What is a
Urianry Tract Infection
Defining Urinary tract infection: A (UTI) is an infection that occurs anywhere along your urinary system, including the kidney, ureter, bladder, or urethra. Most commonly this involves the bladder. UTI’s are divided into upper and lower urinary tract infections, with the upper tract being the kidney and ureters and the lower tract being the bladder and urethra.
Infections usually involve the lower urinary tract, because the urethra is the first point of entry into the body, where bacteria are frequently introduced. Bacteria can ascend the urethra into the bladder causing acute cystitis or sudden inflammation of the bladder. Sometimes the infection can ascend all the way up to the kidney, causing acute pyelonephritis or sudden inflammation of the kidney
UTI’s can be due to bacteria, viruses or even fungi. Most UTI’s are due to bacteria and often bacteria that are present in the GI tract and fecal milieu. The most common cause of a bacterial UTI is Escherichia coli or E. coli. Other common bacteria include Pseudomonas, Klebsiella, and Enterococcus. A variety of viruses and Candida fungi can also cause infections in less common circumstances.
Risk Factors:What Causes Urinary Tract Infection?
- Female Gender: Urinary tract infections are more common in women due to the short length of the urethra and the close proximity of the female urethra to the anus. The longer male urethra tends to protect against infections.
- Increased age: UTI’s are very common after menopause in women and in older men with BPH and other issues with urination.
- Hormonal changes such as menopause, pregnancy, and certain oral contraceptives.
- Steroid use
- Foreign objects in the urinary tract such as a catheter or a ureteral stent after kidney stone surgery
- Impaired bladder emptying
- Kidney stones
- Prostate enlargement
- Structural abnormalities of the urinary tract, such as vesicoureteral reflux in children, hydronephrosis or blockage of a kidney in children and urethral strictures in men
Can Sex cause Urinary Tract Infection?
- Sexual intercourse – termed “honeymoon cystitis,” is a common trigger of Urinary Tract Infection in women.
A UTI classically presents as suprapubic pain, dysuria (painful urination), urinary frequency, and urinary urgency. Often blood is seen in the urine and it often has a foul odor. Suprapubic pain is pain felt in the central lower part of the abdomen, in between the belly button (umbilicus) and the pubic bone. Patients will classically describe a strong, sudden urge to urinate followed by pain while actually urinating. THis often comes on quite rapidly, progressing over the course of a few hours. Fever is possible, though not usually present. Children and older adults may have less obvious symptoms, such as fever, abdominal pain, nausea, lethargy or confusion.
Symptoms of Pyelonephritis:
This is a more serious infection and often requires hospital-level treatment to eradicate. Presence of fever, nausea, vomiting, pain in the back/tenderness when the kidneys are tapped by a physician (termed “costovertebral tenderness or CVA tenderness”) all suggest pyelonephritis. This requires emergency medical therapy and often IV antibiotics.
Urianry Tact Infection:
Quantitative urine culture is the gold standard test to diagnose a UTI; however, this can take 2-3 days to result and many UTI’s can be cured before those results are even back! In practice, your doctor will carefully assess your symptoms, examine you and then perform a urinalysis at the time you think you have a UTI. If the urinalysis suggests an infection, which would be marked by red blood cells, white blood cells (infection-fighting cells) and a positive test for nitrites (a bacterial metabolic product), that is often what is required to make a diagnosis of a UTI at the point of care.
For most UTI’s, treatment involves a 3-5 day course of oral antibiotics. In men or complex situations, such as pyelonephritis, therapy may be for 7-14 days. Treatment is aimed at wisely choosing antibiotics that will treat likely causes of a UTI while being careful to avoid side effects, interactions with other drugs and promoting antibiotic resistance, which may make future infections harder to treat.
Some preventative measures include:
- Drink water and stay hydrated. Urinate frequently.
- Avoid substances that irritate the bladder (alcohol, smoking, and caffeine)
- Urinate after sexual intercourse
- Always wipe from front to back
- Try and avoid constipation
- Refrain from holding your urine when you need to void
- If you are prone to UTI’s consuming Vitamin C or cranberry pills can be an effective deterrent