Urinary Tract Infections
A urinary tract infection, or UTI, is caused by bacteria. A UTI can occur anywhere in the urinary system, which includes the kidneys, ureter, bladder, urethra and the male prostate. The most common form of UTI is cystitis, which is an infection of the bladder. Left untreated, the bacteria can migrate to the kidneys, causing a more serious kidney infection.
It's not unusual for bacteria to accumulate in the body. This happens most frequently in the digestive tract, the vagina or the urethra. Most of the time, the bacteria will collect in your bladder and be expelled through your urethra when you urinate. However, the bacteria sometimes isn't successfully washed from the body. When that happens, infection sets in.
Women and older people are particularly prone to bacterial infections of the urinary system. While uncomfortable, most urinary tract infections respond well to treatment.
- Gender: For a variety of reasons, including the structure of the female urinary tract, women and girls are more likely than men and boys to develop UTI. However, the disorder is often more difficult to treat in males.
- Sexually active teen girls
- Young, pregnant women
- Post-menopausal women don?t produce as much estrogen as they did when younger, which increases the likelihood of UTI.
- Seniors more often experience urinary incontinence, which increases the risk.
- Children are much less likely develop UTI, but because it could indicate an anatomical abnormality, children with UTI are usually further tested.
- Sexual Activity: This is a strong risk factor, especially for younger women. Among other reasons, trace amounts of the partner's urine could be introduced into the urinary tract as a result of vaginal intercourse. The likelihood for infection increases with the use of a diaphragm and/or spermicidal jelly. The jelly kills not only sperm but also protective bacteria that can ward off infection-causing bacteria.
- Pregnancy: The urinary system changes during pregnancy in ways that can increase the risks of UTI. Complicating factors for pregnant women include:
- Women in their first pregnancy
- Women who have closely spaced
- Women who have diabetes or sickle cell trait
- Women who engage in sexual activity during the pregnancy
- Women who've had such infections in the past.
- Diabetes: People with diabetes are at an elevated risk of contracting UTI.
- Prostate Enlargement: Men with enlarged prostates, a common disorder as men get older, are at heightened risk.
- Bowel Incontinence: This is because bacteria most often enters the body from the anus. In women, it's relatively easy to introduce this bacteria into the urinary tract with improper wiping or lack of wiping.
- Kidney stones
The most commonly experienced symptoms of urinary tract infections include:
- A feeling of pressure in the lower pelvis
- Pain or a burning sensation during urination
- Changes in urination including one or more of the following: pain or burning sensation, cloudy or bloody urine, a more frequent urge to urinate, and a foul or strong odor
- Painful sexual intercourse
- Pain in the side, vomiting and chills
- Mental confusion (in seniors) could indicate an untreated infection that?s spread to the blood
If a urinary tract infection is suspected, you'll be asked for a urine sample to be tested for bacteria. Tests used to identify an infection include: A urinalysis - tests for white blood cells or red blood cells in the urine. A urine culture - tests for the type of bacteria in the urine and indicates the kind of antibiotic to use for treatment.
UTI can often be treated with antibiotics. Most cases clear up in as little as three days, but always finish the entire course of treatment, even if it seems that your remaining medication is no longer necessary. Your doctor may prescribe any one of the following antibiotics:
In rare cases when antibiotics don't kill the infection or when the condition becomes chronic, hospitalization might be required. This is because of the possibility of the infection having spread to the kidneys. If this happens, you might be given a course of antibiotics intravenously.
In some situations, patients are administered low-dose antibiotics for an extended period after an infection has been treated, to prevent reoccurrence.
If it is determined that the cause of chronic infections is mechanical failure due to an abnormality of the urinary system, surgery might be required.
Some people, particularly women, are simply more susceptible to urinary tract infections than others. But there are simple steps you can take to reduce the odds of getting a UTI. These include:
- Urinate completely. Urine left in the bladder for long can lead to infection.
- Urinate after sexual intercourse.
- Do not douche.
- After bowel movement, women and girls should wipe from front to back so as not to introduce infection from fecal matter.
- Drink plenty of fluids to wash out the system.
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Last Reviewed: Mar 02, 2007
Martin I Resnick, MD
Formerly, Professor of Urology
School of Medicine
Case Western Reserve University