Urinary Tract Infection (UTIs)

UTIs are infections of the urinary tract, which include the kidneys, ureters, bladder, and urethra. The lower urinary tract – the bladder and the urethra – is the most common site of infection. Around 50–60% of women will develop UTIs in their lifetime, and around 20–30% will suffer from recurrent infections.

An infection in the urinary tract is caused by bacterial growth in the urinary tract. Several factors can contribute to UTIs, including holding urine for long periods, poor vaginal hygiene, hormonal imbalances, and diabetes. Common symptoms include a burning sensation during urination, frequent or intense urge to urinate even if little or nothing is produced, back or lower abdomen pain, and a rise in body temperature. One should consult a gynecologist if the symptoms fail to improve in a day or two with home care.

Types of UTIs

An infection can happen in different parts of your urinary tract. Each type has a different name, based on where it is.

• Cystitis(bladder): You might feel like you need to pee a lot, or it might hurt when you pee. You might also have lower belly pain and cloudy or bloody urine.

• Pyelonephritis(kidneys): This can cause fever, chills, nausea, vomiting, and pain in your upper back or side.

• Urethritis(urethra): This can cause a discharge and burning when you pee.

Urinary tract infections don’t always cause signs and symptoms, but when they do they may include:

• A strong, persistent urge to urinate
• A burning sensation when urinating
• Passing frequent, small amounts of urine
• Urine that appears cloudy
• Urine that appears red, bright pink, or cola-colored — a sign of blood in the urine
• Strong-smelling urine
• Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone. In older adults, UTIs may be overlooked or mistaken for other conditions.

Lab tests are a complete analysis of your whole body. Lab tests are done:

• To diagnose any kind of symptoms.
• To find out how well our organs are working.
• It can monitor chronic health conditions and diseases and find out problems in their early stages.

To Diagnose and monitor Urinary Tract Infection some of the following tests are :

• Urine routine and microscopy
• Urine culture & sensitivity
• CT Urography or Urogram
• USG, MRI, or CT scan of the abdomen
• MRI or CT scan of the pelvis
• Cystoscopy

A urinary tract infection occurs when bacteria enter the urinary tract through the urethra and multiply in the bladder. The urinary system is designed to keep out such microscopic invaders, but sometimes these defenses fail. Bacteria may then take hold and grow into a full-blown infection in the urinary tract.
The most common UTIs occur mainly in women and affect the bladder and urethra.

• Infection of the bladder (cystitis) – This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible.

• Infection of the urethra (urethritis) – UTIs can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea, chlamydia, and mycoplasma, can cause urethritis.

Urinary tract infections are common in women, and many women experience more than one infection during their lifetimes. Risk factors specific to women for UTIs include:

• Female anatomy – The urethra of a woman is shorter than that of a man, so bacteria have to travel a shorter distance to reach the bladder.

• Sexual activity – Sexually active women tend to have more UTIs than women who aren’t sexually active. Having a new sexual partner also increases your risk.

• Certain types of birth control – Women who use diaphragms for birth control may be at higher risk, as well as women who use spermicidal agents.

• Menopause – After menopause, a decline in circulating estrogen causes changes in the urinary tract that make you more vulnerable to infection.

Other risk factors for UTIs include:

• Urinary tract abnormalities – Babies born with urinary tract abnormalities that don’t allow urine to leave the body normally or cause urine to back up in the urethra have an increased risk of UTIs.

• Blockages in the urinary tract – Kidney stones or an enlarged prostate can trap urine in the bladder and increase the risk of UTIs.

• A suppressed immune system – Diabetes and other diseases that impair the immune system — the body’s defense against germs — can increase the risk of UTIs.

• Catheter use – People who can’t urinate on their own and use a tube (catheter) to urinate have an increased risk of UTIs. This may include people who are hospitalized, people with neurological problems that make it difficult to control their ability to urinate, and people who are paralyzed.

• A recent urinary procedure – Urinary surgery or an exam of your urinary tract that involves medical instruments can both increase your risk of developing a urinary tract infection.

Most UTIs are caused by bacteria that are already in the bladder, so flushing them out is the most important way to prevent an infection. Here are some effective ways by which you can prevent recurrent UTIs:

1 . Drink enough fluids

One of the easiest and most effective ways to prevent UTIs is by staying well hydrated. Fluid helps move things through the urinary tract, but it also dilutes the urine so bacteria can’t grow. Make sure you drink 1-2 liters of fluids daily.

2 . Don’t hold the urine

Since stagnant urine creates the perfect environment for an infection to grow, the longer urine stays in the bladder, the greater the risk of bacterial overgrowth. Do not get into the habit of holding on to it for long, since it will make you prone to infection.

3 . Practice good toilet hygiene

After you’re done, make sure you wipe from front to back to keep from pushing bacteria nearer to your urethra. This is especially important after a bowel movement.

4 . Make sure you empty your bladder after sex

Sexual intercourse can move bacteria from the vagina into the urethra, thereby increasing the risk of infection. Urinating after sex flushes out any bacteria that could have migrated to the bladder during intercourse.

5 . Choose contraceptives with caution

If you are prone to UTI, it is best to avoid spermicides and diaphragms. Spermicides not only introduce bacteria into your vagina but also alter your vaginal pH, which can create an ideal environment for bacterial overgrowth. Diaphragms may interfere with your ability to empty your bladder, thereby increasing the risk of infection.

6 . Use female hygiene products carefully

If you get UTI too often, avoid bubble baths, bath oils, and perfumed products around the genital area. Some doctors suggest switching from tampons to sanitary pads, since tampons may give bacteria more opportunity to enter the body and irritate the urethra.

7 . Change out of workout clothes quickly

If you are prone to UTI it is best to change out of your workout clothes right after you are done. Excessive sweat can increase the risk of bacterial multiplication which in turn can migrate into your urethra and lead to UTI.

8. Avoid tight fighting clothes

Avoiding tight-fitting clothing can help keep you dry, preventing bacteria from growing in the urinary tract. Wearing cotton underwear will prevent extra moisture from getting trapped around your urethra.

In most cases, antibiotics are the first line of treatment for urinary tract infections. Depending on your health condition and the type of bacteria in your urine, you will be prescribed different drugs and for how long.

Simple infection

Drugs commonly recommended for simple UTIs include:

• Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)
• Fosfomycin (Monurol)
• Nitrofurantoin (Macrodantin, Macrobid)
• Cephalexin (Keflex)
• Ceftriaxone

Frequent infections

If you have frequent UTIs, your doctor may make certain treatment recommendations, such as:

• Low-dose antibiotics, initially for six months but sometimes longer
• Self-diagnosis and treatment, if you stay in touch with your doctor
• A single dose of antibiotic after sexual intercourse if your infections are related to sexual activity
• Vaginal estrogen therapy if you’re postmenopausal

Severe infection

You may need treatment with intravenous antibiotics in a hospital for a severe UTI.