Wash Your Hands Before Wiping: Wash your hands before you use the toilet or at least before wiping. You should also wash your hands before you get into the shower to avoid passing germs from your hands to your body near the bladder area.

Take Showers And Avoid Baths: Showers are much preferred to baths. If you absolutely must take a bath, don't use any hobble bath or other cosmetic bath additives. Bath water is full of bacteria from your skin. Sitting in a tub just gives the bacteria an easy way to reach the bladder opening area.

How to Wash Yourself: Wash your hands before you get into the shower. Use a fresh clean washcloth. Use a liquid soap because bar soap can harbor bacteria. Do not use a soap for the bladder opening area that has perfumes, creams or other additives. (We usually recommend "Dial" or "Ivory"). Clean the bladder opening area first, before the washcloth picks up any new germs or bacteria. ('The same washcloth or hand that washes the rest of your body will pick up dirt, germs and bacteria from your skin. We don't want to move these germs closer to tire bladder.) Wipe only once with each washcloth. If you need to clean name, use a second washcloth. 'fry not to over-clean this area because washing with soap removes some of the natural protection (mucus) from the bladder opening area. Rinse well and remember to wipe correctly from front to back. The washcloth that cleans the bladder opening area should be used only for that purpose and then laundered.

Douches May Be Okay, But Avoid Other Personal Products: In most cases, a vinegar and water douche or a douche with iodine (Betadine) or benzalkonium chloride is helpful if carried out correctly at appropriate intervals. Don't use airy feminine hygiene sprays, cosmetics, perfumes, towelettes or similar products in the vaginal area unless approved by your physician.

Use Tampons For Periods: Tampons are advised during your menstrual period rather than sanitary napkins or pads. A tampon will keep the bladder opening area drier than a sanitary pad and help keep any bacterial growth arid contamination away.

Avoid Long Intervals Between Urinating: Try to empty your bladder at least every four hours during the daytime while you're awake even if you don't feel the need or urge to void. When you do feel the need to empty your bladder, don't try to "hold it" until a more convenient time or place.

Don't Wear Tight Clothes: Avoid wearing pantyhose or tight slacks for prolonged periods. Cotton panties for general use are suggested. Avoid wearing a wet bathing suit for prolonged periods of time. 'Try to avoid habitual leg crossing. All of these will tend to press the skin folds around the vagina into the body and may introduce more bacteria into the area around the bladder opening

Drink More Water: Start with one extra glass with each meal. If your urine appears any darker than a very pale yellow, this means you are not drinking enough and should increase your fluid intake. Cranberry juice is helpful, but if you don't like cranberry juice you can substitute other beverages.

Avoid Irritating Foods Like Caffeine: Symptoms of bladder irritation may be aggravated by coffee, tea, alcohol, "hot" spices, caffeine, "NutraSweet", chocolate and cola drinks.

Take Vitamin C And Drink Cranberry Juice: Some patients may be instructed to take some additional Vitamin C. This vitamin may help increase your body's resistance to infection. Extra Vitamin C that your body can't use immediately will be released into the urine where it helps block bacterial growth. Cranberry juice may be of some extra benefit in reducing urinary infections. If you don't like cranberry juice, you can get the same benefit from cranberry pills.

Avoid Activities That Increase Your Risk of Bladder Infections: Prolonged bicycling, motorcycling, horseback riding and similar physical activities and exercises may increase your risk of bladder infections. You may need to limit these types of activities. When you do engage in physical activity and exercise, make sure to empty your bladder frequently and drink plenty of water and other fluids. Sexual activity may also increase your risk because it can introduce bacteria into the bladder area. (See below.)

Take Special Precautions After Sexual Activity: After intercourse, empty your bladder arid drink two extra glasses of water. Some patients will be advised by their physicians to take a urinary antiseptic or antibiotic after sexual activity. Make sure you take the medication exactly the way your physician has suggested.

An Estrogen Vaginal Cream May Help Increase Resistance to Bladder Infections: Your physician may suggest an estrogen cream for the vagina if you have had your menopause even it' you are already on an oral estrogen supplement or patch. The cream will help keep the tissues around the bladder opening healthy and more resistant to infection.

Take Antibiotics Only As Prescribed By Your Doctor: If your doctor leas prescribed a medication to take as preventive therapy, you should follow his instructions carefully. Be aware: that medications may be necessary fur up to a year or more depending on the nature aid sever severity of the urinary infection problem. For some patients, a small amount of a urinary antibiotic or antiseptic taken daily will prevent most urinary infections and give the bladder a chance to heal and restore it's natural resistance. Other patients may be told to take an antibiotic only when they think they're getting an infection. Take any prescribed predication exactly the way your physician advised you. If you don't remember how to take it and there are no clear instructions on the bottle of medicine, contact your physician or pharmacist.

If You Follow All These Suggestions And Get An Infection Anyway: The guidelines and suggestions listed here will help most women avoid bladder infections most of the time. If you get an infection in spite of these precautions, seek medical help promptly. A urine specimen for examination should be given to your physician. Seek prompt attention for excessive vaginal discharge or other signs of vaginal inflammation and infection. If an antibiotic has been given to you to use for this purpose, you may begin taking it. In some cases, your physician may request additional tests such as kidney X-rays or an examination of the bladder. Sterilizing your washcloths may be the next reasonable step to take.

Your doctor may recommend sterilizing washcloths for washing and personal hygiene to help prevent recurrent urinary tract infections. This extra step is probably unnecessary for the majority of patients with recurrent infections, but for the more resistant or severe cases it may be very helpful. Home sterilization of washcloths is only one part of an ongoing program to help prevent these infections. Use only those washcloths purchased for this purpose and remember to wipe correctly, from front to back.

1. Wash the washcloths with hot water and soap in your clothes washer. If you don't have a washer, use soap and hot water in your sink.
2. Boil the washcloths in water for at least twenty minutes. (Optional)
3. Take the washcloths out of the water and allow to dry or use your clothes dryer.
4. When dry, place each washcloth in a separate, sealable plastic bag such as a Ziplock bag.
5. LEAVE THE BAGS OPEN AND DO NOT SEAL THEM CLOSED YET!
6. Place the bags containing the washcloths in your microwave. In the center of the microwave, put a large glass of cold water. DO NOT PLACE THE BAGS WITH THE WASHCLOTHS IN THE WATER!
7. Put the microwave on High for five minutes and turn it on. Replace the glass (which is now very hot) with a new glass of cold water and microwave on High for an additional five minutes.
8. Let the bags cool; then close the bags. You now have a sterile washcloth inside a sterile bag

This technique will kill the germs and bacteria by using microwave radiation to sterilize the washcloths. Without the glass of cold water to absorb the heat, the bags would melt and the washcloths would burn.

• Wipe in the correct direction; from front to back.
• Wash your hands before using washcloths, tissues or toilet paper for wiping or washing yourself.
• Use a liquid soap because it tends to be cleaner than bar soap.
• Only wipe once with each washcloth or tissue. If you need more, use a second washcloth
• Clean tire bladder area first when you wash yourself to prevent contamination with bacteria from other parts of the body.
• Don't use these washcloths for any other purpose except to clean the area around the bladder opening.
• Drink extra water. Take Vitamin C. Drink cranberry juice (or take cranberry pills). Use an estrogen cream if you have passed menopause. Take any medication as prescribed by your physician.

If you have any problems or questions, please call our office at 440-985-9898.

copyright © Stephen W. Leslie, M.D., 1996