Urinary Tract Infections

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The urinary tract is composed of the kidneys, the ureters, the bladder, and the urethra. Urinary tract infection (or UTI) refers to infection in the upper portion (kidneys and ureters) or lower (bladder and urethra) portions of the urinary tract.

UTIs are the most common type of bacterial infections seen in a medical office. They are more common in women than in men: About 12% of women will have a UTI every year, and in fact most women will have at least one UTI over the course of their life.

What Causes Urinary Tract Infections?

Urinary SystemUTIs start with bacteria which normally reside in the vagina or in the gastrointestinal tract. These bacteria can make their way to the urethra—the opening where urine comes out—and then climb up into the bladder, causing infection.

The #1 risk factor for UTI is sexual activity. UTI is not a sexually transmitted disease, but the rubbing and friction which occur during sexual activity help the bacteria in the vagina or anus to make their way to the urethra. From there, it’s just a short climb up to the bladder.

Rarely, children can have abnormalities in the structure of their urinary tract which can make them more susceptible to UTIs. In some children, for example, reflux of urine from the bladder up into the ureters can cause UTIs.

UTIs are the most common type of bacterial infections seen in a medical office and they are more common in women than in men.

What are the Symptoms of UTI?

Most UTIs occur in the lower urinary tract, i.e., the bladder and the urethra. These UTIs are commonly called “cystitis” or “urethritis.” The most frequent symptoms of UTI are burning with urination; urinary frequency and urgency, and pain in the lower abdomen. With some forms of UTI, blood may be seen in the urine. This may be just some pink staining with wiping, or you may see a toilet bowl that looks like it’s full of blood.

Women with upper UTIs occasionally have burning with urination, urgency, and frequency, but systemic (“whole-body”) symptoms like fever, chills, nausea, and vomiting are more common. Women often have back or flank pain, high fever, and shaking chills. Women with upper tract infections feel truly ill.

We encourage women with urinary symptoms to be seen in the office to confirm the diagnosis. Urinary infections are sometimes mistaken for vaginal infections, and vice-versa. Vaginal infections are usually characterized by discharge, irritation, itching, and/or odor, but burning on urination is occasionally the only symptom. Similarly, herpes infections can cause burning with urination. Patients with lower abdominal pain should be evaluated for other causes (e.g., ovarian cysts), and blood in the urine can sometimes be caused by stones rather than infection. With the exception of women who have already had numerous culture-proven UTIs, women who have symptoms suggesting a UTI should be seen in the office to rule out other causes for their symptoms.

How are UTIs Treated?

UTIs are generally treated with a short course of oral antibiotics. Most cases will resolve with 3 to 7 days of a first-line antibiotic. Most patients will feel better after a day or two of antibiotics, but it is important to complete the entire prescribed course of antibiotics to make sure the infection is completely cleared. Occasionally, infection with resistant bacteria may require retreatment with a different type of antibiotic.

If you have been diagnosed with a UTI, it’s generally a good idea to drink plenty of fluids to flush out the bacteria. Grape juice or cranberry juice may assist in clearing the bacteria by acidifying the urine.

How Do I Prevent UTIs?

Among healthy young women who have their first UTI, 25% will have a recurrence within 6 months. In some cases this represents relapse of the same infection, while other cases are new infections. Women in either case are generally retreated with good results.

Women who have a long history of recurrent UTIs can be offered prophylaxis: In this case, antibiotics are used to prevent UTIs, rather than waiting for them to occur. Several regimens have been used successfully. Since UTIs are commonly related to sexual activity, one very effective regimen involves taking a single dose of antibiotic with every sexual encounter. Other regimens, including daily doses of antibiotics, are occasionally necessary.

Women who have a long history of recurrent UTIs can be offered prophylaxis: In this case, antibiotics are used to prevent UTIs, rather than waiting for them to occur.

Urinary hygiene advice is customarily offered to women who suffer from UTIs. Women are advised to wipe from front to back; to urinate after intercourse; to drink plenty of fluids; and to make sure they void when they feel the urge. In truth, there is very little scientific evidence to suggest that these measures are effective, but these recommendations are still recommended as healthy low-risk practices.

At the Woman’s Health Pavilion, we offer urgent appointments to women with acute symptoms—including UTI symptoms. If you currently think you have a UTI, you should call today for an appointment.


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