Urinary Tract Infections (UTIs)

Urinary tract infections (UTIs) are bacterial infections in the urethra, bladder, or kidneys. They develop when bacteria find their way to the opening of the urethra and begin to multiply, then travel up the urethra into the bladder or the kidney. UTIs are a serious health problem that affects millions of people each year, and women are especially prone to UTIs, because of the proximity of the anus to the urethra.

A urinary tract infection that develops in the urethra, the channel that drains urine from the bladder to the outside of the body, is called urethritis. A bacterial infection that has moved up from the urethra into the bladder is called cystitis. An infection that has traveled farther up the urinary tract into the kidneys is called pyelonephritis. This is the most dangerous type of urinary tract infection, and generally requires the longest course of therapy.

Symptoms of Urinary Tract Infections

While not everyone with a UTI experiences symptoms, most people do. The most common symptoms include

• Frequent urination
• A painful, burning feeling during urination
• Fever
• Cloudy appearing uring or urine that is reddish in color (blood may be present in the urine)
• Fatigue
• Pain in the back or side, below the ribs even when not urinating
• Nausea and/or vomiting
• Passage of a small amount of urine, despite an intense urge to urinate
• Uncomfortable pressure above the pubic bone in women

Causes of Urinary Tract Infections

The majority of cases of cystitis are caused by Escherichia coli (E. coli), a species of bacteria commonly found in the gastrointestinal tract. Some women are prone to developing UTIs after sexual intercourse. Postmenopausal women are at higher risk for developing UTIs because of the impact of the lack of estrogen on the vaginal environment. Men with enlarged prostates and urinary retention are also more prone to developing UTIs. People with indwelling catheters, as well as immunocompromised people, are also susceptible to developing infections of the urinary tract. In many cases the etiology is unknown.

Diagnosis of Urinary Tract Infections

Urologists will require a urine specimen if you have signs and symptoms of a UTI. Diagnosis is determined by analyzing a urine specimen under a microscope for evidence of infection. Cultures of the sample are taken to determine which bacterial organism is causing the infection so appropriate therapy can be provided. (Urine dipsticks, which test for blood and other substances in the urine, are often inaccurate.)

Treatment for Urinary Tract Infections

Treatment may include:

• Antibacterial medications
• Pyridium or Uristat and/or heating pad to relieve pain
• Behavior modifications, including drinking plenty of water to help cleanse the urinary tract of bacteria

When antibiotics are used, the length of treatment can vary from 3 days to several weeks, depending on the severity of the infection, how frequently infections are developing, and whether the kidneys are involved in the infection. It is always important to take the antibiotics for as many days as your doctor prescribes them, in order to completely eradicate the bacteria.

Prevention of Urinary Tract Infections

In order to prevent the development of UTIs, it is important to drink plenty of water, urinate when you feel the urge, rather than holding urine for extended periods, and urinate after intercourse. Certain substances, such as cranberry pills, lactobacillus, and methenamine may be prescribed to those who are frequently afflicted by UTIs.