Beware Urological Misinformation Aimed at Women on Social Media

Urinary tract infections (UTIs) are quite common, especially for women. Between 50 percent and 60 percent of women are affected by a UTI at some point in their life, according to the National Institutes of Health (NIH). By age 24, 1 in 3 women experiences a UTI that requires antibiotics, prompting an estimated 8 million to 10 million doctor visits per year.

With numbers like that, it's little wonder women seek ways to prevent and treat UTIs at home.

As with every other topic under the sun, millions of videos on social media platforms offer tips and tricks for dealing with UTIs. But problems arise when those videos have no medical evidence behind them. If UTIs are not treated properly, they can migrate up the urinary tract and lead to serious complications, including kidney infections. Sometimes, they can cause permanent damage.

A 2022 study published in the Journal of Urology examined the accuracy of YouTube videos that focused on the treatment and prevention of UTIs. Its findings, presented at the 2022 American Urological Association (AUA) conference, were provocative, if not downright alarming.

"Our program has a major women's pelvic health center where we see a lot of patients with recurring UTIs, overactive bladder and pelvic organ prolapse," said study lead author Zhenyue Huang, M.D., a urology specialist based in Stony Brook, New York. "So, in terms of recurring UTIs, we had so many patients coming into the clinic frustrated. And a lot of times, they'd mention that they'd seen something online and tried something, but nothing was helping."

Given those interactions, Huang and her team became curious about what was on the internet and started watching some YouTube videos. They found the quality of information lacking.

Huang's team members began by examining YouTube videos tagged with the keywords "urinary tract infection" and picked out the 200 most-viewed videos. They then analyzed the videos for metrics and user engagement and assessed the quality and accuracy of the information.

The 54 videos that met their criteria for inclusion had a combined total of more than 12 million views. But the team's findings were pretty bleak:

• More than half of the videos, 52 percent, were created by nonmedical institutions and people.
• Only 42 percent featured a physician, and just 11 percent featured a urologist.
• According to the analysis, 67 percent of the videos were of moderate to poor quality.
• Home remedies and supplements for treating and preventing UTIs were promoted in 69 percent of the videos.
• One-third of the videos, racking up a total of more than 4 million views, featured information that was potentially misleading.

Homeopathic treatments and preventive measures always feature prominently in these kinds of videos, and cranberries are among the most talked-about topics related to UTIs. But drinking regular grocery store cranberry juice—which is often recommended—probably isn't going to help.

"Cranberry supplements have some supportive evidence and they are actually listed in our guidelines," Huang said. "But what matters is the specific component in the cranberry called PAC [proanthocyanidins]. It actually prevents bacteria from adhering to urinary tract tissue. But you really need to take a specific, certified cranberry supplement with a high PAC content to get the benefits of it. Most people are just drinking cranberry juice and they're getting a lot of sugar and a lot of calories but they're not actually getting the component itself."

Another big issue Huang noted is when someone uses cranberry supplements, juice or any other home "treatment" and puts off a much-needed doctor's visit as the infection gets worse—all the while thinking they're curing it.

"Cranberry supplement is really not something that is a major treatment," Huang emphasized. "If someone has an active infection, it's not going to help. Typically, they don't go away on their own and require a short course of treatment with antibiotics. And if the infection progresses to a kidney infection and you keep drinking cranberry juice at home, it can lead to some severe medical consequences if the patient has other comorbidities."

One aspect Huang and her team found frustrating was that while so many of the videos focused on homeopathic, natural "treatments" and preventive measures, a majority of them failed to mention an exciting new treatment that is actually proven to work: vaginal estrogen therapy.

"[It] is a very big thing right now, especially in postmenopausal females with recurring UTIs," Huang said. "Only 7 percent of the videos even mentioned it as a potential treatment. Most of the other videos focused on the homeopathic regimen or dietary remedies."

This finding is in keeping with an overall theme you often see in nonprofessional medical advice videos: homeopathy, home remedies and "one quick trick" are the order of the day. Meanwhile, proven, studied and tested treatments such as boring old antibiotics are ignored.

Fortunately, providers like Huang and others are becoming more aware of what they're up against in terms of social media misinformation. They're working to develop ways to meet their patients where they are rather than trying to get them to pull a complete mental 180 over the course of one appointment.

"You sympathize with the patient, you show them that you're understanding, but then you show them where to get the right information," Huang said. "Also, we should be more aware of what's out there. Now that I understand that nothing on YouTube is reliable, we can help them to follow the content that's created by reliable sources, by medical professionals."

The lead author of another study on social media and misinformation who presented a paper at the AUA conference agreed.

"The best way to do it, really, is if you're interested in doing your own research and getting good information online, I think you should talk to your doctor, ironically," said Justin Dubin, M.D., a specialist in male infertility and sexual medicine who was recently named the director of men's health at Memorial Healthcare Systems in Hollywood, Florida. "Ask if they have any good websites or social media accounts you can follow, and I guarantee you that your doctors are going to have good resources online for you."