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BackTable / OBGYN / Podcast / Episode #42

Recurrent UTIs: Controlling Those Nasty Little Bladder Infections

with Dr. Anne Cameron

In this crossover episode of BackTable OBGYN with Urology, Dr. Suzette Sutherland, Director of Female Urology at the University of Washington, and Dr. Anne Cameron, Professor of Urology at the University of Michigan, share their insights on the prevention and management of urinary tract infections (UTIs).

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Recurrent UTIs: Controlling Those Nasty Little Bladder Infections with Dr. Anne Cameron on the BackTable OBGYN Podcast)
Ep 42 Recurrent UTIs: Controlling Those Nasty Little Bladder Infections with Dr. Anne Cameron
00:00 / 01:04

BackTable, LLC (Producer). (2023, December 27). Ep. 42 – Recurrent UTIs: Controlling Those Nasty Little Bladder Infections [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Anne Cameron discusses Recurrent UTIs: Controlling Those Nasty Little Bladder Infections on the BackTable 42 Podcast

Dr. Anne Cameron

Dr. Anne Cameron is a urologist and assistant professor with University of Michigan Medical School in Ann Arbor.

Dr. Suzette Sutherland discusses Recurrent UTIs: Controlling Those Nasty Little Bladder Infections on the BackTable 42 Podcast

Dr. Suzette Sutherland

Dr. Suzette Sutherland is the director of female urology with UW Medicine in Seattle, Washington.

Synopsis

First, they emphasize the importance of dispelling misconceptions about recurrent UTIs being a result of poor hygiene or incorrect behaviors, explaining that they can stem from genetic or hormonal risk factors. Dr. Cameron describes her algorithm for managing UTIs in specific patient populations. She further discusses the impact of factors such as fluid intake, bowel habits, and vaginal health on the incidence of UTIs. Dr. Cameron also highlights the potential for UTIs in diabetic patients on certain medications and the importance of a collaborative approach with diabetic healthcare teams. Additionally, the doctors explore various treatment strategies, such as cranberry supplements and gentamicin bladder installations, cautioning against antibiotic overuse due to the risk of resistance.

Timestamps

00:00 - Introduction
02:13 - Understanding UTIs: Definitions, Symptoms, and Prevalence
04:39 - Recurrent UTIs: Definitions, Causes, and Treatment Challenges
12:00 - Understanding Asymptomatic Bacteriuria
15:00 - Cystitis vs. Pyelonephritis vs. Urosepsis
20:57 - Antimicrobial Resistance and Antibiotic Stewardship
24:36 - Treatment Guidelines for UTIs
31:13 - Self-start Antibiotic Therapy for UTIs
34:37 - Preventing UTIs: Hydration, Lifestyle Factors, and Bowel Health
38:33 - The Connection Between Vaginal Health and UTIs
42:40 - The Role of Supplements in UTI Prevention: D-Mannose and Cranberry, and Methenamine Hippurate
57:18 - Identification and Treatment of UTIs in Patients with Indwelling Catheters
01:00:04 - The Role of Gentamicin Bladder Installations in UTI Prevention
01:04:27 - The Impact of Diabetes Medications on UTIs

Resources

Transcript Preview

[Dr. Anne Cameron]
Someone getting a bladder infection, a cystitis, and that being left untreated for a day or two turning into urosepsis pyelonephritis is less than 1%. The reason that is because the bacteria that because cystitis are different than the bacteria that because pyelonephritis. They're completely different bacteria and they may all be E.coli, but they have different pili and different fimbriae on the bacteria. People who have pyelonephritis, they don't present with bladder pain, urgency, frequency, and then get a fever and then get flank pain. These people present with fever, flank pain, and they're feeling terrible, nausea, vomiting, they feel absolutely awful. Most of them have no lower urinary tract symptoms. The bacteria basically bypassed the bladder and went straight to the kidneys. Those people are very different. They present clinically very differently.

The people who do get a cystitis that turns into pyelonephritis often have some anatomic abnormality. Those are people who've had kidney transplants and kidney transplant patients all have reflux into their transplant kidney. That's how a transplanted kidney is placed into the bladder. That's normal to have reflux, but it puts them at high risk of pyelo. Also, some people have reflux congenitally or have had some bladder surgery. They might have outlet obstruction, they may be catheterizing, and their bladder functions differently. Those people, a cystitis can turn into a pyelonephritis. In the general population with a normal bladder, cystitis really does not cause pyelonephritis.

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Articles

Special Topics in UTIs: Indwelling Catheter Colonization, Urosepsis & Antibiotic Resistance

Special Topics in UTIs: Indwelling Catheter Colonization, Urosepsis & Antibiotic Resistance

“What About Cranberry Juice?” UTI Treatment & Prevention

“What About Cranberry Juice?” UTI Treatment & Prevention

Let’s Talk UTIs: Strategies for Diagnosing & Managing Recurrent Infections

Let’s Talk UTIs: Strategies for Diagnosing & Managing Recurrent Infections

Topics

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