Urinary tract infections (UTIs)
By Dr Faozat Aragbaye
A urinary tract infection, or (UTI), is an infection in any part of the urinary system, which includes the kidneys, bladder, ureters, and urethra. Most infections involve the lower urinary tract- the bladder and the urethra.
Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder.
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 gastrointestinal (GI) tract. However, sometimes other bacteria are responsible. Sexual intercourse may lead to cystitis. All women are at risk of cystitis because of their anatomy.
- Infection of the urethra (urethritis). This type of UTI 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, gonorrhoea, 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 include:
- Female anatomy. A woman’s urethra is shorter than man’s, which shortens the distance bacteria must travel to reach the bladder.
- Sexual activity. Sexually active women tend to have more UTIs than non sexually active women. New partner also increases the risk of infection.
- Certain types of birth control. Women who use diaphragms or spermicidal agents for birth control may be at higher risk.
- Menopause. After menopause, a decline in circulating oestrogen cause changes in urinary tract that makes women vulnerable to infection.
- Urinary tract abnormalities. Babies born with urinary tract abnormalities
- Blockages in the urinary tract. Kidney stones or an enlarged prostrate 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
- Catheter use. People who can’t urinate on their own and use catheter to urinate have an increased risk of UTIs
- A recent urinary procedure. Urinary surgery or examination of the urinary tract that involves medical instruments can be a risk to developing UTI.
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 amount of urine
- Urine that appears cloudy
- Urine that appears red, bright pink or cola-coloured- a sign of blood in the urine.
- Strong- smelling urine
- Pelvic pain, in women-especially in the centre of the pelvis and around the area of the pubic bone.
Types of urinary tract infection.
Each type of UTI may result in more specific signs and symptoms, depending on which part of the urinary tract is infected.
Part of urinary tract affected Signs and symptoms
Kidneys ( acute pyelonephritis) Upper back and side (flank) pain
Chills and rigour
Bladder (cystitis) Pelvic pressure
Lower abdominal discomfort
Frequent, painful urination
Blood in urine
Urethra (urethritis) Burning with urination. Discharge
Tests and procedures used to diagnose urinary tract infections include:
- Analysing a urine sample. Urine sample for laboratory analysis for white blood cells, red blood cells or bacteria.
- Urine culture. This test can determine the causative organisms and effective medications.
- Ultrasound scanning, CT scan and MRI.
Antibiotics or antimicrobials are usually the first line of treatment for urinary tract infections. Take all prescribed medicine, even after feeling better. Drink lots of water to help flush the bacteria from the body. Cranberry juice is also promoted to prevent or treat UTIs.
Chronic UTIs- repeated infections of the urinary tract infections. Treatment plan for chronic UTIs include:
- A low dose of antibiotic over a longer period to help prevent repeat infections
- A single dose of antibiotic after sex, which is a common infection trigger
- Antibiotics for one to two days every time symptoms appear
- A non-antibiotic prophylaxis treatment
Most UTIs are not serious, but some can lead to serious problems, particularly with upper UTIs. Recurrent or long –lasting kidney infections can cause permanent damage, and some sudden kidney infections can be life-threatening, particularly if bacteria enter the bloodstream (septicaemia).
Women can also have the risk of delivering premature or infants with low birth weight.
There are several measures that can be taken to reduce the risk of developing a UTI:
- Drink lots of water and urinate frequently
- Avoid fluids such as alcohol and caffeine that can irritate the bladder
- Urinate shortly after sex
- Wipe from front to back after urinating and bowel movement
- Keep the genital area clean
- Sanitary or menstrual cups are preferred to tampons
- Avoid using a diaphragm or spermicide for birth control
- Avoid using any perfumed products in the genital area
- Wear cotton underwear and loose-fitting clothing to keep the area around the urethra dry