DISORDERS OF THE KIDNEYS, BLADDER, AND PROSTATE

DISORDERS OF THE KIDNEYS, BLADDER, AND PROSTATE



BLADDER INFECTION


Bladder infection (cystitis, sometimes called “urinary tract infection,” or UTI) occurs frequently in females, because the shorter female urethra does not protect the bladder from bacteria as efficiently as does the male organ. A person with a bladder infection complains of discomfort (sharp pain, cramping, or burning) on urination, urge to urinate (“urgency”), frequent urination, difficulty initiating urination, lower abdominal cramping, and sometimes bloody urine, which may be as severe as small clots. Similar symptoms may be suffered by males who harbor infections in the prostate gland.


Treatment involves the administration of an antibiotic and increased oral fluid intake. Because many antibiotics are well concentrated in the urine, there are a number of acceptable treatment regimens. For the sake of simplicity, the female victim may be treated with trimethoprim-sulfamethoxazole (Bactrim or Septra) in one double-strength tablet twice a day for 3 days, or two double-strength tablets in one dose; ciprofloxacin 250 mg twice a day for 3 days, or 500 mg in one dose; ofloxacin 200 mg twice a day for 3 days, or 400 mg in one dose; norfloxacin 400 mg twice a day for 3 days; lomefloxacin 400 mg, trovafloxacin 100 mg, or levofloxacin 250 mg once a day for 3 days; cefpodoxime 100 mg twice a day for 7 days; amoxicillin-clavulanate 500 mg/125 mg twice a day for 7 days; nitrofurantoin monohydrate/macrocrystals (Macrobid) 100 mg capsule twice a day for 7 days with meals; nitrofurantoin macrocrystals 50 to 100 mg four times a day for 7 days; or fosfomycin tromethamine (Monurol) 3 g in a single dose. If the victim is diabetic or older than 65 years of age, or if the symptoms do not completely resolve or they recur within a few days of therapy, use the same or a different drug for 7 to 10 days. If the victim is pregnant, use amoxicillin, ampicillin, nitrofurantoin, cephalexin, cefadroxil, or trimethoprim-sulfamethoxazole.


Chlamydia are bacterium-like “germs” that are increasingly the cause of reproductive tract infections in women and genitourinary tract infections in men. Because the penicillins (such as ampicillin) are not effective against Chlamydia, any male with a bladder infection should be treated with tetracycline (500 mg four times a day), doxycycline (100 mg twice a day), or trimethoprim-sulfamethoxazole (one double-strength tablet twice a day) for 10 days, or with azithromycin 1 g in a single dose. Any male who develops a bladder or prostate infection (see page 297) should be seen by a physician when he returns from his journey.


The incidence of bladder infections in older women may be decreased by a daily 8 oz (237 mL) glass of cranberry juice. It takes several weeks of juice drinking before this effect begins to occur.


It may not be convenient for a woman to squat in order to urinate outdoors. There are devices available to facilitate a woman’s urinating while standing or squatting. The Whiz Freedom is advertised as the world’s first hydrophobic (repels water), antibacterial, and ecofriendly urine director. This device fits over the pudendal region so that urination can be accomplished when standing or sitting outdoors (or indoors) in such a manner that the urine stream is captured and directed away from the body. Another product intended for the same purpose is the “Lady J.”

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Aug 11, 2016 | Posted by in EMERGENCY MEDICINE | Comments Off on DISORDERS OF THE KIDNEYS, BLADDER, AND PROSTATE

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