Self care advice

For women in whom cystitis is a recurrent problem, self help measures can sometimes prevent recurrence. Signposting to relevant information is also helpful.

• Drink enough fluids: During a UTI patients may be avoiding drinking fluids because passing urine is painful. NHS advice is to “rest and drink enough fluids so you pass pale urine regularly during the day”. Current advice is to remain well hydrated (but not to deliberately increase consumption). This is important, especially during warmer weather
• Empty the bladder completely when passing urine: Wait for 20 seconds after passing urine and then strain to empty the final drops. Leaning backwards is said to help to achieve a more complete emptying of the bladder compared with the usual sitting posture
• Wipe front to back after a bowel motion: This may help to minimise transfer of bacteria from the bowel into the vagina and urethra. NICE advises that evidence is lacking
• Pass urine after sex: Urination immediately after sexual intercourse will theoretically flush out most bacteria from the urethra, but there is no evidence to support this
• Wash the external
  vaginal area before and after sex: This will wash away any bacteria that might be near the urethral opening
• If post-menopausal:  Where vulvovaginal atrophy is an issue, vaginal oestrogen pessaries may help
• Complementary therapies: There is limited evidence that cranberry products and D-mannose can help to prevent UTI (but no evidence that they help with symptoms)
• Reduce intake of
  coffee and alcohol: They seem to act as bladder irritants in some people.