Urinary Tract Infection – UTI
A urinary tract infection (UTI) is an infection from microbes. These are organisms that are too small to be seen without a microscope. Most UTIs are caused by bacteria, but some are caused by fungi and in rare cases by viruses. UTIs are among the most common infections in humans.
A UTI can happen anywhere in your urinary tract. Your urinary tract is made up of your kidneys, ureters, bladder, and urethra. Most UTIs only involve the urethra and bladder, in the lower tract. However, UTIs can involve the ureters and kidneys, in the upper tract. Although upper tract UTIs are more rare than lower tract UTIs, they’re also usually more severe.
Symptoms of a UTI depend on what part of the urinary tract is infected.
Lower tract UTIs affect the urethra and bladder. Symptoms of a lower tract UTI include:
- burning with urination
- increased frequency of urination without passing much urine
- increased urgency of urination
- bloody urine
- cloudy urine
- urine that looks like cola or tea
- urine that has a strong odor
- pelvic pain in women
- rectal pain in men
Upper tract UTIs affects the kidneys. These can be potentially life threatening if bacteria move from the infected kidney into the blood. This condition, called urosepsis, can cause dangerously low blood pressure, shock, and death.
Symptoms of an upper tract UTI include:
- pain and tenderness in the upper back and sides
Treatment of UTIs depends on the cause. Your doctor will be able to determine which organism is causing the infection from the test results used to confirm the diagnosis.
In most cases, the cause is bacteria. UTIs caused by bacteria are treated with antibiotics.
In some cases, viruses or fungi are the causes. Viral UTIs are treated with medications called antivirals. Often, the antiviral cidofovir is the choice to treat viral UTIs. Fungal UTIs are treated with medications called antifungals.
UTI Test & UTI diagnosis
If you suspect that you have a UTI based on your symptoms, contact your doctor. Your doctor will review your symptoms and perform a physical examination. To confirm a diagnosis of a UTI, your doctor will need to test your urine for microbes.
The urine sample that you give your doctor needs to be a “clean catch” sample. This means the urine sample is collected at the middle of your urinary stream, rather than at the beginning. This helps to avoid collecting the bacteria or yeast from your skin, which can contaminate the sample.
When testing the sample, your laboratory will look for a large number of white blood cells in your urine. This can indicate an infection. Your doctor will also ask you to do a urine culture to test for bacteria or fungi. The culture can help identify the cause of the infection. It can also help your doctor choose which treatment is right for you.
If a virus is suspected, special testing may need to be performed. Viruses are rare causes of UTIs but can be seen in people who have had organ transplants or who have other conditions that weaken their immune system.
Upper tract UTIs
If your doctor suspects that you have an upper tract UTI, they may also need to do a complete blood count (CBC) and blood cultures, in addition to the urine test. A blood culture can make certain that your infection hasn’t spread to your bloodstream.
If you have recurrent UTIs, your doctor may also want to check for any abnormalities or obstructions in your urinary tract. Some tests for this include:
- An ultrasound, in which a device called a transducer is passed over your abdomen. The transducer uses ultrasound waves to create an image of your urinary tract organs that are displayed on a monitor.
- An intravenous pyelogram (IVP), which involves injecting a dye into your body that travels through your urinary tract and taking an X-ray of your abdomen. The dye highlights your urinary tract on the X-ray image.
- A cystoscopy, which uses a small camera that’s inserted through your urethra and up into your bladder to see inside your bladder. During a cystoscopy, your doctor may remove a small piece of bladder tissue and test it to rule out bladder inflammation or cancer as a cause of your symptoms.
- A computerized tomography (CT) scan to get more detailed images of your urinary system.
Learn About: Urine Microalbumin Test
Causes and risk factors of a UTI
Anything that reduces your bladder emptying or irritates the urinary tract can lead to UTIs. There are also many factors that can put you at an increased risk of getting a UTI. These factors include:
- age — older adults are more likely to get UTIs
- reduced mobility after surgery or prolonged bed rest
- kidney stones
- a previous UTI
- urinary tract obstructions or blockages, such as an enlarged prostate, kidney stones, and certain forms of cancer
- prolonged use of urinary catheters, which may make it easier for bacteria to get into your bladder
- diabetes, especially if poorly controlled, which may make it more likely for you to get a UTI
- abnormally developed urinary structures from birth
- a weakened immune system
In some cases, certain lifestyle changes may help lessen the risk of some of these factors.
- Shorter urethra
The length and location of the urethra in women increase the likelihood of UTIs. The urethra in women is very close to both the vagina and the anus. Bacteria that may naturally occur around both the vagina and anus can lead to infection in the urethra and the rest of the urinary tract.
A woman’s urethra is also shorter than a man’s, and the bacteria have a shorter distance to travel to enter the bladder.
- Sexual intercourse
Pressure on the female urinary tract during sexual intercourse can move bacteria from around the anus into the bladder. Most women have bacteria in their urine after intercourse. However, the body can usually get rid of these bacteria within 24 hours. Bowel bacteria may have properties that allow them to stick to the bladder.
Spermicides may increase UTI risk. They can cause skin irritation in some women. This increases the risk of bacteria entering the bladder.
- Condom use during sex
Non-lubricated latex condoms may increase friction and irritate the skin of women during sexual intercourse. This may increase the risk of a UTI.
However, condoms are important for reducing the spread of sexually transmitted infections. To help prevent friction and skin irritation from condoms, be sure to use enough water-based lubricant, and use it often during intercourse.
Diaphragms may put pressure on a woman’s urethra. This can decrease bladder emptying.
- A decrease in estrogen levels
After menopause, a decrease in your estrogen level changes the normal bacteria in your vagina. This can increase the risk of a UTI
Everyone can take the following steps to help prevent UTIs:
- Drink six to eight glasses of water daily.
- Don’t hold urine for long periods of time.
- Don’t urinate in public unclean toilets
- Talk to your doctor about managing any urinary incontinence or difficulties fully emptying your bladder.
However, UTIs happen much more frequently in women than in men. The ratio is 8:1. This means that for every eight women who have UTIs, only one man does.
Certain steps may help prevent UTIs in women. For postmenopausal women, using topical estrogen prescribed by your doctor could make a difference in preventing UTIs. If your doctor believes that intercourse is a factor of your recurrent UTIs, they may recommend taking preventive antibiotics after intercourse, or long-term. Some studies have shown that long-term preventive use of antibiotics in older adults reduced the risk of UTIs. Taking daily cranberry supplements or using vaginal probiotics, like lactobacillus, may also help in the prevention of UTIs.
Be sure to discuss with your doctor what the right prevention plan is for you.
UTIs during pregnancy
Women who are pregnant and have symptoms of a UTI should see their doctor right away. UTIs during pregnancy can cause high blood pressure and premature delivery. UTIs during pregnancy are also more likely to spread to the kidneys.
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