Urinary Tract Infections (UTIs)
Urinary tract infections (UTIs) are caused by bacteria that invade the urinary system and multiply, leading to an infection. Women are affected more than men, although men and children can get UTIs.
Most infections are not serious and can be easily treated with antibiotics. However, if left untreated, some infections can result in kidney damage. This is why it is so important to seek appropriate medical treatment if a UTI is suspected.
The urinary tract can be infected from by bacteria from another part of the body that enter the kidney through the bloodstream, or a UTI can occur from bacteria entering the urethra.
Risk Factors
Small children still in diapers often have stool in close proximity to their urethra. The longer they sit in soiled diapers, the more likely the chance of infection. In addition, small girls are more prone to infection because they have a shorter urethra than boys. Uncircumcised boys are more likely to get an infection than circumcised boys because bacteria survive in warm, moist areas like the area under the foreskin. When toilet trained, older girls may be more likely to get a UTI if they wipe themselves from back to front, because this can expose the vaginal and meatal area to bacteria present in the rectum, most commonly Escherichia coli (E. coli).
Sexually active teenagers and adult women are more prone to UTIs because of friction that occurs at the meatus during intercourse, which allows bacteria to enter and ascend the urinary tract. This problem can be avoided by urinating after sexual intercourse.
Another common source of infection is catheters or tubes placed in the bladder. Catheters are normally used when people cannot void, are unconscious or are critically ill, and may stay in place for long periods of time. Some people, especially the elderly or those with nervous system disorders such as spinal cord injury, who lose bladder control may require catheters for the rest of their lives. Bacteria on the outside of the catheter can climb up the device into the bladder and cause infection.
People with diabetes have a higher risk of infection because of changes in the immune system secondary to the high sugar concentrations. Any disorder that affects the immune system raises the risk of developing a UTI.
Many women suffer from frequent UTIs, which is defined as three or more culture-verified UTIs in one year. This condition is known as recurrent cystitis. Usually the recurrent infection stems from a strain or type of bacteria different from the original UTI, which suggests a separate infection.
Signs and Symptoms
Not everyone with a UTI has symptoms, but most people get a least some. These include more frequent urination (the average person urinates six times a day) and dysuria, a painful, burning feeling in the area of the bladder or urethra during urination. Pain at the beginning of urination is usually associated with urethritis, whereas pain in the middle of urination is associated with cystitis.
It is common for a person with a UTI to complain that despite the urge to urinate, only a small amount of urine is passed. It may appear cloudy or even reddish if blood is present. In addition the urine may have a pungent, unpleasant odor. Often women complain of an uncomfortable pressure above the pubic bone and some men experience a feeling of fullness in the rectum.
It also is not unusual to feel bad "all over," with shaky, tired, flu-like symptoms. If a fever is present (greater than 101 degrees Fahrenheit or 39 degrees Celsius) it usually means that the infection has reached the kidneys. Other symptoms specific to kidney infection include pain in the back or side (flank), nausea, and vomiting.
In young children and infants the symptoms of a UTI may be overlooked or mistakenly attributed to another condition. Symptoms in infants and young children include irritability, change in eating habits, unexplained fever that does not go away, urinary incontinence or change in urinary pattern, and loose stools.
Diagnosis
The evaluation of a suspected UTI involves a detailed history, including travel as some parasites can cause UTI symptoms, and physical exam. Your doctor will also want to examine your urine for the presence of white blood cells, red blood cells and bacteria.
You will be asked to give a "clean-catch" urine sample, because simply urinating into a sterile cup may not stop contamination by bacteria on the skin (called skin flora). To get a clean-catch sample, you must stop urinating "midstream." After cleaning the meatus and surrounding area with an antiseptic, you urinate a little to expel any bacteria that may be in the urinary tract. You then stop briefly before urinating into the sample cup. The urine is examined under a microscope. If a UTI is suspected, the urine is cultured to see what type of bacteria is growing and which antibiotics will be effective in killing it. This is called a sensitivity test.
If you have recurrent infections, your urologist may decide to do an imaging procedure of the urinary tract to see if any defects are the cause of the infection. The imaging procedure usually ordered is a renal and bladder ultrasound. At times, a cystoscopy is performed to examine the inside of the bladder. This involves an in-office procedure where a flexible, fiber optic scope is inserted into the bladder.
When to Call a Healthcare Professional
If you suspect that you may have a urinary tract infection, please call your primary care physician or office to schedule an appointment.
 |
|
Copyright © 2008. Urology Associates of Danbury, PC. All rights reserved. |
|