The Curbsiders Internal Medicine Podcast #434: Ur-INe for Recurrent UTI?! with Dr. Kellen Choi, DO AKA The Bladder Teacher
5 snips
Apr 8, 2024 Dr. Kellen Choi, The Bladder Teacher from the University of Kentucky, discusses the complexities of urinary tract infections (UTIs), the importance of hydration, non-antibiotic prophylaxis, vaginal estrogen, and pelvic floor physical therapy. She explores managing UTIs in post-menopausal patients with breast cancer and immunocompromised patients. The conversation also covers differential diagnoses for UTI-like symptoms and the role of pelvic floor dysfunction in genitourinary health.
AI Snips
Chapters
Transcript
Episode notes
Life Details Often Explain Recurrent Symptoms
- Kellen often spends extra time on new visits to uncover life changes that trigger UTIs.
- She cited examples like job-related reduced bathroom access and even pets causing nocturia.
Pelvic Floor Dysfunction Mimics UTI
- Pelvic floor muscle spasm can mimic UTI symptoms like urgency, frequency, and burning.
- Tender pelvic floor points on exam often predict benefit from pelvic floor physical therapy.
Use Guideline Antibiotics For Uncomplicated Cystitis
- For uncomplicated cystitis use guideline antibiotics like nitrofurantoin, trimethoprim-sulfamethoxazole, or fosfomycin as appropriate.
- Avoid nitrofurantoin for systemic illness; choose agent by allergies, pregnancy, and resistance patterns.