DEAR DR. DONOHUE: Everything I read about urinary tract infections deals with women, including what you write. I am a 35-year-old man, and I just had a week of antibiotics for a urinary tract infection. Why is there this bias in dealing with female urinary infections over male infections? — J.F.
ANSWER: The urinary tract infection we’re talking about is bladder infection, cystitis (sis-TIE-tiss). Both men and women come down with bladder infections, but the number of women who develop such an infection is far, far larger than is the number of men — 30 times the number of men. The main reason for this is an anatomical one. The female urethra, the tube that empties the bladder, is much shorter than the male urethra. That allows bacteria to make their way into the female bladder with relative ease. Furthermore, sexual relations force bacteria into the female urethra, something that doesn’t happen in men.
People describe cystitis as a burning pain when passing urine. The infection makes a person want to empty the bladder frequently, and it’s a task that has to be taken care of quickly.
At older ages, men develop almost as many bladder infections as do women. That’s because of prostate enlargement. An enlarged prostate gland makes complete emptying of the bladder impossible. Urine stagnates there and sets up an environment that favors bacterial growth.
Don’t feel left out because you have had only one bladder infection. Recurrent bladder infections are truly unusual for men. If a man were to develop one bladder infection after another, then his doctor would have to look for conditions that lead to repeated infections. Diabetes is one. So is Crohn’s disease, an inflammation of the digestive tract. The inflammation fosters the development of a tunnel between the bladder and the inflamed area of the tract. Bacteria have free access to the bladder. These are only two examples of why cystitis recurs in few men.
The booklet on urinary tract infections explains this common malady in detail and its treatment. Readers can obtain a copy by writing: Dr. Donohue — No. 1204W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I take Coumadin because of atrial fibrillation. I’ve taken it for 13 years. Never in all those years has anyone, doctor or nurse, told me not to eat lettuce or other salad greens. My cousin just did. She wasn’t sure why, but she said those foods mess up Coumadin. I have regular blood tests. None has shown that my Coumadin level needs adjusting. What is this green vegetable taboo? — M.O.
ANSWER: Coumadin thins blood (prevents clots from forming) by decreasing the production of vitamin K. Green, leafy vegetables — spinach, lettuce, Brussels sprouts — are a rich source of vitamin K. If a person on Coumadin splurges on these vegetables, he or she could block the action of Coumadin.
You have gone 13 years taking it. Your blood tests have shown that your diet is not affecting Coumadin’s action. You can eat whatever you wish.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.