Urinary Tract
Infections (UTIs)
What parts of the urinary tract are prone to
infection?
What are
the causes of urinary tract infections?
Who is at
risk for UTIs?
Do you develop more urinary tract infections during
pregnancy?
What are
some symptoms of urinary tract infection to watch out for?
How is a UTI
diagnosed?
Once you get a UTI, can you ever get rid of it
entirely?
Are
there steps I can take to avoid getting a urinary tract infection?
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What parts of the urinary tract are prone to infection?
The urinary tract is
composed of four parts -- the kidneys, the ureters (tubes connecting the
kidneys to the bladder), the bladder, and the urethra (the tube through
which the bladder empties). Most often, infections begin in the urethra
and move up the urinary tract to the kidneys.
What are the causes of urinary
tract infections?
Normal urine is
sterile. It contains fluids, salts, and waste products, but it is free of
bacteria, viruses, and fungi. A urinary tract infection (UTI) occurs when
microorganisms, usually bacteria from the digestive tract, cling to the
opening of the urethra and begin to multiply. Most infections arise from
one type of bacteria, Escherichia coli (E. coli), which normally live in
the colon. In most cases, bacteria first begin growing in the urethra and
often move on to the bladder, causing a bladder infection (cystitis). If
the infection is not treated promptly, bacteria may then go up the ureters
to infect the kidneys (pyelonephritis). Microorganisms called chlamydia
and mycoplasma may also cause UTIs in both women and men, but these
infections tend to remain limited to the urethra and reproductive system.
Unlike E. coli, chlamydia and mycoplasma may be sexually transmitted, and
infections require treatment of both partners.
Who is at risk for UTIs?
Some people are more
prone to getting a UTI than others. Any abnormality of the urinary tract
that obstructs the flow of urine (a kidney stone, for example) sets the
stage for an infection. A common source of infection is catheters, or
tubes placed in the bladder to aid in urination for people unconscious or
critically ill. Bacteria on the catheter can infect the bladder, so
hospital staff take special care to keep the catheter sterile and to
remove it as soon as possible. People with diabetes have a higher risk of
a UTI because of changes in the immune system. Any disorder that
suppresses the immune system raises the risk of a urinary infection. Women
may have more urinary infections than men because the woman’s urethra is
relatively short, allowing bacteria quicker access to the bladder.
Further, a woman’s
urethral opening is near sources of bacteria from the anus and vagina. One
in five women develops a UTI during her lifetime. For many women, sexual
intercourse seems to trigger an infection, although the reasons for this
linkage are unclear. According to several studies, women who use a
diaphragm are more likely to develop a UTI than women who use other forms
of birth control. In addition, women whose partners use condoms tend to
have growth of E. coli bacteria in the vagina, which may increase the risk
of a UTI. Further, in women, the rate of UTIs gradually increases with
age.
Do you
develop more urinary tract infections during pregnancy?
Pregnant women seem
no more prone to UTIs than other women. However, when a UTI does occur
during pregnancy, it is more likely to travel to the kidneys. About 2-4
percent of pregnant women develop a UTI. Hormonal changes and shifts in
the position of the urinary tract during pregnancy may make it easier for
bacteria to travel up the ureters to the kidneys. For this reason, many
doctors recommend periodic testing of urine. A pregnant woman who develops
a UTI should be treated promptly to avoid premature delivery and other UTI-related
risks such as high blood pressure.
What are some symptoms of
urinary tract infection to watch out for?
Not everyone with a
UTI has symptoms, but most people do. Symptoms may include a frequent urge
to urinate and a painful, burning feeling in the area of the bladder or
urethra during urination. It is not unusual to feel bad, tired, shaky,
washed-out, and to feel pain even when not urinating. Often, women feel an
uncomfortable pressure above the pubic bone, and some men experience a
fullness in the rectum. 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.
The urine itself may look milky or cloudy, even reddish if blood is
present. A fever may mean that the infection has reached the kidneys.
Other symptoms of a kidney infection include pain in the back or side
below the ribs, nausea, or vomiting.
How is a UTI diagnosed?
Your doctor will
test a urine sample for pus and bacteria. Although your doctor may begin
treatment before the bacterial cultures are back from the lab, the
cultures will confirm the diagnosis and may cause a change in the
antibiotic chosen. Occasionally when a treatment fails to clear up an
infection, the doctor may order a test that makes an image of the urinary
tract to identify whether there are structural changes contributing to the
infection or impeding treatment.
Once you get
a UTI, can you ever get rid of it entirely?
Many women suffer
from frequent UTIs. Nearly 20 percent of women who have a UTI will have
another, and 30 percent of those will have yet another. Of the last group,
80 percent will have recurrences. About four out of five women who have a
UTI get another in 18 months. Many women have them even more often. A
woman who has frequent recurrences (three or more in a year) should ask
her doctor about treatment options.
Are there steps I can
take to avoid getting a urinary tract infection?
Drink plenty of
water every day. Some doctors suggest drinking cranberry juice, which in
large amounts inhibits the growth of some bacteria by acidifying the
urine. Vitamin C (ascorbic acid) supplements have the same effect. Urinate
when you feel the need; don’t resist the urge to urinate. Wipe from front
to back to prevent bacteria from the anal area from entering the vagina or
urethra. Take showers instead of tub baths. Cleanse the genital area
before sexual intercourse. Avoid using feminine hygiene sprays and scented
douches, which may irritate the urethra.
from
The Office On Women's Health - US Department of Health and Human Services
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