Intended for healthcare professionals

Rapid response to:

Practice 10-Minute Consultation

Uncomplicated urinary tract infection in women

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n725 (Published 30 March 2021) Cite this as: BMJ 2021;372:n725

Rapid Response:

Uncomplicated urinary tract infection in women. BMJ2021;372:n725

Dear Editor

This otherwise excellent article on management of above unfortunately omits any mention of advice re. prevention.

My belief is that a high proportion of uncomplicated UTI’s in women are preventable, by attention to what might be called sexual hygiene, that this is often not known or highlighted, and that much more needs to be done to educate women, and their partners, and their (particularly primary) health care providers (GP’s and practice nurses) about this.

When in practice I produced, and gave out when relevant, a leaflet which read:

''Cystitis (bladder infection) is often caused by the germ E.coli - so-called because it lives naturally in the colon (large bowel). It can easily contaminate the area around and forward of the anus, and at sexual activity be transmitted by e.g. partner's fingers, to the opening of the urethra (tube down from bladder), and then cause infection. Therefore keep this area very clean, and educate partner about this matter''.

This message is not new, but it is often diluted, and lost among ones such as ‘ensure adequate fluid intake’, ‘wipe from front to back’, ‘have a post-coital wee’, etc.

Implementation of this simple direct preventive advice could I belief have enormous benefits - namely big savings in patient suffering, lost work/study time, GP/practice nurse workload, prescribing costs and side-effects, antibiotic resistance, laboratory work, and referral to secondary services.

And not only should every consultation for UTI include giving this information (secondary prevention), but any contact for any related matter, e.g. contraception, be an opportunity for so doing (primary prevention).

Competing interests: No competing interests

19 April 2021
IAIN DUNCAN
RETIRED GP
NORWICH. UK.