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Urinary tract infection is a very prevalent disease. According to the National Women's Health Resource Center, urinary tract infection accounts for more than 8 million doctor visits in the United States and about $1.6 billion in health costs each year. Despite being so common, most women did not know the preventative strategies and risk factors for urinary tract infection in a survey done by the National Women's Health Resource Center last fall. The survey found that only 13 percent of women age 18 to 45 knew that sexual activity is a primary risk factor for bladder infection and that simple precautions can prevent it. The cause of urinary tract infection is bacteria entering the urethra and infecting the bladder, said Dr. Douglas Eggli, a professor of radiology who scans children for urinary tract infection at the Milton S. Hershey Medical Center. "Bacterial organisms from the skin and stool are usually the contaminants," he said. "One of the more common is the E. coli bacteria." Anyone can get urinary tract infection, including children and men, but it is more common in women because of the shorter urethra. In children it is common when they are potty training, Eggli said. Toilet seats are relatively germ-free, according to a study done by Dr. Charles Gerba at the University of Arizona. The average toilet seat has about 49 microbes per square inch, compared with a keyboard, which can contain up to 25,127 microbes per square inch. However, Robertson advises caution when dealing with dirty toilet seats. "Studies, the few that have been done, have said that it doesn't matter; they say that when you sit on bacteria you mostly squish them," she said. "It's a gray area, though, because there are always exceptions where people can put their hand in a wrong place that researchers didn't anticipate." Urine is sterile when it first comes out of the body, but it once it comes in contact with air and other objects in the environment, bacteria can grow on it, Robertson said. Urinary tract infection may also be caused by anatomical abnormalities in the connection between the bladder and ureters, tubes that connect the kidneys and bladder, Eggli said. Urine may reflux and go back into the kidneys. Ignoring the urge to urinate has nothing to do with reflux and the development of urinary tract infection. "Nothing bad really happens, but your bladder capacity may increase," he said. Many people can have urinary tract infection without knowing it, because sometimes it is a "completely silent" disease, Eggli said. If symptoms do arise, they can include pain and burning during urination, frequent urges to go, a fever, abdominal pain and cloudy, foul-smelling urine. If detected, taking antibiotics easily cures it, Eggli said. Urinary tract infection is the No. 2 reason that antibiotics are prescribed, according to the National Women's Health Resource Center. However, the survey also found that 39 percent of women hoped the infection would go away on its own, 23 percent treated it by themselves and 24 percent said that they were too busy to see a doctor. Seven percent said the symptoms went away. If untreated, urinary tract infection can lead to permanent kidney damage and the infection could spread to into the blood stream, Eggli said. Prevention methods for urinary tract disease include proper hygiene, wiping from front to back, emptying the bladder after intercourse and drinking plenty of fluids. Avoiding contact Even though most bacteria don't pose much of a threat, there is still disgust for dirty toilet seats, Robertson said. Many women can avoid touching dirty toilet seats by learning to urinate standing. Many women responded to www.restrooms.org with a way to avoid touching dirty toilet seats when Robertson and her husband, Charles, first began the Web site. They gave suggestions on how women could urinate standing up. The site has received three million hits from all over the world. Robertson details how women can urinate standing up on the Web site, along with some tips if there are any problems. "Most girls can pee standing up, but they choose not to because it can be messy," Eggli said. "It's harder to aim the stream and to control it." The method also may not work for everyone, Robertson said. "Due to slight differences in anatomy and slant, about 20 percent may not be able to do it," she said. There are other products that are now offered to in response to female urination, including a female urinal, disposable cardboard funnels and the TravelMate, a female urological device marketed by the Robertsons that won the 2001 Medical Design Excellence Award. "It's small, so it fits in your glove compartment or your pocket for hiking, skiing and canoeing," Charles said. "Some people don't mind just washing and reusing it. If you pee in your toilet and your underwear you don't throw them out. It's pretty simple to use, but you need to get a feel for it." In addition to convenience, learning how to urinate standing up has some health benefits as well, Robertson said. "It strengthens the pelvic muscles, empties the bladder more completely and decreases incontinence," she said. "Doing Kegel exercises can improve muscle tone and increase ability to push during childbirth. Gravity is on your side." Women urinating while standing has been a practice throughout history in other cultures in Asia, Africa, parts of eastern Europe and even in the Great Plains of America because of the inconvenience of sitting down to urinate, Robertson said. It may not have picked up as a result of cultural bias. "There's this idea of women being prim and proper," she said. "Cultural comfort level plays into it, but I think things are becoming more open." |
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