Download UTI prevention leaflet - Croydon Health Services NHS Trust

Patient Information Leaflet – Prevention and Management of Urinary
Tract Infection (UTI) and Cystitis
Introduction
This booklet is aimed at female patients with a history of urinary tract infections and associated cystitis. It also
contains some contact details of local and national services should you require them.
Urinary Infection
A urinary infection due to bacteria within your bladder causing inflammation, infection and other symptoms as
listed below. Cystitis is a word used to describe your bladder wall when it has become sore and red usually
because of infection.
Your bladder health
Your bladder is a muscular bag which needs to shrink and expand to allow you to store and pass urine when
you wish to. To allow this to happen you need a good blood supply to your bladder muscle and a functioning
nervous and immune system.
The main functions of your bladder are to store and pass urine. Your bladder has to store enough urine,
between 250 and 500mls, to allow you to undertake daily activities and have enough sleep. At night it is normal
to pass urine once and this usually increases over the age of 60 years and up to four times by the age of 90. If
you make your bladder hold too much urine on a regular basis, that is more than 600mls, this can damage your
bladder. Your bladder will empty only when you allow it, a skill you learnt as a child. You need to empty your
bladder completely and regularly every 3 to 4 hours during the day. Some bacteria will get into your bladder
and this is normal. Regular and complete emptying of your bladder will prevent you developing a urinary tract
infection by flushing out these bacteria. Your bladder empties best when you are sitting well back on the toilet.
You should not need to strain to pass urine.
Urine is produced by your kidneys and helps to maintain a healthy bladder. Your urine contains waste products
and chemicals not required by your body. They can be toxic such as nicotine (smoking) which may affect
bladder health in the long term (increased risk of bladder cancer). Your urine is acidic and this creates a
bladder environment where bacteria cannot survive. You need a good urinary flow to flush out bacteria and this
needs to be over 200mls each time you pass urine to be effective.
Authors: Ms Ranee Thakar (CHS), Wendy Ness (CHS), Jessica Holloway (CCG), Dr Rajeev Sagar (CCG)
Version 1: 16.09.2014
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Some general facts
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Urinary tract infection is one of the most common infections in females.
A small amount of bacteria in urine for women is normal. This is flushed out each time you pass urine.
The amount of bacteria in your urine slightly increases with age in women.
Bacteria in your urine usually cause no symptoms.
Within four hours of bacteria getting into your bladder you can have a urinary infection. This depends
on how many bacteria get into your bladder and how often you flush them out.
50% of women will get a urinary tract infection at sometime during their lives.
6% of GP consultations are about urinary tract infections.
E.Coli (bacteria normally living in the bowel) is the most common type of bacteria to cause a urinary
tract infection in a woman.
Causes of urinary tract infections and cystitis
The following table lists the common causes and conditions that may make you more prone to urinary tract
infections and cystitis.
First UTI before the age 15
Diabetic on insulin
Vaginal discharge
Diabetic not on insulin
Thrush
Had radiotherapy to bladder
Sexual transmitted disease
Change in daily routine
Sexual intercourse
Feeling lethargic and tired
Change of sexual partner
Several urinary infections
Frequency of sexual intercourse
Feeling depressed
Pregnancy
Not going to the toilet often enough
Vaginal devices used, tampax
Acid fruit drinks
Post menopause
Stress and anxiety
Contraceptive devices, diaphragm
Had a stay in hospital within last year
Spermicide gel used
Bladder does not empty properly
Condoms used
Congenital bladder abnormalities
Catheterisation
Bladder surgery/operations
Bowel control problems
Medication
Episodes of diarrhoea
Going on holiday
Constipation
Type of clothing
Prolapse of your bowel or bladder
Tightness of clothing
Authors: Ms Ranee Thakar (CHS), Wendy Ness (CHS), Jessica Holloway (CCG), Dr Rajeev Sagar (CCG)
Version 1: 16.09.2014
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Common symptoms that may indicate that you have a urinary tract infection
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Your urine burns/stings as you pass it.
You pass urine more often than you usually do.
You experience more urgency to pass urine.
You get up to pass urine during the night.
You constantly feel the need to pass urine even after you have just been.
Your urine is cloudy.
Your urine has a fishy smell.
You notice blood in your urine.
You feel unwell and weak.
You have a fever and raised temperature.
You have groin pain.
You have bladder/tummy pains.
Preventing infection and cystitis
1. Fluid advice
 Ensure you drink at least 1.5 litres of mixed fluid, avoid caffeinated drinks
 Spread your drinks out over the day
2. Double voiding
 When you have finished passing urine, count to 120, slightly lean forward and pass urine again or stand
up move around a bit and sit down again. This is called double voiding and it will help ensure you
empty your bladder completely.
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Toilet visits
Aim to visit the toilet at least seven times during the day to pass urine.
Pass urine every three to four hours during the day.
Ensure you sit on the toilet seat and well back on the toilet every time you pass urine - do not hover
4. Wet wipes
 When wiping your bottom ensure you wipe from front to back.
 For a period of one month use wet wipes instead of dry toilet paper.
5. Adapt your diet
Try to bring into your diet some of the following that may help you to fight urinary infections and cystitis
(there is no research evidence to support this). Some may colour your urine and cause it to smell.
 Group one - natural antibiotics: Broccoli, strawberries, raw cabbage, chicken, onion, garlic and
peppercorns.
 Group two - generally good for your kidneys: Chick peas, beetroot, asparagus, walnuts, watercress,
artichoke, cauliflower, carrots, parsley and mango.
 Group three - natural diuretics: nettles, watercress, pears, celeriac, yam, leeks, liquorice, parsnip,
cucumber and peaches.
Authors: Ms Ranee Thakar (CHS), Wendy Ness (CHS), Jessica Holloway (CCG), Dr Rajeev Sagar (CCG)
Version 1: 16.09.2014
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6. Sexual activity
If in your case sexual intercourse triggers a urinary tract infection and cystitis attack the following may
be helpful:
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Try to pass urine within 30 minutes after intercourse. Do not forget to double void.
Have a glass of water to drink within 30 minutes after intercourse.
7. Other general information:
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Try for about a month to avoid wearing nylon underwear, tights, and trousers/slacks/leggings.
Consider avoiding the use of tampons during a urinary infection.
8. Bathing
As the most common organisms that cause infection come from your bowel, the following suggestions
may also be helpful or worth experimenting with:
 Change from a bath to a shower.
 Use less scented or coloured soaps when washing your body.
Other sources of information and help:
Bladder and bowel foundation
Bladder & Bowel Foundation
SATRA Innovation Park
Rockingham Road
Kettering, Northants, NN16 9JH
Helpline: 0845 345 0165
Email: [email protected]
The Cystitis and Overactive Bladder Foundation
Advice Line: Tel: 0121 702 0820
Email: [email protected]
PromoCon (Continence products for adults)
Disabled Living, Burrows House, 10 Priestley Road, Wardley Industrial Estate, Worsley, Manchester, M28 2LY
Telephone: 0161 607 8200
Our general email address is [email protected]
How to contact The Lancaster Suite
Continence service at Croydon University Hospital
Tel: (020) 8401 3647 direct line or
Email: [email protected]
Post: The Lancaster Suite, Croydon University Hospital, 530 London Road, Croydon, Surrey, CR7 7YE
Your questions and comments:
If you have any other questions please ask the nurse or doctor who will be happy to help you. If you feel that you would
like to speak to someone regarding care, treatment or anything relating to your care at Croydon University Hospital you
can either talk to the unit manager or to The Patient Advice and Liaison Service (PALS), or you can telephone: (020) 8401
3210.
Authors: Ms Ranee Thakar (CHS), Wendy Ness (CHS), Jessica Holloway (CCG), Dr Rajeev Sagar (CCG)
Version 1: 16.09.2014
Location: T:\Commissioning\Service Redesign Team\2. Service Areas\Urology\2. Urology Pathways\3. UTI
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