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Urinary Tract Infections

URINARY TRACT INFECTIONS

Urinary Tract Infections - German Medical CenterDefinition

A urinary tract infection (UTI) is an infection in any part of your urinary tract — your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra. Bacteria are responsible for the vast majority of UTIs. Fungi can also cause UTIs occasionally (especially in immunocompromised people). UTIs are the second most common type of infection in humans.

Women are at greater risk than men of developing a UTI. It can involve the urethra (urethritis), bladder (cystitis), or kidneys (pyelonephritis). UTIs in men are not as common as in women but can be serious when they occur. When the kidneys are involved, UTIs can be life threatening. The bacterium Escherichia coli (E. coli) causes the vast majority of UTIs.

Anything that delays, hinders or reduces bladder emptying, or cause irritation of the urinary tract can lead to UTIs. Most common of which are:

Obstructions
Any blockage that impedes urine flow and emptying of bladder can cause a UTI (e.g. enlarged prostate, kidney stones, and malignancies).

 

Gender
Women are more common to contract UTI; this is most likely due to their shorter urethra.

 

Bathroom Hygiene

Unclean toilet seats (e.g. use of public/shared toilets) can also be responsible for bacterial transmission. Also wiping from back to front after defecation may lead to UTI. This motion may drag bacteria from the anal area towards the urethra.

 

Diaphragms

Diaphragms may exert continuous pressure on the urethra, which eventually can lead to delayed/decreased bladder emptying. Studies have detected a higher UTI risk in women who use diaphragms.

 

Diabetes

Because of its negative impact on body`s immunity, Diabetes may make patients more susceptible to UTI.

 

Prolonged use of bladder catheters

Catheters are used when someone cannot urinate normally (e.g. chronic prostatic enlargement, neurogenic bladder, postoperative state, etc.). Long-term catheter use can increase the risk of UTI. They may make it easier for bacteria to get into the bladder. Management of catheter-associated UTI may necessitate catheter removal.

 

Spinal Cord Injuries

People with nerves damage around the bladder have difficulty emptying their bladder completely, allowing bacteria to grow in the urine that stagnates in the bladder.

It is not uncommon for women to suffer from frequent UTIs. About 20 % of young women with a first UTI will suffer a recurrent infection. With each UTI, the risk for a recurrent UTIs rises.

Men are less likely than women to have a UTI. But once a man has a UTI, he may be at increased risk for a recurrent infection because some pathogenic bacteria may hide deep inside prostate tissue. Diabetic patients or people with a problem that makes it hard to urinate may have recurrent infections.

If the antibiotic course prescribed according to result of Urine Culture & Antibiotic Sensitivity test was not completed successfully this may lead to recurrence of symptoms as not all assailant bacteria were irradiated.

These may include:

  • Burning sensation associating urination (with early stream, mid-stream or by the end of act)
  • Passing frequent, yet small amounts of urine
  • A strong, persistent urge to urinate
  • Cloudy urine with strong smell. Occasionally dark in case of presence of blood in urine
  • Pelvic pain or discomfort

Sometimes the symptoms are so mild or non-existent despite the presence of a UTI. If the infection involves elder women and men, they are more likely to be tired, unstable, with body aches and abdominal pain. Usually, UTIs do not cause fever if they are in the urethra tract or bladder. Presence of fever and chills may be an indication that the infection has reached the kidneys “Pyelonephritis”. This is considered a serious medical condition that necessitates intense and urgent medical attention.

To find out whether a person has a UTI, your Urologist will inquire about urinary symptoms, proceed for a clinical examination and then request for a urine analysis test in search for  the presence of bacteria and/or abnormally-high white blood cells. The patient will be expected to give a “clean catch” urine sample by washing the genital area then collecting a “midstream” sample of urine in a sterile container. This collection method helps prevent bacteria around the genital area from getting into the sample and resulting in biased result.  To identify the causative bacteria and the best antibiotic to prescribe against, a urine culture and sensitivity test is request along with the microscopic analysis.

In case of recurrent infection, your Urologist might advise a series of specialized investigations to detect a possible cause (for example, strictures). Some of these include:

  • Renal Ultrasound
  • Intravenous pyelogram (IVP)
  • Cystoscopy, which uses a small camera to examine the bladder
  • CT scan

Antibiotics are used to treat UTIs. Lower UTIs can be treated with oral antibiotics. Upper UTIs require intravenous antibiotics. The choice of antibiotic and course of treatment depend on the patient’s history, severity of symptoms, and the type of bacteria causing the infection (according to urine culture result).

Most young people with UTIs have uncomplicated UTIs, which can respond well to prescribed antibiotic with gradual regression of symptoms with few days. However, taking the full course of antibiotic is imperative because symptoms may disappear before the infection is fully cleared. A follow-up urine analysis is recommended to confirm that the urinary tract is infection-free, days after the end of antibiotic course.

Severely-ill patients with kidney infections must be hospitalized, with a proper urological care and intravenous antibiotics. Kidney infections may necessitate weeks of antibiotic treatment.

Changing some routine habits may help a person be less susceptible to recurrent UTIs:

 

Fluid Intake

Increased hydration; drinking lots of water can help flush bacteria from the system. Drinking six to eight glasses of water daily is advised.

 

Urination Habits

A person should urinate often and when the urge arises; do not hold urine for long periods of time. Bacteria can grow when urine stays in the bladder too long. Women and men should urinate shortly after intercourse to flush away bacteria that might have entered the urethra during intimate act.

 

Clothing

Cotton underwear and loose-fitting garments are always advisable. Cotton allows aeration of the area and minimizes moisture. Tight-fitting pants and polyester underwear should be avoided because they can trap moisture and this may facilitate bacterial growth.

Valuable Note
While the above prophylactic steps are useful, they do not guarantee that you won’t get a UTI. Contact your Urologist whenever you have any symptoms. UTIs are mostly treatable and with no lasting complications. Nevertheless, neglecting taking medical advice early can give the infection the golden opportunity to infiltrate more into your urinary tract and lead to more serious outcomes.

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