I received a call from one of my girlfriends last weekend. She was complaining about a Urinary Tract Infection (UTI) that she contracted again. The symptoms, including a frequent and intense urge to urinate, burning on urination, lower abdominal pain, and cloudy or bloody urine, are all too familiar to many women and even to quite a few men.
UTIs are the second most common type of infection, accounting for millions of visits to healthcare providers each year.
Women are significantly more likely to contract a UTI than men due to certain anatomical differences as I’ll discuss below. In fact, a woman’s lifetime risk of contracting a UTI is greater than 50%. And although not common, a UTI can be quite serious for men.
A UTI becomes a recurrent infection for about 20 percent of the female population. Some women suffer three or four episodes yearly. This is alarming since the conventional treatment is antibiotics. The more frequently antibiotics are used, the more likely it is that antibiotic-resistant strains of bacteria develop.Furthermore, in addition to killing bad (harmful) microbes, antibiotics kill good (helpful) microbes as well. This can lead to recurrent yeast infections and other health issues in women.
So, why do men get a pass? You see, a man’s urethra is long, at least compared to a woman’s. It runs the whole length of his penis and then in his lower abdomen to the bladder. The length of a man’s urethra is typically in a range of about 15 cm to 29 cm, depending on his anatomical variations, including penis length.
By contrast, the female urethra is only about4.8-5.1 cm long. There’s not much variability in length, because it only extends from its external opening between the clitoris and the vagina to its connection to the bladder in her lower abdomen. It is much easier for an ascending infection to travel 5 centimeters in women than 20+ centimeters in men. This is one of the reasons for the higher incidence of UTIs in women.
To make matters worse, the female urethral opening resides near sources of bacteria – the vagina and the anus. I will address only the latter source today, since healthy vaginal flora is much less likely to cause a UTI.
The anus is a source of all kinds of fecal bacteria. One particularly abundant microbial resident of the bowel is Escherichia Coli, commonly knows as E. Coli. Guess which microbe causes the vast majority of UTIs? That’s right, E. Coli.
When I travel to the Middle East, I appreciate the fact that a bidet (shatafa) is a common fixture in the bathrooms. This little “water fountain,” which is also common in many parts of Asia, is used to clean the anus after a bowel movement. That’s a very healthy habit and one that I heartily recommend to you.
In the US, however, it is customary to simply wipe one’s butt with dry toilet paper and move on with one’s life. 🙂 Not good, my dear. Simply using dry toilet paper to clean oneself is ineffective and, therefore, unhygienic. Not only does it leave residual odor between the glutes, but it can also lead to UTIs. Normal leg movements throughout the day can result in the migration of E. Coli or other microbes from the anus to the urethral opening. The result can then be urethritis (inflammation of the urethra) and / or cystitis (inflammation of the bladder).
That is why I strongly recommend that you use more than just dry toilet paper (such as moist towelettes or wet and soaped paper towel) after a bowel movement. As I always repeat, an ounce of prevention is worth a pound of cure.
So very truly yours,
Dr. Inna
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