- With Mayo Clinic urologist
Erik P. Castle, M.D.read biographyclose window
Erik P. Castle, M.D.Erik P. Castle, M.D.
Dr. Erik Castle is a board-certified urologist who joined the Mayo Clinic staff in Arizona in 2007.
Dr. Castle is an associate professor of urology at College of Medicine, Mayo Clinic, and a senior associate consultant in the Department of Urology, where he also is assistant residency coordinator.
He was an assistant professor in the Department of Urology at Tulane University in New Orleans from 2004 to 2006 after serving as a clinical instructor/fellow at Mayo Clinic in Arizona for one year.
Dr. Castle's research interests include prostate cancer, bladder cancer and kidney cancer. He is the director of the Desert Mountain Prostate Cancer Research Fund and is the principal investigator of Castle labs housed at the Samuel C. Johnson Medical Research Building at Mayo Clinic in Arizona. His basic science research is focused on novel secondary hormonal therapies of prostate cancer as well as genomics of prostate and bladder cancers.
His surgical expertise includes laparoscopic urology, robot-assisted radical prostatectomy with nerve sparing, robot-assisted radical cystectomy with neobladder, robot-assisted retroperitoneal lymph node dissection, robot-assisted partial nephrectomy and other robotic urologic oncology procedures. He has performed many of these procedures as demonstrations internationally. He is a member of the American Association of Clinical Urologists, the American Urological Association, the Endourological Society, and the Society of Laparoendoscopic Surgeons. He is past president of the international Society of Urologic Robotic Surgery. He is also the director of the international laparoscopic nephrectomy courses throughout Mexico on behalf of the American Urologic Association.
- Bladder infection in men
Treatments and drugs (1)
- Chronic bladder infection: Is there a cure?
Chronic bladder infection: Is there a cure?
I’m a woman who has had a chronic bladder infection for four years. My doctor keeps giving me antibiotics, but the infection keeps coming back. What can I do?
from Erik P. Castle, M.D.
You're not alone. Various studies have found that between 27 and 50 percent of otherwise healthy women experience at least one recurrent bladder infection (cystitis) within a year of the first infection.
There can be several causes of chronic bladder infections, such as:
- Kidney or bladder stones
- Bacteria entering the urethra during sexual intercourse
- Altered estrogen levels during menopause
- Abnormal urinary tract shape or function
- Genetic predisposition
In general, women who have two or more culture-documented bladder infections in a six-month period should be evaluated by a urologist to determine the underlying cause. The evaluation may include:
- Urine culture of a sample obtained with a catheter
- Cystoscopy — looking into the bladder with a lighted scope
- Computerized tomography (CT) scan
Treatment is directed at the underlying cause, when possible. If no source of infection is found, lifestyle modifications combined with vaginal estrogen replacement, if applicable, is all you may need. Lifestyle changes that may reduce your risk of bladder infection include:
- Drinking plenty of liquids, especially water
- Urinating frequently
- Wiping from front to back after urination or a bowel movement
- Taking showers rather than baths
- Gently washing the skin around your vagina and anus daily using a mild soap and plenty of water
- Using forms of birth control other than a diaphragm and spermicides
- Emptying your bladder as soon as possible after intercourse
- Avoiding deodorant sprays or scented feminine products in the genital area
- Drinking cranberry juice, though studies with promising results had limitations
Otherwise, long-term, low-dose, preventive antibiotics is the only treatment option. In such cases, you may need to take antibiotics for as long as six months to two years.Next question
Bladder infection in men
- Hooton TM. Recurrent urinary tract infection in women. http://www.uptodate.com/home/index.html. Accessed Sept. 9, 2011.
- Dielubanza EJ, et al. Urinary tract infections in women. Medical Clinics of North America. 2011;95:27.
- Urinary tract disorders. In: Rakel RE. Textbook of Family Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191205553-4/0/1481/0.html#. Accessed Sept. 9, 2011.
- What I need to know about urinary tract infections. National Kidney & Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/uti_ez/. Accessed Sept. 9, 2011.