Ms. Vance, age 28 years, has noticed urgency, frequency, and dysuria recently, as well as an unusual odor to the urine

Ms. Vance, age 28 years, has noticed urgency, frequency, and dysuria recently, as well as an unusual odor to the urine. Urinalysis indicated a heavy concentration of Escherichia coli in the urine, some pus, and WBCs. Ms. T was prescribed antibiotics, which she took for the first few days. This seemed to give her relief, but she then stopped taking the medication. Within a few days, the symptoms returned, but she decided to “just live with it.”

Question 1: Women are predisposed to cystitis due to the anatomy of their urinary tract. The urethra, which is the tube that carries urine out of the body, is shorter in women than in men, making it easier for bacteria to enter the urinary tract and cause an infection. Additionally, the close proximity of the anus to the urethra in women can increase the risk of bacteria entering the urinary tract through fecal contamination.

Question 2: Some preventive measures that may help reduce the recurrence of cystitis include:

• Drinking plenty of fluids, especially water, to help flush bacteria out of the urinary tract
• Urinating after sexual activity to help flush out any bacteria that may have entered the urinary tract during intercourse
• Wiping front to back after using the toilet to help prevent fecal contamination of the urethra
• Avoiding using perfumed soaps or deodorants around the genital area, as these can irritate the urethra and increase the risk of infection
• Wearing cotton underwear and avoiding tight clothing, as these can help keep the genital area dry and reduce the risk of bacteria growth

Question 3: Other signs and symptoms that may indicate cystitis include:

• Pain or discomfort in the lower abdomen
• A frequent urge to urinate, even when there is little or no urine to pass
• Blood in the urine
• A burning sensation when urinating
• Cloudy or foul-smelling urine
• Pelvic pain
• Pain during sexual intercourse

Question 4: If Ms. Vance does not adhere to the treatment prescribed, she may experience a number of potential problems. These may include:

• The infection may not fully resolve and could become chronic, leading to ongoing discomfort and possibly more serious complications in the future
• The infection may spread to the kidneys, which can cause more serious health problems
• The infection may be passed on to sexual partners, leading to a cycle of recurrent infections
• The infection may become resistant to the prescribed antibiotic, making it more difficult to treat in the future.