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I am a 62 year old female who has had frequent utis over the years.  In 2007 I had a cystoscope that showed vaginal atrophy but no other abnormalities.   The urologist put me on low dose daily nitrofuran as a preventative  measure.  After taking it for 4 months I accidentally discovered on a routine blood test that I had drug induced hepatitis. Apparently I was allergic to it.  Since that time I have tried vaginal estrogen which did not help.  I started taking cranberry capsules twice a day and instead of getting them 5-6 times a year I get them 1-2 times a year.  My problem is urinary frequency. I urinate about 10-12 times a day.  Do you have any advice on this?  Thank you

Answer
Lee:

Yes.  Go back and see the urologist.  Alternative medications such as sulfa/trimethoprim can be used as prophylaxis if you can't take nitrofurantoin.  The vaginal estrogen should still be used because it helps a little even if you can't see a big difference.

Other suggestions:

Wash hands before wiping after voiding.
Wipe only once from front to back.
Avoid baths; take only showers.
Avoid any reusable sponges or louffas; use only very clean washcloths.
Best way to make very clean washcloths? Place them in plastic bags as soon as they come out of the drier.  Open them only when ready to use.
Use only a gentle, liquid soap on the bladder area such as Dial, Ivory, Neutrogena or Eucerin.  You can also use any liquid soap that is safe for babies. (Use a liquid soap because it's cleaner than any bar soap)
When in the shower, wash your hands first,  Then, open the plastic bag and take out a clean washcloth.  Wet it, put the gentle liquid soap on it, then clean the bladder area FIRST!  This avoids transporting germs from other parts of the body to the area just around the bladder opening.
Take some extra vitamin C twice a day.

These suggestions help most people reduce their risk of infections.  Good luck.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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