Chronic Urinary Tract Infections
Condition Overview
A urinary tract infection (UTI) is a bacterial infection that occurs in any part of the urinary tract system including the bladder, urethra, or the kidney. UTIs are more common in people with a vagina due to a shorter urethra (less distance for the bacteria to travel to the bladder and kidneys).
Causes
UTIs can be caused by incomplete bladder emptying, poor hygiene, and overactive pelvic floor muscles.
There is a normal amount of urine that is leftover in the bladder following urination, called a post void residual. If we exceed this normal amount, bacteria can multiply and cause a UTI. When we urinate, our bladder contracts while our pelvic floor muscles relax. If our pelvic floor muscles do not relax fully we are not going to empty our bladder appropriately. This means there will be an increase in urinary retention and bacteria will multiply, causing infection.
In addition, fecal or urinary incontinence leads to pad or diaper usage. If you are unable to change these garments regularly, there could be an increase in bacteria leading to a UTI. Furthermore, if you have trouble cleaning yourself following a bowel movement due to loose stool or loss of functional mobility this can increase the risk of E-coli transfer to the bladder tract and cause a UTI.
Overactive/tight pelvic floor muscles can also mimic signs and symptoms of a UTI without actually having an infection.
Signs and Symptoms of a UTI:
Urinary urgency*
Urinary frequency*
Pain/burning with urination*
Feelings of incomplete bladder emptying* or passing small amounts of urine*
Pelvic pain/cramping*
Cloudy or foul smelling urine
Pink or discolored urine
* Can also be seen in those folks with an overactive pelvic floor. This goes to show that the pelvic floor muscles and chronic UTIs can mimic each other so closely. This is why it is essential to make sure you are getting tested for a UTI when these symptoms present themselves. If there is no infection despite feeling these symptoms you could have an overactive pelvic floor and it would be beneficial to see a pelvic floor physical therapist.
How PT Can Help
In physical therapy, we will discuss your symptoms and go over each of the systems of the pelvic floor (bladder, bowel, sexual health and if necessary, gynecological health). If you do not currently have a true UTI and with your consent we will perform an in-depth muscle examination including an external and internal pelvic floor assessment. With this, we will determine if you have an overactive pelvic floor, and assess your abdominal, hip, and pelvic floor muscle strength, endurance, and coordination.
From our findings we will set-up a treatment plan depending on your pelvic floor characteristics!
We will educate you about optimal bladder and bowel health and hygiene habits.
Manual treatment can include but is not limited to dry needling, myofascial release, cupping, and connective tissue mobilization.
Exercises can include but are not limited to kegels, hip and abdominal strengthening, downtraining/pelvic floor stretches, and functional mobility exercises.
With each session we will reassess and progress as appropriate!