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urinary tract infections (UTI)

 

what is a urinary tract infection?  What causes it?

Urinary tract infections are infections of the urethra, bladder or kidneys caused by bacteria.  Cystitis is an infection of the bladder; urethritis is an infection of the urethra (opening of the bladder); pyelonephritis is an infection of the kidneys.

 

how do urinary infection occur?

Infections of the urinary tract generally start when bacteria enters from the outside.  Normally thee should be no bacteria in the urinary tract.  They bacteria that causes most urinary infections are commonly found in the lower intestine.  The trouble starts when they move into the urethra and up into the bladder.  In both men and women, bacteria leaving the body through the rectum can sometimes re-enter through the urethra.  If they succeed in reaching the bladder, they will find a warm, moist environment in which to settle and multiply rapidly.  However, because a woman's urethra is much shorter (<1 inch long) than a man's urethra (which runs the full length of the penis), bacteria invading a woman's urinary tract have a much shorter trip and a far better chance of getting established.

 

Toilet habits:

After urination or a bowel movement, bacteria can enter the urethra through the vagina in two ways.  First, wiping from back to front with a toilet tissue can bring bacteria directly into the entrance of the urinary tract.  Second, even if you keep your rectal area very clean, bacteria can reside in your underwear and work their way around the vaginal area during exercise, bike riding, and while wearing tight jeans or thongs.

 

sexual intercourse:

Vaginal manipulation (fingering) and the thrusting of sexual intercourse can spread bacterial throughout the genital area while temporarily traumatizing the urethra.  Symptoms usually begin withing 12 to 48 hours after sex.  Women who have recently become sexually active frequently have urinary tract infections, often referred to as "honeymoon cystitis".

 

dehydration:

Inadequate intake of fluids (especially water), excessive sweating, and drinking alcoholic and caffeine beverages all lead to dehydration.  Urinary tract infections are more likely to occur and symptoms are usually more severe if you are dehydrated.

 

what are the symptoms:

Common symptoms of bladder infections include:

  • Painful urination
  • Burning, stinging or pressure sensation during & especially at the end of urination
  • Frequent urination
  • An urgent feeling to urinate
  • A need to urinate more often in the night
  • Cloudy, bloody urine or urine with a distinct odor
  • Lower abdominal pain

Common symptoms of kidney infections include:

  • Fever and/or chills
  • Back pain
  • Severe abdominal pain
  • Vomiting or nausea

 

How is it diagnosed?

By a urinalysis test.  You will be asked to give a urine sample, which will be tested for bacteria, white cells, and blood.  A culture and sensitivity may be preformed on the urine sample to determine the most effective antibiotic to treat the infection.  If you have a fever a blood sample may be needed.

 

How is it treated?

Urinary tract infections are usually treated by antibiotics.  It is very important to take all of the medication prescribed.  If the antibiotic is stopped to soon, a second infection may occur that may be more difficult to treat.  A medication to relieve the pain may also be prescribed.

 

Is there anything else that will help?

Drinking plenty of fluids (especially water) will help clear the urinary tract.  Water is the best fluid, at least 64 ounces a day is best.  Avoid alcohol and caffeine drinks.  These is some evidence that cranberry juice is helpful in creating an unfavorable environement for the bacteria to grow.

 

things that may help prevent future infections:

  • Practice good hygiene
  • Females should wipe from front to back after urinating or having a bowel movement
  • Drink plenty of fluids, especially water
  • Urinate immediately after intercourse
  • Urinate every 3 to 4 hours during the day
  • Use vaginal lubricants during intercourse
  • Drink cranberry juice when you know you will be sexually active
  • Clean the external genitalia prior to intercourse

 

for what reasons should i return to the health center

  • Worsening back pain
  • Inability to urinate
  • Fever
  • Vomiting
  • If discomfort persists, you should be evaluated for other causes of your symptoms, such as chlamydia, genital herpes, vaginitis, and vaginal tears
  • If you are sexually active, you should discuss contraception with your health care provider