What is a urinary tract infection?
A urinary tract infection (UTI) is an infection of the urinary tract that is caused by microorganisms that include bacteria (predominantly), fungi, and even viruses.
What are upper and lower urinary tract infections?
Based on the organs involved, UTIs can be:
- Upper UTIs: In this, there may be infection of the kidneys and their collecting duct systems
- Lower UTIs: In this, there may be infection of the bladder, urethra, and prostate
How are urinary tract infections caused?
They are majorly caused by bacteria that typically reside in our gut (E. coli is most commonly involved). Less commonly, fungi and viruses (in the case of immunocompromised patients) may also be responsible.
Most commonly, the bacteria found in our faeces usually ascends upward from the urethra into the bladder and multiplies, leading to infection.
In special cases, such as immunocompromised patients, some other source of infection, for example, endocarditis, can spread through the blood and infect the kidneys and lead to complications.
Who’s at an increased risk of getting urinary tract infections?
You’re at a higher risk if:
- You’re a woman
- You are postmenopausal
- You have high blood sugar
- You have a catheter, ureteric stent, or nephrostomy tube
- You’re suffering from kidney, ureteric, or bladder stones
- You have some kind of anatomical anomaly, such as vesicoureteric reflux, bladder fistula, uterine prolapse, etc.
- You have a neurological problem like spina bifida, multiple sclerosis, or diabetic neuropathy
- You’re suffering from a prostate problem (such as enlarged prostate (BPH) or prostate cancer) or a ureteral stricture
Why are women more prone to UTIs?
Women are more susceptible since:
- They have a shorter urethra compared to men, making it easier for the bacteria to ascend and lead to infections
- They do not have a prostate (the fluid secreted by the prostate has antibacterial properties)
- They undergo more hormonal changes, which influence how the bacteria adhere to the urinary tract lining
- They are more prone to urethral trauma during sex, which makes it easier for bacteria to get into the bladder from the surrounding region
- The urethra is located closer to the anal region in women, which makes it easy for bacteria to travel to the vagina and cause infections
What are the symptoms of a urinary tract infection?
You may experience:
- Abnormal increase in the frequency and urgency of passing urine
- Pain sensation while passing urine
- Intense desire to pass urine even though the bladder has already been emptied
- Cloudy or reddish urine with a bad odour
- Fever with chills (shivering)
- Vomiting
- Pain and tenderness in the lower abdomen
- Rarely, mental confusion in the case of elderly patients
How is a urinary tract infection diagnosed?
Your doctor will take a detailed history of your symptoms and advise you to get the following tests:
- Urinalysis is the main method of detecting a UTI. It includes dipstick tests, urine culture and sensitivity, and microscopic examination
- Special investigations that can indicate some underlying cause of the infection include:
- Per rectal prostate exam in case of an enlarged prostate or cancer
- Pelvic examination in women with recurrent episodes to detect uterine prolapse, cystocele, etc.
- Cystoscopy, to visualise the bladder and detect any kind of inflammation
- Intravenous pyelography (IVU) for the detection of any anatomical anomalies in the urinary tract
- Micturating cystourethrogram to identify vesicoureteric reflux (VUR)
How is a urinary tract infection treated?
Antibiotics are the mainstay of treatment. Your doctor will prescribe your antibiotic based on the results of your urine culture and sensitivity. In the case of uncomplicated infections, treatment usually lasts for 3-5 days, while complicated infections require a longer dose (7-10 days).
What are the complications of urinary tract infections?
Untreated, recurrent infections can lead to:
- Permanent kidney damage
- Sepsis, a serious, life-threatening condition involving the entire body
How can I prevent urinary tract infections?
Some preventive measures that can reduce your risk (especially for women) include:
- Consuming no less than 2 litres of water each day
- Regularly emptying your bladder completely
- Emptying your bladder before and after sex
- Having good personal hygiene
- Taking cranberry juice or tablets may be beneficial
Can a urinary tract infection go away on its own?
How long does a urinary tract infection last?
After starting treatment, it usually takes about 3-5 days for an uncomplicated infection to subside.
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