From the Guidelines
The nurse practitioner should not mention emptying the bladder after intercourse as a risk factor for urinary tract infections (UTIs), as this is actually a preventive measure rather than a risk factor. Recent antimicrobial use, having a new sexual partner, and spermicide use are all legitimate risk factors for UTIs, as supported by the study published in The Journal of Urology in 2018 1. Recent antimicrobial use can disrupt normal vaginal flora, allowing uropathogens to colonize. New sexual partners can introduce different bacteria, and sexual activity itself can push bacteria toward the urethra. Spermicide use alters vaginal pH and microbiome, promoting bacterial growth, as noted in the study 1. In contrast, emptying the bladder after intercourse helps flush out bacteria that may have been introduced near the urethral opening during sexual activity, reducing infection risk. Some key points to consider in counseling Donna about risk factors for urinary tract infections include:
- Recent antimicrobial use as a risk factor due to its potential to disrupt normal vaginal flora
- Having a new sexual partner, which can introduce different bacteria
- Spermicide use, which alters vaginal pH and microbiome
- Other factors such as frequency of urination, delayed voiding habits, and use of certain products like hot tubs or bubble baths, as mentioned in the study 1 For Donna's case, the NP should discuss these actual risk factors while recommending preventive measures like post-coital urination, adequate hydration, and proper wiping technique from front to back.
From the Research
Risk Factors for Urinary Tract Infections
The following are risk factors for urinary tract infections (UTIs) that may be relevant to Donna's situation:
- Emptying the bladder after intercourse: This is a recommended practice to help prevent UTIs, as it can help flush out bacteria from the urinary tract 2, 3.
- New sexual partner: Having a new sexual partner can increase the risk of UTIs, as it may introduce new bacteria into the urinary tract 4, 5.
- Spermicide use: Using spermicides can increase the risk of UTIs, as they can alter the natural balance of bacteria in the urinary tract 4, 5.
Recent Antimicrobial Use
Recent antimicrobial use is not typically considered a risk factor for UTIs, but rather a potential treatment option. In fact, studies have shown that antimicrobial agents such as nitrofurantoin, trimethoprim-sulfamethoxazole, and fluoroquinolones can be effective in treating UTIs 2, 3, 4, 5. However, it is worth noting that recent antimicrobial use can also contribute to the development of antimicrobial resistance, which can make UTIs more difficult to treat 2, 3.