General Info about Urinary Tract Infection 

Infections of the urinary tract are common. Urinary tract infections (UTI's) are caused by bacteria that invade the urinary system and multiply, leading to an infection. Women are affected more than men.

The urinary system consists of the kidneys, ureters, bladder, and urethra. The key elements in the system are the kidneys, a pair of purplish-brown organs located below the ribs toward the middle of the back. The kidneys remove liquid waste from the blood in the form of urine, keep a stable balance of salts and other substances in the blood, and produce a hormone that aids the formation of red blood cells. Narrow tubes called ureters carry urine from the kidneys to the bladder, a triangle-shaped chamber in the lower abdomen. Urine is stored in the bladder and emptied through the urethra.

There are three types of urinary tract infections:

Urethritis is infection of the urethra 

Cystitis is infection of the bladder 

Pyelonephritis occurs when bacteria ascend up the ureters and infect the kidneys.

What are the causes of Urinary Tract Infection ? 

The most common cause of UTI is bacteria from the
 bowel that lives on the skin near the rectum or in the vagina which can spread and enter the urinary tract through the urethra. Once bacteria enters the urethra it travels upward causing infection in the bladder and sometimes other parts of the urinary tract. 

Sexual intercourse is a common cause of urinary tract infections and the anatomy of women may make them more prone to infections since during sexual intercourse bacteria in the vaginal area could be massaged into the urethra by the motion of the penis. 

Women who change sexual partners or begin having sexual intercourse more frequently may experience more frequent bladder infections. 

Another cause of bladder infections or UTI is holding back urine. The bladder is a muscle that stretches to hold urine and contracts when the urine is released. Waiting long causes the bladder to stretch beyond its capacity which over a period of time can weaken the bladder muscle. When the bladder is weakened it may not empty completely and some urine is left in the bladder which may increase the risk of urinary tract infection or bladder infection. 

Another common source of infection is caused by catheters or tubes placed in the bladder. 


What are the risk factors? 

Some people are more prone to getting a UTI than others.

Studies have also shown that women who use diaphragms for birth control may be at higher risk. 

People with diabetes have a higher risk of infection because of changes in the immune system secondary to the high sugar concentrations.

Any abnormality of the urinary tract that obstructs the flow of urine (a kidney stone) increases the risk for an infection. 

UTIs may occur in infants who are born with abnormalities of the urinary tract, which sometimes need to be corrected with surgery.


What are the symptoms of Urinary Tract Infection ? 

The most commonly occuring symptoms are:

A strong persistent urge to urinate. 

Frequent urination, a painful, burning feeling in the urethra during urination.

Often, women feel an uncomfortable pressure above the pubic bone, and some men experience a fullness in the rectum. 

The urine itself maybe cloudy or reddish if blood is present.

More specific symptoms are:-

Acute pyelonephritis may cause flank pain, high fever, severe chills and nausea or vomiting. 

Cystitis may result in pressure in the lower abdomen and strong-smelling urine. 

Urethritis may lead to pus in the urine. In men, urethritis may cause penile discharge.



How can we diagnose Urinary Tract Infection ? 

A urinalysis, to look for 'pus' cells in the urine can be
 helpful in diagnosing UTI. 

In some patients Ultrasound examination of the kidney maybe necessary to rule out any infection of the kidney. 

A dip stick test is also available and it can give diagnosis within a short period. 

Another test that may be performed is called a voiding cystorography (VCUG). It involves instilling a chemical into the bladder and taking serial X-rays as the patient urinates.This test is usually undertaken if the UTI keeps occuring repeatedly in children. 

If the above tests are positive a urine culture can reveal the infectionand types of bacteria causing the infection.


How can Urinary Tract Infection be treated ? 

UTI is treated with antibiotics. Treatment of patients with recurrent infections varies depending on the cause.

Postmenopausal women may receive hormone replacement therapy. 

People with an obstructive cause (e.g., kidney stone or enlarged prostate) may require surgical correction. 



More Valuable information about Urinary Tract Infection... 

Preventive measures

Drink at least two to three litres of fluid depending on whether you live in cold or warm area. 

Make sure you get enough vitamin C in your diet. It makes the urine acidic, which in turn decreases the number of bacteria. 

Void urine at 2-3 hour intervals.

Void urine before bedtime and after intercourse. 

Cleanse the genital area with water before sexual intercourse. 

Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.

Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra. 

Avoid bubble baths and other chemicals in bath water.

Having good vaginal muscle tone is beneficial and may be achieved by doing Kegel exercises. 



Frequently asked questions about Urinary Tract Infection... 

Which specialist should I see if I have Urinary Tract Infection?

You should see a Urologist.

Why are men less affected than women by UTI?

Transfer of infection along the shorter female urethra is easier, while the longer male urethra protects against the transfer of bacteria to the bladder. Also, the prostatic fluid has antibacterial action.

Does urine contain infectious organisms?

Urine is normally sterile.

Is UTI dangerous?

Repeated UTI can can damage the kidney and may lead to kidney failure.

Which specialist should I see if I have a UTI?

You should see a General practitioner, however if UTI is recurrent see a urologist. 


Glossary 

Cystoscopy - This is a test conducted to test the bladder and ureteric orifices.

Micturing Cystourethrography - This is a test done to diagnose the disordered bladder emptying and urethral abnormalities.