Dr. Angelish Kumar, a urologist, discusses UTIs, their prevention, treatment, and their relation to physical and mental health. Topics include recurrent UTIs, post-coital antibiotics, medication in the bladder, ketamine usage, bladder cancer, and preventing UTIs in young women.
Creating a comfortable and welcoming environment for female patients is crucial in specialized care for bladder issues.
Over 50% of women will experience a UTI in their lifetime, with risk factors such as the short length of the female urethra and specific bacteria like E. coli playing a role.
Individualized treatment plans, regular urination frequency, and addressing the impact of chronic urinary symptoms on mental health are essential for comprehensive care.
Deep dives
Understanding Female Urology and Bladder Issues
Dr. Angelish Kumar, a board-certified urologist specializing in female urology, discusses her journey into the field and the need for specialized care for women experiencing bladder issues. She emphasizes the importance of creating a comfortable and welcoming environment for patients, focusing on their unique needs.
Urinary Tract Infections (UTIs)
Dr. Kumar delves into the prevalence and causes of UTIs, explaining that over 50% of women will experience a UTI in their lifetime. She highlights the risk factors, including the short length of the female urethra, and discusses the role of specific bacteria, such as E. coli, in causing UTIs. Dr. Kumar also addresses misconceptions around UTI prevention and the importance of individualized treatment plans.
Bladder Health and Mental Health Implications
Dr. Kumar provides insights into maintaining bladder health, including guidelines for regular urination frequency and the appearance of urine. She also emphasizes the impact of chronic urinary symptoms on mental health and relationships, underscoring the need for comprehensive care and support in addressing these issues.
Preventing UTIs with Post-Coital Prophylaxis
One of the ways to prevent urinary tract infections (UTIs) in sexually active individuals is through post-coital prophylaxis. This involves taking a low dose of nitrofurantoin, an antibiotic, after sexual activity to prevent UTIs. However, some patients may not find it practical to take a therapeutic dose of nitrofurantoin every day. In such cases, alternatives like methenamine, a urinary antibacterial agent, and cranberry supplements may be recommended to boost the body's defenses. While antibiotics carry a risk of bacterial resistance, nitrofurantoin has a lower risk compared to other antibiotics and causes less collateral damage to the body's healthy flora.
Diagnosing and Managing UTIs with Negative Urine Cultures
Some patients experience discomfort and pain similar to a urinary tract infection (UTI) but have negative urine cultures. This commonly happens when antibiotics are prescribed, symptoms temporarily improve, but another UTI occurs shortly after stopping the antibiotic. Negative cultures can occur in about 20-30% of cases and may not accurately reflect the presence of an infection. For patients who experience symptom relief with antibiotics, even with negative cultures, it is likely they have a UTI. However, if symptoms persist despite antibiotic treatment and negative cultures, other factors like chronic bladder inflammation or hypersensitivity may be contributing. In these cases, a comprehensive evaluation, including cystoscopy, may be necessary to assess the bladder's inner lining and identify potential causes.
Dr. Angelish Kumar is a board-certified urologist in New York City specializing in surgical and nonsurgical treatments for recurrent urinary tract infections, bladder leakage, vaginal laxity, and bladder pain. She is the founder of private medical practice Women’s Urology New York and is a Clinical Instructor of Urology at Mount Sinai Hospital. Eileen and Dr. Kumar break down everything there is to know about UTIs: What they are, why they happen, prevention, treatment, new research, and the importance of considering physical and mental health hand-in-hand. To make an appointment or learn more about Dr. Kumar, visit her website, https://womensurologynewyork.com
