# my 3 week old w/UTI



## summerlilies (Feb 6, 2006)

My 3 week old son is intact because of the information I learned reading this board. Now could you please help me again?

My 3 week old has E. Coli bacterial kidney infection. It's basically a UTI as the E. Coli is in his bladder and kidneys. We have just spent 3 days in the hospital and he will now be on home IV therapy for 2 more weeks.

It was AWFUL in the hospital as they had to do a spinal, a catheter, several IV's including a PICC line (an IV that runs from his arm to his heart), X-ray, sonogram, etc. etc. He is not done yet with testing and invasive procedures. In addition, because of the massive doses of antibiotics he has to receive, he will wipe out all his good gut flora which compromises his immune system.

So, here are my questions:

1) It has been told to us that he was at greater risk for a UTI in the first year of life because he is intact -- is this true?

2) We have been told that now that he has had an UTI, he is much more likely that he will get more of them -- is this true?

3) Is there anything I can do to reestablish his good gut flora besides exclusively breastfeed which I already do? I am worried about getting thrush.

4) It is presumed that he got the E.Coli in his system because some of his stool got into his foreskin and then traveled up in his system. Since I am not supposed to retract and clean him, what can I do to prevent this from happening again? I also use cloth diapers -- is it possible that the diapers were harboring the E.Coli?

Thanks for your help. We are grateful that the infection was caught and treated, because he may have died from it.


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## buckeyedoc (Nov 9, 2006)

While there have been studies that show no association between UTIs and not being circumcised, there are also several that do show a link, especially during the first year of life. I think that's why the AAP and many pediatricians mention it. However, it's a really rare problem (not helpful to you, though, since your li'l guy is one of the unlucky ones). It might have nothing to do with being intact, though, since some circ'd little guys get them, too.

I don't know about how likely it is to recur during this year. Are you supposed to collect urine periodically to double-check that the infection is really gone and doesn't come back? Did the doctors find any underlying reason for the UTI, like an abnormality with his ureters, bladder, or urethra? I would hope that with the breastfeeding and your baby's immune system continuing to mature, he would become more resistant to infections.

My lactation consultant swears by having moms take acidophilus (or yogurt) to help themselves and their babies with thrush (or to prevent thrush). While I can't figure out the mechanics of it, she feels that the acidophilus _will_ colonize the baby through close contact and breastfeeding and that it will help him.

Neither of my DSs have gotten stool in their foreskins, but I do try to wipe them off very well after a blow-out. If your DS has a long foreskin (like one of mine does), just try to maneuver the wipe around the tip to get into any crevices. It's possible to do without retracting. Stool shouldn't be able to get deeply into there, anyway, since there is no actual space under the foreskin in a baby.

Good luck! I hope your baby is better soon. That must have been scary and stressful for you and your family.


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## baybee (Jan 24, 2005)

If your baby had an eye infection, (which many newborns do) would the drs
say it was because you didn't amputate the eyelid? No, it doesn't make sense
that an amputative operation would have been a way to protect your child from a very serious infection. Circumcision would have traumatized him and given him an open portal to infection and you would have felt twenty times more terrible about your child being ill.

Breast milk is a magic elixir for fighting infections and recolonizing the gut after antibx. Congratulate yourself on giving your baby the best chance possible. Now, really focus on taking care of yourself and allowing your body to produce the finest milk possible. Ask for help. Eat quality organic food, take high quality vitamins (I recommend Usana). There's a lot of info on the MDC boards about probiotics, do a search on that.

E coli infections are rising in newborns since the rise in giving women antibx to women in labour for Group B. Strep. With bacteria, it seems like fixing one problem just leads to the next.


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## MCatLvrMom2A&X (Nov 18, 2004)

Quote:


Originally Posted by *summerlilies* 
My 3 week old son is intact because of the information I learned reading this board. Now could you please help me again?

My 3 week old has E. Coli bacterial kidney infection. It's basically a UTI as the E. Coli is in his bladder and kidneys. We have just spent 3 days in the hospital and he will now be on home IV therapy for 2 more weeks.

It was AWFUL in the hospital as they had to do a spinal, a catheter, several IV's including a PICC line (an IV that runs from his arm to his heart), X-ray, sonogram, etc. etc. He is not done yet with testing and invasive procedures. In addition, because of the massive doses of antibiotics he has to receive, he will wipe out all his good gut flora which compromises his immune system.


So, here are my questions:

1) It has been told to us that he was at greater risk for a UTI in the first year of life because he is intact -- is this true? *Those studies were flawed since they compaired full term circed infants with premature intact ones.*

2) We have been told that now that he has had an UTI, he is much more likely that he will get more of them -- is this true? *Unless he has a physical abnormality like urinary reflux he will be no more likely to have a UTI again than the avg. person. If he does have urinary reflux then the foreskin will play a valuable roll in keeping out bacteria as long as it is left alone.*

3) Is there anything I can do to reestablish his good gut flora besides exclusively breastfeed which I already do? I am worried about getting thrush.*you can take acidopholis yourself I dont know that it would be ok to give it to the baby this young tho maybe someone else will know more about that*

4) It is presumed that he got the E.Coli in his system because some of his stool got into his foreskin and then traveled up in his system. Since I am not supposed to retract and clean him, what can I do to prevent this from happening again? I also use cloth diapers -- is it possible that the diapers were harboring the E.Coli? *Unless someone retracted his foreskin and allowed the poop to get into there then it isnt really possible for the poo to have caused this. Since he would have peed and flushed anything out that was left in there. My ds has a long foreskin and the most I have done with a blowout diaper is to gentley run the wip from base to tip while gently pulling other than that I left it alone. If you feel that didnt get it all and want to make sure pop him into the bath for a few minutes and swish his penis around that will definatly do the job. For the diapers I would wash them in the hottest possible water to kill off anything bad in there and dry them on high heat as well.*

Quote:

Thanks for your help. We are grateful that the infection was caught and treated, because he may have died from it.
It is great they caught it for sure. By the way when they cathed him were you sure to watch so they didnt retract him at all?


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## LavenderMae (Sep 20, 2002)

I agree w/ Melissa (pp). Foreskin is fused to the glans during infancy and that actually prevents feces from getting in there (that's one of the major functions of forekin during infancy). And everything else she wrote is also spot on!

I hope your little guy is all better very soon. I would also start taking probiotics and my midwife says it's okay to give probitiocs to an infant as well but of course I would do your own research on that.


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## Quirky (Jun 18, 2002)

It is more likely that he has a defect in his urinary tract. Did they do an ultrasound and/or talk about a VCUG? You need to have him seen by a (foreskin-friendly) pediatric urologist.

Keep in mind that girls get UTIs at three times the rate of intact boys. And no one ever suggests cutting bits off girls to prevent UTIs. So don't feel bad for a second about leaving him intact. I've had plenty of UTIs in my life and there's not one square centimeter of my genitals that I'd be willing to sacrifice to avoid another one!

It's totally safe to give probiotics to babies. In fact, there's research suggesting that colic may occur as a result of an imbalance in baby's gut flora, and that probiotics may reduce colic. So I would definitely start giving your baby a high-quality probiotic. It can only help. You can get baby probiotics in powder form from Whole Foods or your local health food store, and just express a squirt or two of breastmilk, mix the powder in, and swab it in baby's mouth. Do this three or four times a day and it will help reestablish his gut flora.

And take probiotics yourself, and try to cut out or cut way down on any sugars and refined grains in your diet. Also watch like a hawk to make sure your ds has a good latch so that he doesn't traumatize your nipples in any way.

I'm so sorry your ds has suffered so much in the first weeks of his life -- but believe me, he would have suffered lifelong ill effects from a circumcision, so be strong and know you made the right decision! I hope your little guy is fully recovered and home safe and sound.


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## wendy1221 (Feb 9, 2004)

Quote:


Originally Posted by *Quirky* 
It is more likely that he has a defect in his urinary tract. Did they do an ultrasound and/or talk about a VCUG? You need to have him seen by a (foreskin-friendly) pediatric urologist.

Keep in mind that girls get UTIs at three times the rate of intact boys. And no one ever suggests cutting bits off girls to prevent UTIs. So don't feel bad for a second about leaving him intact. I've had plenty of UTIs in my life and there's not one square centimeter of my genitals that I'd be willing to sacrifice to avoid another one!

It's totally safe to give probiotics to babies. In fact, there's research suggesting that colic may occur as a result of an imbalance in baby's gut flora, and that probiotics may reduce colic. So I would definitely start giving your baby a high-quality probiotic. It can only help. You can get baby probiotics in powder form from Whole Foods or your local health food store, and just express a squirt or two of breastmilk, mix the powder in, and swab it in baby's mouth. Do this three or four times a day and it will help reestablish his gut flora.

And take probiotics yourself, and try to cut out or cut way down on any sugars and refined grains in your diet. Also watch like a hawk to make sure your ds has a good latch so that he doesn't traumatize your nipples in any way.

I'm so sorry your ds has suffered so much in the first weeks of his life -- but believe me, he would have suffered lifelong ill effects from a circumcision, so be strong and know you made the right decision! I hope your little guy is fully recovered and home safe and sound.









This is EXACTLY what I was going to post. My middle son WAS born w/ a UT defect and NEVER had a UTI. But THAT is MUCH more likely to cause a UTI than being intact!


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## erinwestpoet (Aug 18, 2005)

I can't help you on the other stuff, but I do know about probiotics. My daughter was also placed on antibiotics (very strong, right after her birth). Her homeopathic ped recommended the Jarrow Baby JarroDophilus. You need all the probiotics, not just acidophilus. This formula has the main 6. For newborns, use only 1/16 tsp per day. You can mix with a small amount of water if that is easier. If you are nursing, you can dab it on your nipple beforehand. I found this to be easiest, but it definitely needs to be measured out before you start dabbing. You can find this at Whole Foods in the refrigerated probiotic section in Whole Body. Good luck to you. Oh, and I'd continue with the probiotics until you notice normal breastfed poop (if you are nursing).


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## Kleine Hexe (Dec 2, 2001)

You've gotten good info already.

I'll add that the Drs you've spoken with are not very knowledgeable about foreskins and intact penises.

Maybe you could contact Paul Fleiss in CA.


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## Fyrestorm (Feb 14, 2006)

Quote:


Originally Posted by *MCatLvrMom2A&X* 
1) It has been told to us that he was at greater risk for a UTI in the first year of life because he is intact -- is this true? *Those studies were flawed since they compaired full term circed infants with premature intact ones.*


Sorry to hijack...do you have a link to this. I could really use it on some of the other boards I'm on, but I would need to back it up...TIA

::::now back to this poor babies UTI::::


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## Quirky (Jun 18, 2002)

Good references here: http://www.nocirc.org/statements/breastfeeding.php

Quote:

Unfortunately, Army hospitals in the 1980s instructed parents to retract the foreskin to wash-a procedure that has been abandoned because of the danger of contamination by E. coli.8 This may have allowed E. coli to enter the urinary tract and caused the slight increased incidence of UTI reported by Wiswell.

Quote:

Breastfeeding now is documented to dramatically reduce the incidence of urinary tract infection (UTI).

In the early 1980s, Thomas E. Wiswell, M.D., a vociferous advocate for routine circumcision, opined that lack of male circumcision might be the cause of UTI, and he set out to prove it with two retrospective studies that were published in 1985 and 1986.12,13 The studies, carried out by searching through old medical records maintained by the United States Army on children of Army personnel, failed to examine an existing clinical population. The study purported to show that the incidence of UTI in circumcised and intact infants were 1.4 and 0.14, respectively. The difference of 1.26 percent is not clinically significant. Wiswell's studies suffered severe methodological flaws, including lack of control for confounding factors,14 such as maternal infection, perinatal anoxia, low or high birthweight,15 breastfeeding, socio-economic status, urogenital deformities, and the nature of infant hygienic care.

Escherichia coli, bacteria present in feces, is the most frequent etiologic agent of acute uncomplicated urinary tract infection (UTI) in infants and children, accounting for 85 to 90% of all pathogens recovered from urine cultures.16

After Wiswell's studies were published, Coppa et al. discovered that human milk contains oligosaccharides that are excreted in infant urine and inhibit the adhesion of E. coli to the tissue of the urinary tract.17 This protective effect was quickly confirmed in a preliminary report in 1990 by another group of Italian scientists, headed by Pisacane,18 and further confirmed by Swedish researchers.19 The Pisacane group then produced a prospective case-control study, published in 1992,20 that found breastfed infants have only 38% as many UTIs as non-breastfed infants.20

A recent study that tried to correct for some of the deficiencies in Wiswell's studies found that 195 circumcisions would be necessary to prevent one hospitalization for UTI.21

Wiswell could not have known about the significant effect of breastfeeding protection against UTI because these studies17-20 had not been published at the time he conducted his studies,12,13 which do not control for breastfeeding. The number of breastfed infants in his studies is unknown. Consequently, his data is inconclusive and inaccurate.

Even if one were to accept Wiswell's data, breastfeeding has an additional advantage that male circumcision could never provide: breastfeeding reduces UTI in both male and female infants.3,22 Females have a four times greater incidence of UTI than males,16 which may be because females lack the protective effect of the preputial sphincter (see box). Breastfeeding actually delivers the protection against UTI infection that has been touted for circumcision.3,18,19,20 Circumcision is an inappropriate and ineffective way to reduce the risk of UTI in infants.


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## summerlilies (Feb 6, 2006)

Thank you all for taking the time to respond to my questions. It has been helpful.

The VCUG is the next procedure he needs to make sure he doesn't have urinary reflux. I suppose this procedure is going to be traumatic too. How do I find a foreskin friendly doctor?

When we showed up in the hospital to do the initial tests, it was close to midnight and my ds had been fighting this infection for 2 days already due to many errors (they lost his bloodwork, one doctor told us our baby was fine, another doctor told us to give the baby tylenol and evaluate later, etc). Anyway, we told the only doctor there that we did not want him to retract when he did the catheter. He said he HAD to retract to the tip of the penis and then sterilize so that he could get a clean sample. We told him NOT to retract at all. He said he HAD to. We called another doctor and he said the same thing. Anyway, we had to do something because the doctor said that our baby may be barely hanging on and that permanent damage could be happening as we were there debating about retracting. So, he retracted to the tip as far as I know. I was near my baby's head trying to console him at the time.

Thanks for all the tips about the probiotics. We are going to check them out today...

Who is Paul Fleiss in California? We are in Maryland.

The home IV therapy is pretty extensive. It takes an hour 3x per day to give it to him and it needs to be done around the clock. So I have been setting my alarm and waking up to do all the steps. It's all so scary and I am really worried. I chose to come home though because I think there was more risk in us staying in the hospital with all the germs floating around.

This may be unrelated, but can someone help? The soft spot on the top of my ds's head is sunken. I heard this can be a sign of dehydration, but he is voiding and stooling and nursing normally. Should I worry or is this normal?

Thanks again everyone... we'll keep you posted about the results of the VCUG. I am going to hold off on doing the procedure as long as I can so as to not traumatize him too much too early. I read the info on the link and it sounds like traumatic experiences could interfere with breastfeeding...


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## guestmama9908 (Jan 23, 2007)

I am a Pedi Nurse. You can do a sterile catheterization without retracting to the tip. Those Doctors were incorrect. They should NEVER retract even to the tip. You can usually visualize the meatus and cleanse properly without retraction. Retraction even to the tip can cause trauma and introduce bacteria.

You should not hold off on the VCUG. I understand that you may feel that it will be traumatic. However if you remain unaware of a urinary tract abnormality he may continue to get UTI's. This could detect any such abnormality and allow you to have it corrected preventing further infection and further trauma.

As long as your son is peeing and his urine is clear to light yellow and he is having 6 to 8 wet diapers in a 24 hour period and he is having at least one stool I would not consider him dehydrated. My DD's soft spot occasionally does this even though she is weeing and pooing normally.

I would contact http://www.doctorsopposingcircumcisi...t/contact.html
and see if they could give you a recommendation for a urologist in your area.

Sending healing vibes your little man's way!


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## Tinijocaro (Jan 4, 2003)

Check into Patent Urachus as another rare, but possible source for the E Coli to get into the bladder. A friend's son had it, it took them a while to find it, but he's fine now after a surgical procedure.

http://www.nlm.nih.gov/medlineplus/e...pages/9667.htm


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## MCatLvrMom2A&X (Nov 18, 2004)

When your son goes into for the VCUG ask them there if they know how to do a cath without retraction. If they dont and you get the same BS from them dont let them do the test until they get a nurse to come down from the NICU that knows how to cath without retraction. There has to be someone there on staff who knows how to do this since babies in the NICU are almost always intact. It is imparative that you dont allow anyone to retract at all since he already has issues.

The VCUG they will insert a cath. then put dye into it then watch and make sure that it doesnt go back up into his kidneys.

I am so sorry that none of the Dr.'s you delt with knew what they were doing. I understand you did the best you could in a difficult situation so dont beat yourself up over it.









If you look at the sticky on the main CAC page The Definition of Retraction & Why it is BAD you will see the steps to the proper way to do a cath. on a intact child.


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## wendy1221 (Feb 9, 2004)

Jake was cathed a few times during testing. I had to forcefully take a nurse's hand off of his penis twice, but then she went and found someone who got it in NO PROBLEM without retracting.


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## angie3096 (Apr 4, 2007)

Hi.
My daughter was born with grade 5 kidney reflux. She had her first UTI at 6 weeks, her VCUG was done at 11 weeks. It was less upsetting than the hospital stays for the UTIs! The catheter for the test doesn't hurt any more than the catheter for the urinalysis. During the test my daughter did not seem distressed; she only cried when they put the catheter in.
My daugher has been treated with traditional medicine but ALSO with toftness chiropractic and reflexology. Alternative therapies did not fix her completely, but her urologist has said several times that he is amazed by her recovery and her "body's ability to heal itself" so I really encourage you to look into alternative treatments. They were going to remove her right kidney but in the end just did a ureteral reimplant. They said they had never seen a child make such an amazing recovery. Good luck!








Angie


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## Kleine Hexe (Dec 2, 2001)

Quote:


Originally Posted by *summerlilies* 
Who is Paul Fleiss in California? We are in Maryland.

(

I copied and pasted this info from the Mothering home page under the link "Experts" and then under Marilyn Milos, RN Circumcision and Genital Integrity Here's the contact info for the Dr Fleiss in CA.

"May I suggest you contact Paul Fleiss, MD, who has written two wonderful articles about circumcision for Mothering magazine, for yet another opinion. He is in Los Angeles, California,and his number is 323-664-1977. He's very willing to speak to parents on the phone."


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## JoJoMomma (Apr 6, 2007)

I am not as certain as others that the UTI studies were all flawed. Keep in mind that this is a board to support not circumcising and you will get more of that side of the story here just as you might get more of the other side on an pro-circ board. Find a great Urologist and ask your questions there. And don't look backwards ... you made your decision, and it was the right decision for you at the time. Go forward to help your boy.


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## Quirky (Jun 18, 2002)

Quote:


Originally Posted by *JoJoMomma* 
I am not as certain as others that the UTI studies were all flawed. Keep in mind that this is a board to support not circumcising and you will get more of that side of the story here just as you might get more of the other side on an pro-circ board. Find a great Urologist and ask your questions there. And don't look backwards ... you made your decision, and it was the right decision for you at the time. Go forward to help your boy.

So, JoJoMomma, welcome to Mothering. What can you tell me about the UTI studies you have read and why you believe they are not flawed?

And what parts of a girl's genitals do you believe it would be worth considering removing in order to prevent a UTI?


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## Daisyuk (May 15, 2005)

Quote:


Originally Posted by *Quirky* 
So, JoJoMomma, welcome to Mothering. What can you tell me about the UTI studies you have read and why you believe they are not flawed?

And what parts of a girl's genitals do you believe it would be worth considering removing in order to prevent a UTI?

Especially as they are several times as common in girls.

I'm awaiting your answer with interest JoJoMomma, especially as we know the studies that totally refute everything that Wiswell had to say on the matter.

What else would you be prepared to cut off a child to prevent something? Tonsils, adenoids, appendix, gall bladder, spleen, and don't forget those pesky breast buds - one in EIGHT women will get breast cancer at some point, and there's always formula isn't there, they don't really need them, and breast cancer in men is also much more common than penile cancer..they don't need them at all.

After all, if you take out all their organs when they're babies they'll never remember it, they won't get horrible diseases and there will only be little scars, so it will be ok, _won't it_?


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## LavenderMae (Sep 20, 2002)

Quote:


Originally Posted by *Quirky* 
So, JoJoMomma, welcome to Mothering. What can you tell me about the UTI studies you have read and why you believe they are not flawed?

And what parts of a girl's genitals do you believe it would be worth considering removing in order to prevent a UTI?









:

And even if the studies had some truth (I do not think they do) to them girls are still much more likely to get UTI's than intact boys. And I have never had anyone suggesting I circ my dd or myself.


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## MCatLvrMom2A&X (Nov 18, 2004)

Quote:


Originally Posted by *JoJoMomma* 
you made your decision, and it was the right decision for you at the time. Go forward to help your boy.

Actually she didnt make the decision for herself the decision was never really hers. She left it up to her son to choose as it should be.


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## iamleabee (Jul 28, 2005)

UTI's are more common in girls than boys because the urethral opening is closer to the anus in girls than in boys. what could be removed from girls to prevent this?


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## guestmama9908 (Jan 23, 2007)

Quote:


Originally Posted by *iamleabee* 
UTI's are more common in girls than boys because the urethral opening is closer to the anus in girls than in boys. what could be removed from girls to prevent this?

I believe the PP's were being facetious. They were simply shedding light on the fact that no one would ever recommend a portion of a girl's genitalia be removed in order to prevent UTI. Yet as soon as an intact male contracts a UTI the Doctor's immediately blame the fact that he has a foreskin and say that it makes him more likely to contract UTIs.


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## calngavinsmom (Feb 19, 2003)

Quote:


Originally Posted by *iamleabee* 
UTI's are more common in girls than boys because the urethral opening is closer to the anus in girls than in boys. what could be removed from girls to prevent this?


Simple really. The procircers claim that intact boys are more prone to UTIs because there are more "nooks and crannies" for feces to get "trapped" in than in circumcised boys. Apply the same theory to girls....if there were no labia for feces to get "trapped" in, there would be less chance for them to contract a UTI.

It is a simple misunderstanding of the actual structure and care of an intact penis that makes people make these assumptions.

It is all BS anyway, male or female.

Take care,
Tara


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## baybee (Jan 24, 2005)

I don't know why people seem to think that UTI's are caused by bacteria going up and in. They are a result of bacteria coming from the top down. The whole
kidney, bladder, ureter and urethra combo is a down and out cleaning machine. God would have put the hole further away from the bum if there was going to be a problem.


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