When men have burning on urination, they usually have a venereal disease. When women have the same symptom, they usually have a bladder infection. If you are a woman who suddenly develops burning on urination, have to urinate frequently and feel terrible discomfort when your bladder is full, or have urgency to urinate whenever your bladder is full, check with your doctor. You could have a bladder or a vaginal infection.
If you have a bladder infection, a single dose of 500 mg of the antibiotic, ciprofloxacin offers a 90 percent cure rate (1) and a seven day course of 500 mg twice a day will cure 98 percent (2). More than 75 percent of all recurrent bladder infections are caused by a single germ called E. Coli. (3) Women with recurrent E. Coli bladder infections usually suffer a genetic susceptibility in which the bacteria, which is found in everyone's intestines, have multiple little hairs called cilia that function like little feet that allow them to climb from the skin around the vagina, up the urinary tube, into the bladder (4).
If you are a women who gets recurrent bladder infections, make sure that your doctor orders a urine culture when you have symptoms. If the culture grows the bacteria , E. Coli, more than once, you probably have E. Coli syndrome. Your doctor should order a laboratory test to see if that E. Coli can be cured by taking ampicillin. If you are not allergic to penicillin, he should give you a prescription for #100 500 mg ampicillin pills. Take one pill just before you have vaginal intercourse and one pill four times a day for three days when you have symptoms. If the E. Coli that grows from your urine is resistant to ampicillin, your doctor usually prescribes a quinolone antibiotic, and you take a half pill before vaginal intercourse and one pill a day for three days when you have symptoms.
Surgical procedures to widen the opening to the bladder are ineffective. (5) If the urine culture does not grow any bacteria, the odds are that you have a mycoplasma or chlamydia infection that can be cured when you and your partner take the one of the newer long-acting erythromycins, such as Biaxin or Zithromax. I usually prescribe Zithromax 250 mg, 2 pills the first day and then one a day for 7 days for both partners. If you still have symptoms, you will need a more thorough evaluation from your doctor.
1a) The etiology of urinary tract infection: Traditional and emerging pathogens. American Journal of Medicine, 2002, Vol 113, Suppl. 1A, pp 14S-19S. A Ronald., Univ Manitoba, Fac Med, Winnipeg, MB, CANADA.
1) Guibert J. Acute cystitis in women: Effectiveness of ciprofloxacin versus pefloxacin given as a single oral dose. Presse Med 1995 FEB 11;24(6):304-308. 92% clinical cure for ciprofloxacin. Mean time to clinical resolution was about 40 hours
2) A Iravani, AD Tice, J Mccarty, DH Sikes, T Nolen, HA Gallis, EP Whalen, RL Tosiello, A Heyd, SF Kowalsky, RM Echols. Short-course ciproflox treatment of acute uncomplicated urinary tract infection in women: The minimum effective dose. Archives of Internal Medicine 155: 5 (MAR 13 1995):485-494. Bacteriologic eradication was reported in 95 (89%) and 101 (98%) of patients in the groups who received ciprofloxacin, 500-mg single dose and 250 mg BID for 7 days, respectively.
3) R Ikaheimo, A Siitonen, T Heiskanen, U Karkkainen, P Kuosmanen, P Lipponen, PH Makela. Recurrence of urinary tract infection in a primary care setting: Analysis of a 1-year follow-up of 179 women. Clinical Infectious Diseases 22: 1 (JAN 1996):91-99.
4) Hooks on the bacteria E. Coli. Nature January 12, 1995.
5) Dilatation is ineffective. British Journal of Urology November, 1992.