How to avoid an UTI and cystitis?

Here's how Prof. Graziottin answers this question from her patients:

First of all, every woman should know that Uropathogenic Escherichia Coli (UPEC) is a true “terrorist inside the bladder wall”. Why? Because they are there even when the urine exam is negative. So you have the enemy inside the bladder wall. This will also cause a progressive inflammation of the bladder wall. So first you have the cystitis and then you have persistent pain in the bladder. And then this may lead to interstitial cystitis. So it's a very serious condition to block the Escherichia coli, so to say, in the first episodes of cystitis.

There are three major “triggering conditions” for the cystitis and urinary tract infection: 

First of all, and women know that very well, intercourse may “traumatize” the urethra, more so when the woman has very tightened pelvic floor muscles. Cystitis appears 24 to 72 hours after intercourse. 
When cystitis is the first symptom women complain of, 60% of women complain also of pain at intercourse at the entrance of the vagina, squeezed, so to say, by the tightened pelvic floor muscles.

• Second, the second etiology of recurrent cystitis is acute diarrhea or constipation because this increases the possibility that contingent plotons, so to say, of Escherichia coli, your pathogenic, cross the bowel wall and through the lymphatics or the blood, aggress the bladder.
• The third and very, very important is the environmental cold. Environmental cold increases the aggressiveness of Intracellular bacterial communities. Why? when a rapid and marked difference of temperature – between, for example, the beach in hot summer, and the bar when you go to take a beer or a water. The sudden difference causes rapid dysbiosis in the gut and this increases the likelihood that your pathogenic bacteria cross the bladder wall and aggress via the lymphatics of the blood the bladder.

And at the same time, this increases the aggressiveness of the intracellular bacterial communities. So this double attack increases the likelihood of a “cystitis a frigore”, said caused by the cold, as the old physicians, Latin physicians, used to say 2,000 years ago.

To prevent recurrent bladder infections the winning strategy is to avoid antibiotics, except in severe cases of hemorrhagic cystitis, as they worsen gut dysbiosis, increase antibiotic resistances, worsen irritable bowel syndrome and the vulnerability to Escherichia coli attack. 

A preventive approach with phytotherapy can be made including D-mannose and red-current at nighttime, may help. 

Oral and vaginal probiotics may contribute to protecting the bowel, the vagina and the bladder!

And don't forget to recommend the relaxation of the physiotherapy for the pelvic floor.

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