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Doctor's Diagnosis: Urinary tract infection

Sometime in their lives, most women — and some men — will find out what it’s like to have bacteria multiplying uncontrollably in their bladder: they will experience a urinary tract infection.

The kidneys are continuously making urine, which is stored in the bladder, and then eventually eliminated from the body. Normally there are no bacteria present in the urine. Bacteria, however, can sometimes overcome the body’s defenses and infect the urine. Most often these bacteria come from the rectum and work their way up into the bladder. Because of the differences in anatomy, females are much more likely than males to encounter this problem. Being sexually active and using certain forms of birth control, such as a diaphragm, increases the risk. 

The resulting bladder infection often makes the patient feel miserable. A feeling of pelvic pressure, a need to urinate frequently, and burning or painful urination are common. The urine itself may be bloody or cloudy. 

The diagnosis is often made from the patient’s history alone, especially if the history includes previous bladder infections. There are urine tests that can be done in the doctor’s office to help confirm the diagnosis.

The most reliable and useful test is a culture of the urine. This will not only identify which bacterium is causing the problem, it can also help determine which antibiotics will be most effective. The problem is that the results will take a day or two and the patient does not want to wait to begin treatment. Also, it requires a “clean catch” specimen. The patient must clean their genital area, begin urinating, discard the first flow of urine and “catch” some of the next flow in a sterile cup.

Easier said than done.

Usually, the infection responds quickly to the antibiotics. Patients often feel better in a day or two but it is essential that they take all of the medicine they have been prescribed, to make sure the infection is completely eliminated. 

If not treated promptly, the infection can spread to the kidneys. This is a much more serious condition and may require hospitalization for treatment. 

Urinary tract infections are relatively uncommon in males, but those with certain congenital abnormalities and problems such as an enlarged prostate are at risk.

The discussion would not be complete without mentioning cranberry juice. Although some swear by it, the evidence is very mixed — at best — that it actually prevents bladder infections.

Dr. Stephen Picca of Massapequa is Board Certified in both Internal Medicine and Anesthesiology. He is retired from practice. Questions and comments can be sent to Dr. Picca at

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