Why do I keep getting UTIs after hysterectomy?

It is not uncommon for women to suffer from urinary tract infections or UTIs after hysterectomy surgery. Women are unfortunate to have a shorter urethra than men, making them four times more likely to get urinary tract infections. Moreover, 50% of all women will get at least one UTI during their lives.

After a hysterectomy, there are various hormonal changes. The epithelium of the vagina and urethra are estrogen-dependent.

Reduced estrogen levels negatively affect the tissues, making them atrophic and prone to vaginal and urinary infections.

Because of this, more than 10% of postmenopausal women suffer from recurrent urinary tract infections.

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Characteristic signs of a UTI after hysterectomy include:

• A burning or itching when passing urine
• More frequent urination, often little bits at a time
• Lower abdominal or back pain
• Urine is cloudy or has traces of blood
• Urine smells unpleasant
• Feeling unwell – shaking, shivering, nauseous, being tired
• Fever of 38ºC (100.4ºF) or higher

What are the risk factors of UTI after hysterectomy?

Some factors that are associated with urinary tract infection in the postoperative recovery period of a hysterectomy include:

• Inserting instruments during preoperative exams will increase the risk of developing UTI in the postoperative period. For example, cystoscopy, catheterization, or urodynamic testing.
• The type of hysterectomy is also associated with increased UTI rates. There is a higher risk of UTI after a vaginal compared to an abdominal hysterectomy. Furthermore, women have a significantly increased risk of UTI when they perform Pelvic Organ Prolapse (POP) surgery together with the hysterectomy.
• Having a bladder catheter after surgery will increase the odds of UTI. And the longer the catheter stays in place, the risk of infection increases.

Chronic UTI after hysterectomy

If you have more than one UTI within six months, you suffer from what doctors call recurring UTI. In this case, a urologist may help you with a treatment plan.

Prophylactic low-dose antibiotic

Treatment may include a low prophylactic dose of antibiotics that you may need to take for six months to two years. Another option is self-start antibiotic therapy, where women can start a 3-days antibiotic treatment as soon as they recognize the first symptoms of UTI.

However, these treatments come with a few downsides. Taking antibiotics for a long period of time puts you at risk of side effects like yeast infections, diarrhea, and kidney disease. And, when you stop, you will be just as susceptible to frequent urinary tract infections as before the therapy.

Long-term use of antibiotics may also make bacteria less responsive to antibiotics. As antibiotic resistance is a major health concern worldwide, researchers seek alternative ways to prevent and treat frequent urinary tract infections.

Vaginal estrogen cream

A new study from the Swedish Karolinska Institutet shows that topical treatment with estrogen helps restore the bladder’s inner lining. Hence, women are better able to fight off new bacterial infections.

The inner lining of the bladder is covered with protective epithelial cells. Low estrogen levels after hysterectomy may cause the bladder’s epithelium to become fragile and less resistant, giving invading bacteria a chance to reach underlying tissues and cause infections.

Alternative ways to treat UTI after hysterectomy

If many bladder infections bother you, consider the following treatment options.

Probiotic suppositories

Probiotics are a new and promising alternative to standard treatments with antibiotics. A new strategy doctors are looking into is using Lactobacillus probiotics to fight off pathogenic bacteria. Especially as quite a few bacteria have become resistant to certain types of medicines. A clinical study shows that treatment with a probiotic intravaginal suppository (LACTIN-V) may reduce urinary tract infections in women with a history of recurrent UTIs.

Uqora Promote is a product that has two strains of bacteria, Lactobacillus Rhamnosus and Lactobacillus Reuteri. They help to balance the cervicovaginal ecosystem naturally. If you are prone to UTIs, this is a product you may like to try out.

Cranberry juice

Drinking cranberry juice or taking concentrated cranberry tablets reduces the risk of frequent urinary tract infections. Recently, scientists discovered that certain chemicals in cranberries prevent bacteria like E. coli, which causes 90% of all UTIs, from spreading in three ways.

• Firstly, they make it difficult for the bacteria to attach themselves to the surface of the urinary tract.
• Secondly, these chemicals hinder the movement of the bacteria, making spreading the infection more difficult.
• Thirdly, they slow down the production of the enzyme urease. This enzyme adds to the aggression of the disease.

Acupuncture

The results of a Norwegian study show us that acupuncture may, for some women, be an effective way to prevent frequent UTIs. After a six-month treatment with acupuncture, they found that women had a 50% reduction in residual urine. Residual urine refers to small amounts of urine remaining in the bladder after going to the bathroom.

Not fully emptying the bladder is often a problem for women after a radical hysterectomy and one of the reasons some women keep getting UTIs. The research also shows that there was no change in the residual urine levels of the women in the group without acupuncture treatment. Furthermore, 73% of the treated women became free of infections during the follow-up period of 6 months.

Easy to apply self-help tactics

• Drinking plenty of water to wash away any bacteria that are present in the bladder and urethra.
• Don’t hold your urine for a prolonged time. Go when you feel the need to pee and empty the bladder completely.
• Wipe always from front to back. Do it the other way, and you risk wiping bacteria from the anus to the urethra.
• Prefer to take a shower rather than soak in a bathtub allowing bacteria to enter the urinary tract.
• Clean your vagina and anus daily with water and mild soap.
• Urinate after intercourse to flush out any bacteria that got into the urethra.
• Avoid intimate hygiene products. Intimate washes and other types of vaginal cleansers increase the risk of bacterial infection and UTIs.

Take the quiz

If you are showing symptoms of a urinary tract infection, but you’re not sure, then take this Urinary Tract Infections Quiz

In conclusion

If you are also worried about the growing phenomenon of antibiotic resistance, then discuss this with your doctor. Ask him about the alternatives we mentioned in this post to treat your urinary issues after a hysterectomy.

Maybe you have heard about another treatment for frequent urinary tract infections in women. Perhaps if a remedy worked well for you, please share it in the comments below.

Source

Urinary Tract Infection After Hysterectomy for Benign Gynecologic Conditions or Pelvic Reconstructive Surgery

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