Although Urogynecologist Jaime Sepulveda, M.D., is renowned for treating pelvic floor disorders in women, the most common medical condition he diagnoses and treats at Miami Urogynecology Center in South Miami is urinary tract infections, commonly known at cystitis.
“During their lifetimes, three out of four women will have at least one episode of cystitis,” said Dr. Sepulveda. “Urinary tract infection can leave a patient feeling unwell, and it can be costly in terms of money and time. The good news is, the condition is easily treated with simple antibiotics.”
In most cases — 98 percent of the time — the cause of a urinary tract infection is bacteria called E-coli, which is found in the environment, foods and intestines of people and animals. E-coli is “good” bacteria with a bad reputation because, although it is necessary in humans for healthy bowel function, it can cause sickness, including cystitis.
“E-coli lives in the bowel close to the urinary system and when it gets into the urethra or bladder, it can cause a urinary tract infection,” Dr. Sepulveda explained. “Left untreated, this infection can spread to the kidneys, where serious complications can develop.”
Women are at greater risk of developing urinary tract infections compared to men, and females at the age of menopause are most likely to suffer from the condition. Symptoms can include increased urinary frequency and urgency, pain during urination and the feeling that the bladder is not completely emptying. In some situations, blood is present in the urine.
“Antibiotics are extremely effective in treating urinary tract infections,” Dr. Sepulveda said. “New patients sometimes come to me and complain that their infection is not going away. This often happens when a patient has developed an antibiotic resistance and the medication no longer is effective. Some patients suffer a relapse or recurrence of the infection. To prevent these medical issues, I prescribe primary-use antibiotics to ensure the infection is knocked out completely.”
Genitourinary syndrome of menopause (GSM), which is characterized by a decrease in estrogen that causes dryness and irritation, is a common condition that can lead to a urinary tract infection. New therapies, such as topical estrogen creams, can lessen the incidence of infection and improve a patient’s overall health. Other factors and conditions such as bowel incontinence, irritable bowel syndrome and chronic constipation also come into play when dealing with a urinary tract infection. Dr. Sepulveda says that by treating IBS, for example, the rate of cystitis can be reduced.
Women can take preventive measures to decrease their risk of developing cystitis. Dr. Sepulveda advises women to stay hydrated by drinking at least eight glasses of water a day, decrease the intake of bladder irritants such as alcohol and caffeine, maintain good estrogen supplementation and, when necessary, take low doses of suppressive antibiotics. He also encourages women to know their bodies, cautioning that a positive urine culture does not necessarily indicate the presence of a urinary tract infection. Not infrequently, false positives are caused through fecal contamination during the collection process. It is important that women have the symptoms of an infection in addition to a positive urine culture before antibiotics are prescribed, Dr. Sepulveda says.
“When diagnosing cystitis, I assess risk factors, either episodic or recurring. Then I evaluate the bladder and exclude the factors within the bladder that can predispose a urinary tract infection,” he explained. “I treat the whole set of symptoms, not just one result or one culture.”
“Urinary tract infections are so frequent, so common and so easy to treat,” concluded Dr. Sepulveda. “They are a quality of life issue for many women. While I am not saving lives on an everyday basis, I most certainly am committed to improving the quality of life for every one of my patients.”
Dr. Jaime Sepulveda’s practice, Miami Urogynecology Center, is located at 6200 Sunset Drive, Suite 504, in South Miami. For more information, call 305-669-6267 or visit www.miamiurogynecologycenter.com.