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