Help! My wife blames me for her recurrent urinary tract infections

Dear Doc,

My wife has been having recurrent urinary tract infections and surprisingly she blames me and accuses me of being unfaithful. Are UTIs sexually transmitted? And if not, what could be causing my wife this problem?

Kevo, Eldoret

Dear Kevo,

Urinary tract infections (UTIs) are infections within the urinary tract, that is, either in the kidney, ureter, bladder or urethra. UTIs are quite common in women and in about 20 per cent of all women, the UTIs are recurrent — they keep coming back. Some people may have recurrent UTIs for no good reason, while in others, it may be due to abnormalities in the structures of the urinary system, or it may be due to pregnancy, steroid use, spinal cord injury, nerve problems, kidney stones or some immune disorders.

In most cases, the bacteria that cause UTIs are the ones that live in the intestines, and they can travel from the anus to the urethral opening (where urine comes out), since the two are not far from each other. Women also have a very short urethra (the tube that carries urine to the outside) compared to men, which makes it easier for bacteria to travel up to the bladder and cause infection there. The bacteria can also get to the urethra when using a dirty toilet due to splashing, and also due to the close contact during sexual intercourse. In addition to this, when there is a sexually transmitted infection, it can cause infection within the reproductive structures and also within the urinary system. Regardless of whether it originated from an STI or not, having multiple partners increases the risk of acquiring sexually transmitted infections and breeds an environment of mistrust that can destroy a relationship.

Having a UTI may cause a burning or irritating sensation when passing urine, feeling very pressed, urine leaking out before getting to the toilet, going to urinate many times, even though very little urine comes out; change in urine colour and/or smell, blood in urine, lower abdominal pain, lower back pain, fever and chills, nausea, bloating and feeling tired.

It is important to note that someone can have UTI-like symptoms that are caused by inflammation of the urinary bladder (cystitis) due to other causes other than infection. These include some medications, radiation, other chronic illnesses and interstitial cystitis. UTIs are treated with antibiotics after a urine test. Due to the recurrence, she should also have a urine culture done. She may also benefit from a vaginal swab for analysis and culture. For recurrent UTIs, she may be given a low dose antibiotic to take over a long time. She may also be advised to take an antibiotic every time after sexual intercourse or take antibiotics for a short time (one or two days) every time she gets symptoms. She can also learn how to do a urine test at home every time she gets symptoms to make sure that it is a urine infection.  To prevent urinary tract infections, she can do this:

Go to the toilet as soon as she needs to and empty the bladder completely

Always use a clean toilet

Take a lot of water daily, not just when there’s an infection

Wear cotton underwear and loose-fitting trousers

Avoid using scented soaps, feminine hygiene products and douches

Wipe herself from front to back

Both of you should clean the genital area thoroughly before sexual intercourse and urinate immediately after

Barrier contraceptive methods such as condoms, diaphragms and spermicides can cause irritation, so consider using another method. When using a condom, make sure you use a good lubricant.

I sexual intercourse with this lady a month ago and now she says she’s pregnant. I doubt it is mine since we used protection and besides that, I found out that the pregnancy is four weeks and a few days old. How do I get DNA done before that child is born?

K, Nairobi

Dear K,

In the first place,  it is possible for a pregnancy to occur even when you have used a barrier method/protection such as  a condom. This may be due to contact with pre-ejaculate fluid if the condom was not used throughout the encounter. The other reasons for this would be rupture of the condom or spillage during withdrawal/removal. It is possible to do paternity DNA testing during pregnancy by isolating the baby’s DNA from the mother’s blood between 15 and 20 weeks of pregnancy. If the result is inconclusive, it needs to be confirmed by using amniotic fluid or chorionic villus sampling, where a sample is taken from the tissues surrounding the growing fetus. These procedures are invasive and may trigger a miscarriage so it is best to wait for the baby to be born. For any of these tests, you need the consent of the mother and the possible father(s) and you may require legal consent, and the tests require a complex medical procedure.

In regards to the reported age of the pregnancy, medical practitioners count the age of a pregnancy from the day the last periods started, not from the day someone got pregnant. For example, if someone got pregnant four weeks ago and they had their periods two weeks before that, the pregnancy is said to be six weeks old. This counting system, however, is not exact, so you cannot determine paternity definitively based on that.

What does the word genetic mean? Is it different from generic drugs?

Ali

Genetics refers to the biological make-up of an individual based on the genes they have. Genes are units of biological material found in our cells that “dictate” how our body develops and different traits that we get. We get a set of genes from each of our parents, which means that traits are passed down from our parents to us such as skin colour, hair colour, eye colour and blood type. Genes could also carry traits that cause disease or that make it easier for someone to get a particular disease, for example hypertension, diabetes, sickle cell disease, some cancers, some psychiatric disorders, among others. This means that there are some diseases that we are at higher risk of developing if our parents or other close relatives also had them.

The active ingredient in a drug is known as the generic name of that drug. This is different from the brand name, which is the name given to that drug by a specific company. For example, the active ingredient chlorpheniramine (generic name) is known by the brand name piriton, allergy relief, Nyquil, Chlorphen ...

Another use of the term generic is in reference to medication that is made to be similar to the original medicine that was developed by a specific company. This generic medication is similar to the original medication, but is usually cheaper since the company that developed the original molecule had to bear the cost of developing the drug, taking it through research and drug trials and seek approval from the relevant authorities.

Send your questions to [email protected]