Pink Prescriptions - October 2021

Urinary Tract Health: From UTIs to Kidney Stones


October 2021 Issue
Pink Prescriptions

When is the last time you thanked your kidneys? Those two, small bean-shaped organs in your lower back are incessant workhorses for your health. Here’s what these superstars are doing while you go about your day: They are regulating your body’s fluid levels, filtering waste and toxins from your blood, releasing hormones that regulate your blood pressure and direct production of red blood cells. If that is not enough, they also activate vitamin D to maintain healthy bones and keep blood minerals, such as sodium, phosphorus, and potassium, in balance. We all experience malfunctions occasionally, and unfortunately, one in three Americans is at risk for developing kidney disease. Read on to get more in touch with your kidneys and urinary tract. Here’s what we asked our local health experts:

PinkRx1021 BersaniBy Tiffany Bersani, M.D.
Beaufort Memorial Hospital

What makes some women have frequent UTIs?
UTIs can affect both men and women, but women are at higher risk. That’s because it’s easier for bacteria to enter a woman’s urethra due to its proximity to the rectum, where many bacteria live. A woman’s urethra is shorter than a man’s, so once bacteria are inside, they don’t have far to go to reach the bladder. Women are also more likely to get a UTI if they are pregnant, have gone through menopause, or use diaphragms or spermicide for birth control. Other risk factors for frequent UTIs include:

• A problem that hampers urine flow, such as a kidney stone
• Age (older women and toddlers are at greatest risk)
• Difficulty emptying the bladder
• Having had a UTI before
• Medical conditions that weaken the immune system, such as diabetes
• Sexual intercourse (sexually active women are at greater risk)

Dr. Tiffany Bersani is an OB-GYN with Beaufort Memorial Obstetrics & Gynecology Specialists. She sees patients in both Bluffton and Beaufort and can be reached at 843-522-7820.

PinkRx1021 LangleyBy Michael J. Langley, M.D.
Coastal Carolina Hospital

Lately it seems I get up to go to the bathroom several times during the night. What causes this and what can I do to minimize interrupting my sleep to urinate?
This problem, called nocturia, can affect both women and men, but often it is more of a complaint from men. Many female patients think it is caused from a problem with their bladder, while most male patients attribute it to their prostate. Actually, neither are true. In most cases, both female and male patients are waking up because their kidneys are over producing urine at night. (This should not be confused with overactive bladder.) The kidneys typically function better during sleep when the body is in a recumbent position and blood pressure is usually lower. The kidneys use this time to absorb extra fluid that has built up during the day, such as swelling in the feet, etc., which causes the need to expel during the night.

Treatment options are limited. However, it is recommended to limit intake of fluids four hours prior to bedtime. In addition, there are some effective medications that help reduce output at night, though they can have side effects.
I’ve heard kidney stones are excruciatingly painful.

What can I do to minimize my risk of getting them?
The majority of kidney stone disease is caused by genetics. This disease has to do with the kidneys and very little to do with what you eat or drink. The big three to consider when trying to avoid kidney stones are: 1. Drink two-liters of water each day in addition to the other things you normally drink. 2. Restrict salt intake to two-grams or less per day. This isn’t much. Morton Lite can be a good salt substitute. 3. High protein diets can promote kidney stones. If you are following such a diet, the two-liters of water each day is imperative.

If a patient has had two or more episodes of kidney stones, a urine test called 24-Hour Urine Profile will be ordered. This is an in-depth study of your urine over a 24-hour period that can target the probable cause for stone disease and allow your physician to tailor the treatment specifically to the test results.

DID YOU KNOW? Coastal Carolina Hospital is the only hospital in Beaufort County, and one of only two hospitals in South Carolina, to offer fixed-base, 24/7 Lithotripsy treatment. This is a terrific machine that offers non-invasive shock waves directly to kidney stones to break them up into tiny pieces, allowing the body to pass the stones with a significant reduction in pain. Most hospitals have this machine on a traveling basis, whereas Coastal Carolina has this service available 24/7/365.

Michael J. Langley, M.D. has more than 30 years experience in urology medicine and offers a broad range of general urological services. His major clinical interest is in the management of challenging cases of prostate cancer, urinary incontinence, kidney stone disease. He also has extensive experience in the medical management of prostate enlargement, bladder cancer and nocturia. Dr. Langley is board certified by the American Board of Urology and is a member of the American College of Surgeons. He is the current Chief of Staff at Coastal Carolina Hospital and is a provider at Matador Core Performance.

PinkRx1021 RahnBy Tiffany Rahn, PA-C
Beaufort Memorial Hospital

Can UTIs cause kidney damage?
UTIs are fairly common and in most cases, can be treated successfully without causing kidney damage. If you are experiencing symptoms of a UTI, such as urinary frequency, burning, and hesitancy, you should be seen by a medical provider in order to be properly diagnosed and treated.

Some possible complications:
• An untreated UTI could lead to a kidney infection, which can occur when the bacteria that infects the lower urinary tract travels to one or both kidneys. Kidney infections can be serious, and it’s important to treat them as soon as possible to avoid getting very sick.

• In addition, UTIs caused by problems like an enlarged prostate gland (in men) or a kidney stone can lead to kidney damage if the problem is not corrected, or the infection continues. UTIs in young children that are associated with high fevers may sometimes cause kidney damage if not treated promptly.

• It is important to complete any treatment prescribed by your provider. One of the biggest reasons that people have chronic UTI’s, which may affect the kidneys in the long run, is they fail to complete their antibiotic regimen. Commonly this can cause antibiotic resistance, which may lead to chronic UTI’s that are difficult to treat.

Tiffany Rahn, PA-C, is a board-certified physician assistant with Beaufort Memorial Express Care. A former EMT and paramedic, Rahn has worked as a physician assistant in a variety of medical settings and is currently completing her Doctoral studies in Medical Science.

PinkRx1021 AshbyBy Eve Ashby, D.O., FACOOG
Beaufort Memorial Hospital

What healthy sex habits can help minimize UTIs?

“Honeymoon cystitis” is a term that was often given to urinary tract infections after having intercourse. This may be due to bacteria exposure to the female urethra during active intercourse and hence the development of a UTI two to three days after intercourse. Sometimes this happens sporadically, but for some women this may be a frequent issue.

Healthy hygiene practices can be helpful
in avoiding or minimizing these UTIs:
• In pre-menopausal women it is important to void shortly
after intercourse and keep hydrated.

• In postmenopausal women, because of the natural decrease in vaginal
estrogen, urinary tract infections are more common. Using a little bit of estrogen cream around the urethra at night two to three times a week can strengthen the urethra and help minimize UTIs.

• If there is anal intercourse, it should not be followed by vaginal
intercourse, as this will increase the risk of E. coli infection of
the vagina and the bladder.

• Remember to adequately clean any vaginal contraceptive,
such as a diaphragm or NuvaRing after intercourse, or any sexual aids after use, with a non-perfumed or unscented mild soap.

• Abstaining from intercourse when you’re on your menstrual cycle
is another option to avoid infection.

• If recurrent UTIs seems to prevail, consider using an unscented soap
and eliminate any perfumed vaginal products.

• If frequent UTIs continue to be a problem, consider following up
with a urologist to make sure there are no anatomic abnormalities to the urethra or bladder.

Dr. Eve A. Ashby is a board-certified gynecologist with Beaufort Memorial Lowcountry Medical Group and sees patients in Beaufort and Okatie. Dr. Ashby is also an Assistant Professor and Regional Director of Medical Education for A.T. Still University School of Osteopathic Medicine.

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