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0:04
Now, in the recurrent UTI,
what should we do to reduce
recurrences in patients
with recurrent UTI?
Here you see again
the definition and
10% to 20% will have
recurrent UTIs.
This is very bad
for the patients.
The treatment of the acute
episode is not enough.
We need something
for prophylaxis.
0:30
First, we have to ask
about risk factors.
There are urogenital
risk factors:
incontinence, obstruction,
sphincter detrusor dyssynergia,
surgery. Of course,
these we have
either to improve
or to consider.
There are general risk factors
like the history of the
UTI. What does it mean?
The mother has history,
the daughter has recurrent UTIs.
This is genetic. And diabetes
mellitus, that is an
immune situation,
and oestrogen deficiency
in post-menopausal women.
But there are also behavioral
risk factors:
sexual intercourse,
diaphragm use, spermicides
and antibiotic usage,
as I have shown you.
1:12
Therefore, the
prevention should first
go to the risk factors. For
behavioral risk factors,
for example, patients
who don't take
enough fluid or delay urination
or post-coital urination delay,
or wiping from back to
front after defaecation.
We have to ask whether this
is very important or not.
There are not many
studies showing this.
In older women we have
urinary incontinence
and we have the so-called
non-secretor status.
This is of course genetic
or, if the patient
has cystocele or
post-void residual urine.
Then, I mentioned already,
sexual intercourse
frequency and using
different spermicides or
genetic factors affecting
the immune system.
