Urinary tract infections (UTIs)

Dr. G. Sarath Babu, MD, (JIPMER) DM, (PGI, Chandigarh), Consultant Nephrologist and<br />
Transplant Physician, Vijaya Super Speciality Hospital, Vijayawada

Published: Dec 7, 2022 04:49:14 PM IST
Updated: Dec 7, 2022 04:55:27 PM IST

Urinary tract infections (UTIs)The urinary tract is divided into two sections: lower and upper. The ureters (tubes that convey urine from the kidneys to the bladder) and kidneys make up the upper urinary tract (which filters the blood to produce urine). The urethra (the tube that transports urine from the bladder to the outside) and the bladder comprise the lower tract (which stores urine). Bacteria entering the urinary tract through the urethra and spreading to the bladder primarily cause UTIs. The urinary system is intended to keep germs out. However, the defenses do occasionally fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract.

UTIs are a prevalent health issue that affects millions of individuals each year. These infections can occur anywhere in the urinary system. Women are more likely than males to have a UTI. An infection that is restricted to the bladder can be uncomfortable and irritating. However, if a UTI spreads to the kidneys, it can cause major health concerns.

Factors that Contribute to UTIs are:

  • Sexual intercourse: During sex, bacteria near the vagina can get into the urethra from contact with the penis, fingers, or sex toys.
  • Using spermicide or a diaphragm for birth control might potentially lead to more UTIs.
  • Frequently holding urine or/avoiding urination
  • A stone in the ureters, kidneys, or bladder that blocks the flow of urine through the urinary tract.
  • A narrowed tube in the urinary tract that slows the flow of urine.

Types of UTIs

  • If the infection stays just in the bladder, it is called a bladder infection, or "simple cystitis."
  • If the infection travels up past the bladder and into the kidneys, it is called a kidney infection, or "pyelonephritis." Bladder and kidney infections are both types of UTIs.

Symptoms of UTIs

  • Burning or pain during urination
  • Frequent urination
  • A feeling of urgency every time you have to urinate, but not always being able to pee
  • Feeling like bladder still isn’t empty, even directly after urination
  • Blood in urine
  • Fever
  • Nausea or vomiting
  • Pain in the back or side, below the ribs
  • Tiredness
  • Women may feel an uncomfortable pressure above the pubic bone

Diagnosis of UTIs
A UTI is frequently diagnosed based on symptoms such as discomfort with urination or frequent urine. If a urine test is positive for infection, it will reveal bacteria, white blood cells, red blood cells, and/or nitrites. To avoid contamination, a urine sample is obtained using the clean catch method. When urine is cultured in a laboratory, the bacteria may be identified, and the test can determine which medications will be helpful in treating the infection.

If UTIs become a repeated problem, other tests may be used to see if the urinary tract is normal. These tests may include:
Intravenous pyelogram (IVP): This procedure involves injecting a contrast dye into a vein. This is useful for detecting malignancies, structural problems, kidney stones, and obstructions. It also examines the blood flow in the kidneys.

Cystoscopy: This test involves inserting a thin, flexible tube with a viewing device into the urethra to examine the bladder and other sections of the urinary tract. There may be structural alterations or obstructions, such as tumors or stones.

Kidney and bladder ultrasound: This test is used to detect the size and form of the bladder and kidneys, as well as to look for a tumor, kidney stone(s), cysts, or other obstructions or abnormalities.

Prevention of UTIs

  • Large doses of vitamin C restrict the development of certain bacteria by acidifying the urine.
  • Urinate whenever you feel the need. Do not wait.
  • After each bowel movement, clean the perineum and urethral meatus from front to back to reduce concentrations of pathogens at the urethral opening.
  • Shower instead of bathing in a tub because germs in bath water might enter the urethra.
  • Before and after intercourse, clean the vaginal region and urinate immediately.
  • Women should not use feminine hygiene sprays or scented douches
  • During the day, void at least every 2 to 3 hours and totally empty the bladder.
  • Cotton underwear and loose-fitting clothing assist to keep the urethra dry. Tight clothing and nylon underwear keep moisture trapped. This can aid in the growth of germs.
  • Small dosages of frequent antibiotics can be used to treat repeated instances of urinary tract infection.
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