What is a urinary tract infection?

A Urinary Tract infection (UTI) is an infection caused by bacteria, fungi and in rare cases by viruses. So, UTI is one of the most common human infections. It can occur anywhere in the urinary tract, including the kidneys, ureters, bladder, and urethra.

Most urinary tract infections involve the bladder and urethra, but can also involve the kidneys and ureters. The kidneys and ureters make up the upper urinary tract while the bladder and urethra make up the lower tract.

It is important to note that lower tract Utis are more common and less severe than the upper tract UTIs. Conversely, upper tract UTIs are usually rarer and more severe when they occur. UTI is a common gynecological problem.

Symptoms of UTI

UTI symptoms depend on the infected part of the urinary tract. For example, lower tract UTIs occur in your urethra and bladder.

Lower tract UTI symptoms include:

• Frequent urination
• Urine that looks like tea or cola
• Urine with a strong odor
• Rectal pain in men
• Pelvic pain in women
• Poor urinary stream
• Passage of cloudy urine
• Painful urination
• Urgency of urination
• Passage of bloody urine

On the other hand, upper tract UTIs affect the kidneys, causing a potentially life-threatening condition known as urosepsis, if the bacteria move into the blood from the infected kidney. Urosepsis may cause low blood pressure, shock, and death.

Upper tract UTI symptoms include:

• Fever
• Nausea
• Vomiting
• Chills
• Upper back pain and tenderness

What are the symptoms of UTI in men?

The symptoms of an upper tract infection in men are similar to those in women. For the lower tract infection, the symptoms include rectal pain and the other shared symptoms.

What are the symptoms of UTI in women?

Lower urinary tract infection in women causes pelvic pain and other common symptoms. Upper tract infection symptoms are similar for men and women.

How is UTI treated?

Your doctor treats the causes of UTIs. They will do some tests to determine the causative organism and confirm the diagnosis.

Bacteria are the commonest causes of UTIs, hence the use of antibiotics to treat UTIs in most cases. However, in some cases, fungi and viruses cause UTIs. Your doctor may use antivirals such as cidofovir to treat viral UTIs, and antifungals for fungal UTIs. 

Which antibiotics can be used for a UTI?

Treatment with antibiotics depends on the affected urinary tract. For example, lower tract UTIs respond to oral antibiotics while upper tract UTIs require the use of intravenous antibiotics.

It is important to note that resistance to antibiotics may occur. So, urine culture helps select antibiotics that work best against the causative bacteria.

Further, a treatment option may be the use of cell chemistry (rather than antibiotics) to alter the interaction between the bacteria and the body. However, treatments other than antibiotics are still being examined.

What are the home remedies for a UTI?

First of all, you can do certain things to help your drugs work better. However, there are no home remedies to cure a UTI. A chemical in cranberries helps prevent UTI bacteria from attaching to the bladder lining. So cranberries or cranberry juice do not cure UTI after it has occurred. They only help to prevent future UTIs. These home remedies may help clear UTIs.

What happens to untreated UTIs?

The earlier you treat a UTI, the better because untreated UTIs become more severe the further they spread. Lower UTI is easier to treat while a UTI that spreads to the upper urinary tract is difficult to treat. Also, upper UTI may spread into the blood causing life-threatening sepsis.

So, if you suspect you have a UTI, speak with your doctor. Your doctor will examine you, and ask you to do a urine or blood test to confirm the diagnosis.

How is the urinary tract infection diagnosed?

To begin with, speak to your doctor if you suspect you have a UTI. Your doctor will ask about your symptoms and examine you. In addition, they will test your urine for microbes to confirm a diagnosis of UTI.

Give your doctor a clean catch urine sample, collected in the middle of your urinary stream. This helps prevent sample contamination by bacteria or yeast from your skin.

Your doctor looks for high white blood cell count in your urine. This indicates an ongoing infective process. Also, your doctor will do a urine culture to check for causative bacteria or fungi and the treatment that is right for you.

If your doctor suspects a viral UTI, special tests may be done. Though very rare, viral UTIs occur in people who have had organ transplants or those with immunosuppression.

Diagnosis of upper tract UTIs

If your doctor suspects you have an upper tract UTI, they may ask you to do a complete blood count, urine test, and blood culture to rule out the spread of infection to the bloodstream.

Diagnosis of recurrent UTIs

If you experience recurrent UTIs, your doctor may want to check if you have urinary tract obstructions or abnormalities. They may ask you to do the following tests:

• An ultrasound
• A cystoscopy
• A CT scan
• An intravenous pyelogram

What are the causes and risk factors of a urinary tract infection?

Reduction in bladder emptying and urinary tract irritation may predispose to UTIs. Factors that can increase your risk of contracting a UTI include:

• Old age
• Prolonged bed rest
• Decreased mobility after surgery
• A previous UTI
• Enlarged prostate
• Kidney stones
• Prolonged urinary catheter use, making it easier for bacteria to enter your bladder
• Poorly controlled diabetes mellitus
• Immunosuppression
• Pregnancy
• Congenital abnormality of urinary structures

Other risk factors of a UTI for men

It is important to note that most risk factors of a UTI are the same for men and women. Additionally, for men, the enlarged prostate gland is a unique risk factor.

Other risk factors of a UTI for women

The shorter urethra in women

Women have a shorter urethra than men. The length and location of the female urethra increase UTI risk. The female urethra is close to the vagina and anus.

Normal vaginal and anal flora may lead to an infection of the urethra and bladder. The bacteria travel a short distance from the urethra to the bladder and the rest of the urinary tract.

Sexual intercourse

After sexual intercourse, most women have bacteria in their urine. During sexual intercourse, the pressure on the female urinary tract facilitates the movement of bacteria from around the anus to the bladder. However, your body is likely to remove the bacteria within 24 hours.

Spermicides

Women who use spermicides may have skin irritation, increasing the risk of bacteria getting into the bladder. So, spermicides increase the risk of a UTI.

Use of condom during sexual intercourse

Latex condoms that are non-lubricated may cause friction and skin irritation in women during sexual intercourse. This increases your risk of getting a UTI.

However, the appropriate use of condoms helps reduce the spread of sexually transmitted infections. You can prevent friction and skin irritation from condoms by using enough lubricant during sex.

Diaphragms

Diaphragms may increase pressure on the female urethra, decreasing bladder emptying as a result. This may increase the risk of a UTI.

Decreased estrogen levels

Your normal vaginal bacteria may change following a decrease in your estrogen levels after menopause. This may increase the risk of a UTI.

Finally, some additional UTI risk factors for women may not be as important as previously believed. For example, poor bathroom hygiene as a risk factor for a UTI is subject to debate. Also, the risk of wiping from back to front after going to the bathroom was disproved in some studies.

How can urinary tract infection be prevented?

You can prevent UTIs by following these steps:

• Do not hold urine for too long when pressed
• Drink six to eight glasses of water daily
• Speak with your doctor if you find it difficult to empty your bladder fully
• Talk to your doctor if you have urinary incontinence

UTIs are more common in women than men with a ratio of 8:1. So, only one man has a UTI for every eight women with UTIs.

Women can take certain steps to help prevent UTIs. For example, postmenopausal women can use topical estrogen prescribed by the doctor to prevent UTIs.

Your doctor may recommend you take antibiotics after intercourse if they think sex is a factor in your recurrent UTIs. Similarly, they may recommend long-term use of antibiotics. Research shows that long-term use of preventive antibiotics by older adults reduces UTI risk.

Further, daily intake of cranberry supplements or the use of vaginal probiotics (e.g. lactobacillus) may help prevent UTIs. Studies show that probiotic vaginal suppositories alter vaginal bacteria and reduce the risk of UTIs.

Talk to your doctor to help you plan your prevention measures.

What is a chronic urinary tract infection?

Chronic UTIs are UTIs that fail to go away after treatment. Similarly, they can be defined as recurrent UTIs. Women have more recurrent UTIs than men. However, most UTIs resolve after treatment.

Many recurrent UTIs occur as a result of reinfection with the same type of bacteria. However, some recurrent cases may be due to structural abnormality in the urinary tract.

What to do with UTIs in pregnancy

UTIs in pregnancy can elevate your blood pressure and cause premature delivery. In addition, they are more likely to spread to the kidneys. During pregnancy, it is important to see your doctor immediately if you have symptoms of a UTI.

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