We have all probably experienced or heard of someone who has experienced some form of urinary discomfort in their lifetime.  The most common symptoms reported include urinary urgency, burning/discomfort, and frequency, but what exactly is your urinary system trying to tell you?

Urinary Tract Infections (UTI’s)

A UTI is a bacterial infection in the urinary system caused by some type of microorganism such as: E. coli, Pseudomonas, Klebsiella pneumoniae, or Staphylococcus.  Urinary tract infections include two components: cystitis, which is the infection of the lower urinary tract/bladder; and pyelonephritis, which is an infection of the upper urinary tract/kidneys.

Common symptoms include:

• urinary hesitancy (unable to start your stream), urgency, frequency (unable to completely empty your bladder), dribbling, and dysuria (painful urination). Additional symptoms include hematuria (blood in urine), fevers, chills, flank pain, pain in lower back, one side more than the other.  Over 50% of women will experience some form of a urinary tract infection in their lifetime, but who is at risk, how is one treated, and how can someone prevent an infection or recurrence?

 Population at Risk:

• Females are at a higher risk than males due to the shorter distance from the urethra to the anus
• Recent sexual intercourse and history of previous UTI diagnosis
• Persons who use spermicide alone, diaphragms, or spermicide-coated condoms
• Diabetics
• Structural and functional urinary tract abnormalities

Evaluation and Treatment:

If a person has concerns for a UTI, then they should contact their doctor’s office for further workup and treatment including:

• Physical exam
• Urinalysis by dipstick
• Urine culture and sensitivity. The importance of a culture: this will allow correct treatment of specific bacteria causing infection and will allow the provider to prescribe the specific and correct antibiotic.

Diagnosis is made based on clinical and laboratory findings.  Treatment includes the use of antibiotics in which the urine culture will reveal which antibiotic the microorganism is most susceptible to.  Some of the common antibiotics used for UTI’s include Macrobid, Bactrim, Ciprofloxacin, Keflex, and Augmentin.  Patients are encouraged to complete the antibiotics entirely and to not save for later once they start feeling better.  For some patients, a urinary analgesic like the over the counter AZO or phenazopyridine is beneficial in the first few days following diagnosis to help provide relief from discomfort.

Prevention from Reoccurrence:

• Stay well hydrated and urinate often
• Take showers instead of baths as well as avoiding fragrance filled soaps and body washes
• Avoid tight fitting undergarments and sweaty undergarments
• Females should always wipe from front to back only
• Avoid douching, powders, or sprays in the genital area
• Urinate after sexual activity

See a provider if you have any concern for a possible urinary tract infection.  Your provider will evaluate and decide the best medical management for your urinary health.

Some Tips to Stay Safe as the Temperatures Rise During the Coronavirus Pandemic

While we haven’t specifically spoken about the global pandemic happening around us on our blog, like other Americans, it has been heavy on our hearts and minds. As health professionals, this novel coronavirus has proven to be a formidable foe to the medical industry, as well as to our patients, friends, and families. We are striving to be at the forefront of the information that is continuously evolving, and more is known day by day. We have some tips for you to stay safe as all of us continue to stumble through this uncertain time.

 

As the country is slowly re-opening, we feel it is important to continue some of the practices recommended to reduce the risk of infection. This includes:

-washing hands often with soap and water for at least 20 seconds

-cleaning hands with a hand sanitizer that contains at least 60% alcohol if soap and water is not available (rub until hands feel dry)

-avoid touching the eyes, nose, and mouth – especially when out in public

-at-risk individuals continue to stay home as much as possible (over 65 years old, those with high blood pressure, diabetes, autoimmune disorders, other high-risk conditions)

-stay at least 6 feet away from other people who are not in the same household when out in public

-avoid other people or family members who are sick

-wear a cloth face covering or mask when out in public and staying at least 6 feet away from others physically is not possible, such as a grocery store or pharmacy

Face coverings are recommended because studies have shown that people can transmit the virus before showing any signs or symptoms.

 

For our pregnant patients, the available medical literature specific to COVID-19 currently does not suggest that pregnant women are at increased risk of infection, severe complications, or death compared to nonpregnant women. This is true regardless of trimester. Currently, in addition to the usual precautions listed above, we are recommending that our pregnant patients sequester, or shelter at home, for the two weeks prior to their planned delivery date, or at 37 weeks if there is no planned delivery date while waiting for labor. This is an increased effort to reduce the possibility of coronavirus infection during the time of delivery. Studies to this point have indicated it is unlikely that coronavirus can be transmitted to the baby during pregnancy, labor, or delivery, but it is possible to pass the infection to a newborn. For women who have confirmed or suspected infection at the time of delivery, we would discuss the choice to breastfeed and recommended precautions on an individual basis. However, coronavirus has not been detected in breastmilk, so pumping for your baby is certainly an option.

 

As we are still navigating what has become known as the “new normal” in the midst of this pandemic, we are all continuously learning. You may have learned a new hobby, created a new masterpiece, experimented with a new recipe, or reached a new fitness goal. Right now, one of the best ways to explore something new is to get outside. As the Texas State Parks are opening, this is a good opportunity to immerse, yourself in nature, and take some time to get some fresh air.

 

We urge you to continue to stay safe, stay mindful of your health – both physically and mentally, and to explore opportunities that will allow us all to come out better on the other side of this pandemic.

Here’s the bad news: Human Papilloma Virus (HPV) is a sexually transmitted virus that can cause us cervical and possibly vaginal and vulvar cancers, as well as genital warts, and it is much more common than most women realize. It is predicted that 80% of sexually active people will be infected with HPV at some point in their life. There are over 150 different types of HPV, most of which will not cause us problems; however, there are certain HPV types that can cause cervical and possibly vaginal and vulvar pre-cancer and cancers. For instance, HPV types 16 and 18 accounts for nearly 70% of cervical cancers and HPV types 6 and 11 account for 90% of genital warts.  Seven Oaks Women’s Center offers HPV testing.

HPV Vaccine

So what’s the good news? We can do something to protect ourselves and our loved ones from being infected by HPV. In the United States, there are 3 approved HPV vaccines, of which, Seven Oaks carries the vaccine that covers the most HPV types: Gardasil 9. This vaccine protects us from the most common types of HPV to cause cervical cancer and genital warts.

As of 2019, most insurance companies have extended the coverage of the HPV vaccine to women ages 9-45 (previously, the vaccine was only offered to women up to the age of 26). The vaccine is a 3 shot series with the second vaccine given 1-2 months after the first and the third vaccine is given 6 months after the first. If a woman has previously received any of the vaccines in the series but has not yet completed the series by the recommended time intervals, it is not recommended to restart the vaccine series, but rather just finish it.

Studies have already demonstrated the dramatic effect this vaccine has on reducing the number of HPV infections and subsequent cervical cancers that we see, not just in the United States, but worldwide. If you have not been vaccinated, we encourage you to do so as soon as possible. Please ask your provider more about how you can be vaccinated today!

Abnormal Cells

If your Pap test shows abnormal cells, additional tests may be performed. These tests include:

Colposcopy: A colposcopy closely examines the vagina, vulva, and cervix by using a lighted magnifying instrument called a colposcope.

LEEP (Loop Electro-Surgical Excision Procedure): A small electrical wire loop is used to remove tissue and precancerous cells from the cervix.

Conization: Also known as a cone biopsy, conization removes a cone-shaped section of precancerous tissue high in the cervix to provide a biopsy sample for laboratory examination to tell if cancer is present.

HPV Treatment Options

Although there is no treatment for the virus itself, the cell changes caused by HPV (ex: warts) can be treated. Pre-cancer cell changes can be also identified beforehand by Pap tests and treated. HPV vaccines can prevent infection with the types of HPV most likely to cause cancer and genital warts, although the vaccines are most effective when given at a younger age.  Consider having HPV testing at your next appointment.

HPV infections can go away on their own with the help of your immune system and in most cases, it can clear within 18 to 24 months.

Contact Seven Oaks Women’s Center to discuss the options you have available.