A urinary tract infection (UTI) is an infection that occures in any part of your urinary system – kidneys, ureters, bladder and urethra.
Its an infection which can arise from the level of the kidney, throughout the structures urine passes, up to the urethral orifice (the opening that lets urine out of the body). It’s more common in women due to possession of a shorter urethra (tube connecting the bladder to the urethral orifice) and its nearness to the anus. In males UTI is uncommon, except in the first year of life and in men over 60 years, in whom urinary tract obstruction mainly due to the swollen prostate gland.
Risk factors for acquiring UTIs include
• Obstruction of urine flow from the bladder due to bladder stones, cancer or strictures after infection
• Foreign bodies in the urethra e.g. urinary catheters
• Diabetes mellitus
• Poor personal hygiene
UTIs are caused by bacteria, in which over 75% of cases are caused by bacteria arising from the alimentary canal. Bacteria may be acquired from dirty underwear or bathrooms although this is less likely to cause symptomatic infections. Parasites are also implicated but in rare cases.
Candidiasis, syphilis or genital herpes are not UTIs. Gonorrhoea and chlamydia infections are regarded as sexually transmitted infection (STIs) and technically UTIs.
Symptoms of UTIs include
• Pain on urination
• Lower abdominal pain especially after urination
• Increased frequency of urination
• Feeling of the need to pass urine immediately after complete urination (urinary urgency)
• Urine may appear cloudy, bloody or have an abnormal unpleasant odour
• Fevers or malaise may indicate progression of disease
In addition to signs and symptoms, blood tests, including analysis of urine (urinalysis) may be required to detect the exact causative bacteria and hence better drugs for treatment can be obtained through drug susceptibility tests.
Most cases of UTIs are treated as Out Patient cases although admission may be indicated in cases of serious complications. There are several antibiotics and urinary tract antiseptics available for treatment.
Prevention of UTIs especially in individuals who have had recurrences includes lifestyle modifications such as:
• Adequate fluid intake at least 2 litres per day
• Good personal hygiene
• Regular complete emptying of the bladder
• Urination before and after sexual intercourse
• Practice “double urination” by emptying the bladder, and then attempting to empty it again 10-15 minutes later
• Drinking cranberry juice can help
Complications of untreated UTIs may include kidney damage after ascension of the bacteria, or spread of the bacteria into the blood (sepsis)