Urinary Tract Infections and Disabilities

In the general adult population, urinary tract infections (UTIs) are 30 times more common in women than in men. The female anatomy, especially that of the pelvic floor, makes it easy for bacteria to travel from the outside of your body into your urinary tract (which includes your kidneys, bladder, and urethra). The rectum, the last part of your large intestine which ends in the anus, and the vagina, are very close to your urethra. The urethra is the tube connecting your urinary system to the outside of your body. Bacteria can easily travel from the vagina or rectum to the urethra and from there, into your bladder and, eventually could make it to your kidneys.

Notice the last risk factor listed is immobility. In addition to the fact that women overall are more likely to have UTIs, women with mobility impairments are even more at risk. Some women with mobility impairments also have neurogenic bladder or have urinary incontinence. Both of these place a woman at an even higher risk of a UTI.

• Previous history
• Sexually active women
• Post-menopausal women
• Catheterization
• Neurogenic bladder
• Diabetes Mellitus
• Kidney disease
• Weakened immune system
• Immobility

• Burning when you urinate
• A new pattern in the frequency of urination
• Bladder Spasms
• Fever
• Flank (back and side) pain
• Blood in your urine

If you are a woman who is at a high risk of recurring UTIs, there are a couple of things you should know. First off, the symptoms listed above are the ones to watch for. Dark, cloudy, and foul-smelling urine are NOT signs of a treatable UTI if you use a catheter to empty your bladder. When you use a catheter regularly, you will always have bacteria in your urine and that is normal.

Some doctors may recommend taking what is called a prophylactic antibiotic. This just means you take antibiotics all the time or on a regular schedule to try to stop bacteria growth. Speak with your doctor in-depth before you agree to this treatment. Long-term antibiotic use can cause the bacteria to become resistant to antibiotics and to just keep growing. This can create a problem when you have a more serious infection. Discuss all of the prevention methods discussed below with your doctor before you start long-term antibiotics.

For all women...

• Practice good hygiene habits – clean thoroughly after urinating, always wipe from front to back, urinate after sexual activity
• Don’t hold your urine any longer than necessary
• Avoid moist environments – wear cotton, looser fitting underwear and change if you sweat too much or have any leakage
• Stay hydrated
• Prevent constipation
• Manage fecal incontinence
• Take a probiotic and/or a cranberry supplement to maintain a balance between good and bad bacteria

These are helpful tips on preventing UTIs in all women. Also, view a copy of a consumer-oriented handout provided by one of our medical advisors, Dr. Sophie Fletcher,

For women who catheterize...

• Thoroughly wash your hands before and after catheterization
• Always properly clean and store your catheter
• Cath the number of times a day your doctor recommends
• Make sure your bladder is completely empty

Treatment will vary depending on the individual and how serious the infection is. To prevent an infection becoming more serious, watch for the symptoms listed above and call your doctor as soon as you suspect an infection.