intercourse, | | | | high blood sugar, is always prone to get infection. |
| are advised to take a single dose of prophylactic | | | | The infection in such kidneys can only be avoided/ |
| broad-spectrum antibiotic like norfloxacin, | | | | prevented if it is protected from damage by |
| ciprofloxacin, lomefloxacin or ofloxacin, etc., after | | | | these diseases. That is, a strict control of both |
| sexual intercourse/ coitus. This is an important | | | | high blood pressure and diabetes is required. This |
| step in the prevention of UTI in such patients, and | | | | aspect has also been emphasized earlier. |