Pyelonephritis primary prevention: Difference between revisions
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*Voiding after every intercourse | *Voiding after every intercourse | ||
*Use barrier contraception and avoiding spermicides | *Use barrier contraception and avoiding spermicides | ||
*[[Acupuncture]] <ref name="TidsskrNorLaegeforen1998-Aune">{{cite journal | author=Aune A, Alraek T, Huo L, Baerheim A | title=[Can acupuncture prevent cystitis in women?] | journal=Tidsskr Nor Laegeforen | year=1998 | pages=1370-2 | volume=118 | issue=9 | id=PMID 9599500 }} ''(cf acupuncture group, x2 incidents in the sham group, x3 in the control group)''</ref><ref name="ComplementTherMed2001-Alraek">{{cite journal | author=Alraek T, Baerheim A | title='An empty and happy feeling in the bladder.. .': health changes experienced by women after acupuncture for recurrent cystitis | journal=Complement Ther Med | year=2001 | pages=219-23 | volume=9 | issue=4 | id=PMID 12184349}}</ref><ref name="JAlternComplementMed2003-Alraek">{{cite journal | author=Alraek T, Baerheim A | title=The effect of prophylactic acupuncture treatment in women with recurrent cystitis: kidney patients fare better | journal=J Altern Complement Med | year=2003 | pages=651-8 | volume=9 | issue=5 | id=PMID 14629843}} ''(highlights need for considering different TCM diagnostic categories in acupuncture research)''</ref> One study showed that urinary tract infection occurrence was reduced by 50% for 6 months.<ref name=Alraek2002>{{cite journal | author = Alraek T, Soedal L, Fagerheim S, Digranes A, Baerheim A | title = Acupuncture treatment in the prevention of uncomplicated recurrent lower urinary tract infections in adult women. | journal = Am J Public Health | volume = 92 | issue = 10 | pages = 1609-11 | year = 2002 | id = PMID 12356607}}</ref> However, this study has been criticized for several reasons.<ref name="AmJPublicHealth2003-Katz">{{cite journal | author=Katz AR | title=Urinary tract infections and acupuncture | journal=Am J Public Health | year=2003 | pages=702; author reply 702-3 | volume=93 | issue=5 | id=PMID 12721123 (no abstract)}}</ref> | |||
*Prevention of recurrence of [[cystitis]] | *Prevention of recurrence of [[cystitis]] | ||
*Use of topical [[estrogen]] among post-menopausal women | *Use of topical [[estrogen]] among post-menopausal women | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
Preventative measures to avoid Pyelonephritis include the measures for preventing a urinary tract infection which include voiding after intercourse, use of barrier contraception, increasing fluid intake and frequency of urination, cleaning the urethral meatus after intercourse and use of estrogen (among post-menopausal women). Single-dose prophylactic antimicrobial therapy prior to sexual intercourse may be administered to patients who have recurrent episodes of cystitis that are associated with sexual activity. Prevention of recurrence of cystitis may also be helpful in preventing development of pyelonephritis.*Cleaning the uretheral meatus after intercourse[1]
Primary Prevention
The following preventative measures may reduce the risk of urinary tract infections which are an important cause of Pyelonephritis: [2][3]
- Increasing the intake of fluids and the frequency of urination
- Abstinence from sexual activity
- Cleaning the uretheral meatus after intercourse[4]
- Voiding after every intercourse
- Use barrier contraception and avoiding spermicides
- Acupuncture [5][6][7] One study showed that urinary tract infection occurrence was reduced by 50% for 6 months.[8] However, this study has been criticized for several reasons.[9]
- Prevention of recurrence of cystitis
- Use of topical estrogen among post-menopausal women
- Anatomical evaluation of structural and functional defects may be needed for recurrence of urinary tract infections
- Glycemic control in diabetic patients
- Avoidance of unnecessary catheterization
The use of cranberry juice to prevent cystitis and thus pyelonephritis remains controversial. Cranberry Juice is thought to prevent the adherence of uropathogens to urothelial cells, but its benefit is yet to be proven.[10][11]
References
- ↑ H. H. Meyhoff, J. Nordling, P. A. Gammelgaard & R. Vejlsgaard (1981). "Does antibacterial ointment applied to urethral meatus in women prevent recurrent cystitis?". Scandinavian journal of urology and nephrology. 15 (2): 81–83. PMID 7036332.
- ↑ Raz, R.; Stamm, WE. (1993). "A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections". N Engl J Med. 329 (11): 753–6. doi:10.1056/NEJM199309093291102. PMID 8350884. Unknown parameter
|month=ignored (help) - ↑ H. H. Meyhoff, J. Nordling, P. A. Gammelgaard & R. Vejlsgaard (1981). "Does antibacterial ointment applied to urethral meatus in women prevent recurrent cystitis?". Scandinavian journal of urology and nephrology. 15 (2): 81–83. PMID 7036332.
- ↑ H. H. Meyhoff, J. Nordling, P. A. Gammelgaard & R. Vejlsgaard (1981). "Does antibacterial ointment applied to urethral meatus in women prevent recurrent cystitis?". Scandinavian journal of urology and nephrology. 15 (2): 81–83. PMID 7036332.
- ↑ Aune A, Alraek T, Huo L, Baerheim A (1998). "[Can acupuncture prevent cystitis in women?]". Tidsskr Nor Laegeforen. 118 (9): 1370–2. PMID 9599500. (cf acupuncture group, x2 incidents in the sham group, x3 in the control group)
- ↑ Alraek T, Baerheim A (2001). "'An empty and happy feeling in the bladder.. .': health changes experienced by women after acupuncture for recurrent cystitis". Complement Ther Med. 9 (4): 219–23. PMID 12184349.
- ↑ Alraek T, Baerheim A (2003). "The effect of prophylactic acupuncture treatment in women with recurrent cystitis: kidney patients fare better". J Altern Complement Med. 9 (5): 651–8. PMID 14629843. (highlights need for considering different TCM diagnostic categories in acupuncture research)
- ↑ Alraek T, Soedal L, Fagerheim S, Digranes A, Baerheim A (2002). "Acupuncture treatment in the prevention of uncomplicated recurrent lower urinary tract infections in adult women". Am J Public Health. 92 (10): 1609–11. PMID 12356607.
- ↑ Katz AR (2003). "Urinary tract infections and acupuncture". Am J Public Health. 93 (5): 702, author reply 702-3. PMID 12721123 (no abstract).
- ↑ Hooton, TM. (2012). "Clinical practice. Uncomplicated urinary tract infection". N Engl J Med. 366 (11): 1028–37. doi:10.1056/NEJMcp1104429. PMID 22417256. Unknown parameter
|month=ignored (help) - ↑ Jepson R, Mihaljevic L, Craig J. "Cranberries for preventing urinary tract infections". Cochrane Database Syst Rev: CD001321. PMID 14973968.