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Urinary Tract Infection Abstract: Only bleeding from the uterus can render a woman niddah. At times, hematuria may be confused with vaginal bleeding. The physician can assist the woman by informing her of the presence of a UTI and of the possibility of resulting hematuria. Discussion: Only bleeding from the uterus renders a woman niddah. Bleeding from other organs in the genital area does not. Occasionally, a woman may discover a red stain on underwear or toilet tissue and be concerned that it is from a vaginal source [1]. If she has symptoms suggestive of cystitis (e.g., dysuria, frequent urination), a urinalysis and urine culture should be performed [2]. If the doctor sees macroscopic hematuria or gets positive results from a urine culture, the woman should relate this information to her rabbi. In such a case, assuming that she is not expecting her menses at that point, the stain probably will not render her niddah. Implications for Patient Care: If a UTI is suspected, the woman should be told that this may cause hematuria. If a woman presents with presumed vaginal bleeding but has UTI symptoms, urinalysis and culture should be performed. If there are signs of cystitis or a positive culture, this information should be related to the woman, who can convey it to her rabbi for a halachic ruling. Medical References [1] Kaunitz AM. Differential diagnosis of genital tract bleeding in women. UpToDate Feb 21, 2014. [2] Gupta K et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52:e103-20. http://cid.oxfordjournals.org/content/52/5/e103.long Users of Internet filtering services: This site discusses sensitive subjects that some services filter without visual indication. A page that appears 100% complete might actually be missing critical Jewish-law or medical information. To ensure that you view the pages accurately, ask the filtering service to whitelist all pages under jewishwomenshealth.org. This material is intended for general information purposes only. The patient's individual circumstances should be considered when making specific treatment decisions. Reproduction of the contents of this article for other than personal use |