urinary tract infection UTI treatment

Urinary Tract Infection (UTI)

What is Urinary Tract ?

Urinary system includes the kidneys, ureters, bladder and urethra. This system helps to remove waste from the body. The kidney filters waste from blood. Tubes called ureters transport these waste products, or urine, from the kidneys to the bladder, where it is stored until it is expelled from the body through the urethra. All these components can become infected, but most infections involve the lower tract.

Urinary tract infection (UTI) ? uti urinary tract infection treatment

A urinary tract infection or UTI is an infection that can occur anywhere along the urinary tract. Depending on what part of the tract is infected, UTI is named differently. Most urinary tract infections are caused by bacteria Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract (especially the rectum). However, sometimes other bacteria are responsible.

Why do urinary tract infection, UTI affect women ?

Urinary tract infections UTIs are one of the most common clinical bacterial infections in women, accounting for nearly 25% of all infections. Around 50–60% of women develop UTI in their lifetimes. Adult women are most commonly affected as their urethra is shorter than men and opens closer to the anus, making it easier for bacteria to enter the urinary system and cause an infection.

Women are more likely to get an infection if they:-

  • have had a UTI before
  • have had several children
  • have diabetes
  • are obese
  • have any kind of surgery.
  • Menopause also heightens the risk of developing a UTI. During menopause, estrogen levels decline. This decline can prompt changes in the tissues surrounding the urethra, potentially leading to a UTI.
  • UTIs can also occur during pregnancy. If you are pregnant and suspect you have a UTI, be sure to inform your doctor promptly. If untreated, it may cause problems for you and your baby.

How do urinary tract infections (UTIs) develop ?

Most urinary tract infections start in the lower urinary tract, which is made up of the urethra and bladder. Bacteria from the bowel live on the skin near the anus or in the vagina. These bacteria can spread and enter the urinary tract through the urethra. If they move up the urethra, they may cause a bladder infection (called cystitis). Bacteria that have infected the bladder may travel to the upper urinary tract, the ureters and the kidneys. An infection of the kidneys is called pyelonephritis. An upper urinary tract infection may result in a more severe illness compared to a lower urinary tract infection.

Types of urinary tract infection, UTI

Types of urinary tract infections include:

  • Cystitis is infection of the bladder,
  • Urethritis affects the urethra (the tube that empties urine from the bladder to the outside).
  • Pyelonephritis is a serious condition caused by kidney infection.

Urinary tract infection, UTI symptoms

A feeling of pressure in the lower pelvis or lower back ache. There may be stinging, painful or frequent urination with urgent urge to urinate often with little or no urine passed. Often there is a need to urinate at night and the urine may also become cloudy or smell unpleasant. Blood in the urine and fever can also occur along with nausea, vomiting, chills and fever indicating a severe infection.

If you experience any of these symptoms, it’s important to inform your doctor immediately. Kidney infections are serious. They need to be treated promptly.

Symptoms associated with a UTI, such as painful urination, can sometimes be attributed to other issues, such as an infection of the vagina or vulva. Tests may be necessary to confirm the diagnosis. Be sure to let your health doctor know if you have any of these symptoms.

Recurring infections in women

Your body’s reduced ability to resist bacteria getting into the bladder and causing infection may increase the susceptibility to infections. Sexual activity can elevate the risk of cystitis in certain women. Your vagina, bladder and urethra can be influenced by the hormone oestrogen. After menopause the levels of oestrogen in the body reduce and the tissues become thinner, weaker, and dryer, increasing the risk of recurrent cystitis. Infections are also more prevalent during pregnancy due to alterations in the urinary tract. In many cases there is no apparent cause.

Higher risk patients ?

Old age, being female and post some surgical procedures can increase the risk of infections. Diabetes increases the risk. Surgeries that are done on or near part of the urinary tract and immobilization after surgery will also increase the risk.

Urinary tract infection diagnosis

Testing of the urine may reveal pus cells or red blood cells.

  • A urine specimen is necessary to identify the type of bacteria present in the urine and determine the appropriate antibiotic for treatment.
  • You may be advised an ultrasound scan to check your kidneys, ureters and bladder.
  • If you are suffering from recurrent urinary infection you may be advised to have a cystoscopy in which the inside of your bladder is examined using a camera.

How to reduce risk of UTI ?

These simple measures can reduce the risk of urinary tract infection:

  • Drink about 8 glasses of water daily.
  • Cranberry juice and vitamin C.
  • Do not let the bladder get too full. Pass urine regularly when you feel the need.
  • After using the toilet, always wipe from front to back.
  • Avoid irritants such as  vaginal deodorants, perfumed bath oils, soap or talcum powder around genitals.
  • Cleanse your genitals daily but not too frequently or vigorously.
  • Go to the bathroom before and immediately after having sex.
  • Lubricate adequately during sexual intercourse.
  • Wear cotton underwear and loose-fitting clothes to allow air to keep the area dry.
  • If you have diabetes, ensure you maintain control over your blood sugar levels.

Urinary tract infection, UTI treatments

Urinary tract infection, UTI treatments could include:

  • Drinking plenty of water.
  • Consider over-the-counter remedies containing sodium citrate or potassium citrate.
  • Antibiotics courses.

If you suffer from recurrent cystitis you may need a low dose of an antibiotic regularly for a longer period of time. A urinary tract infection can be uncomfortable and painful, but can easily be treated with antibiotics.

Author

Dr Sobia Mohyuddin

MCPS, FCPS, MRCOG, Consultant Obstetrics & Gynaecology

Doctor Sobia Mohyuddin is a highly skilled and experienced Obstetrician and Gynecologist, with 25 years of training and experience in renowned, large institutions. She holds the position of Associate Professor and Fellow at the College of Physicians and Surgeons Pakistan. She is also a member of the Royal College of Obstetricians and Gynecologists (UK).