DM Bladder Infections

Bladder infections are very, very common in adults and in children. They are most common in women and millions of office visits to physicians occur yearly in this country for treatment of this problem.

As a urologist who does not treat pediatric patients I will confine all my comments to the adult population. In men, bladder infections are not very common and are usually seen in two populations. The first is when bladder infections are a consequence of prostate infections. (see prostatitis on this web site) The second is in men who have significant prostate enlargement or BPH and are unable to empty their bladders well. (see BPH on this web site) In these conditions the primary underlying condition, prostatitis and BPH are treated to correct the bladder infection problem.

In women the situation is different. Frequently bladder infections are due to the proximity of the urethra and vagina, such that during sexual activity bacteria which may be located outside the urethra in the vaginal area can be massaged into the bladder resulting in acute cystitis. The second common group is in menopausal women who frequently do not have adequate estrogen in the vaginal area making the bladder more susceptible to infection.

Often the evaluation can be very easy with simply a medical history, an examination and a check of the urine in the office. In the more pervasive situation with recurring infections sometimes X-rays of the kidneys, ultrasound or other tests may be needed. We can examine the bladder carefully with a telescope called a cystoscope. This type of testing is certainly not always necessary, but sometimes it is needed to get an answer especially in the recurring infection patient.

Treatment is generally with antibiotics and medications to give relief from pain and urinary urgency and frequency. Treatment can often be very brief, usually 3 to 5 days most of the time. A treatment that is effective when infections are clearly tied to sexual intercourse is to take a mild antibiotic either before or after sexual activity. It is only a rare situation where any type of surgery or hospitalization will be necessary for the patient suffering from bladder infections.