Antibiotics or NSAIDs for uncomplicated urinary tract infection?

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5037 (Published 08 November 2017) Cite this as: BMJ 2017;359:j5037

Dysuria is caused by soap, not by bacteria

The reason why NSAID is able to treat dysuria (1 ) is most likely because most cases of dysuria is caused by inflammation of the urethra due to soap, not to bacteria. This is what I discovered when I asked 50 women with symptomatic urinary tract infection (UTI), urethral syndrome (dysuria without bacteriuria), or asymptomatic bacturia (ABU) how often they washed their sexual organs with soap. In the two first groups 15/17 and 14/14, respectively used soap, whereas 13/19 among those with ABU used water only (p<0.00001). I told all of them to use water only, and at follow-up dysuria had disappeared in almost all of those who had followed my advice (2).

Kronenberg A, Bütikofer L, Odutayo A, et al. Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial. BMJ 2017;359:j4784.
Ravnskov U. Soap is the major cause of dysuria. Lancet 1984;1:1027-8.

Competing interests: No competing interests

10 November 2017
Uffe Ravnskov
Independent researcher
Magle Stora Kyrkogata 9, 22350 Lund, Sweden