Urinary
Tract Infections:The urinary
tract consists of the kidneys, ureters (which connect
the kidneys and the bladder), bladder, and urethra. Urinary tract
infections (UTIs) can occur in any part of the urinary tract. Most UTIs
are caused by bacteria. They can also be caused by fungi or viruses.
UTIs are the second most common type
of infection in humans. The National Kidney & Urologic
Diseases Information Clearinghouse (NKUDIC) reports that UTIs account for
over eight million doctor visits annually.
Causes, incidence, and
risk factors:
Urinary tract infections are caused
by germs, usually bacteria that enter the urethra and then the bladder. This
can lead to infection, most commonly in the bladder itself, which can spread to
the kidneys.
Most of the time, your body can get
rid of these bacteria. However, certain conditions increase the risk of having
UTIs.
Women tend to get them more often
because their urethra is shorter and closer to the anus than in men. Because of
this, women are more likely to get an infection after sexual activity or when
using a diaphragm for birth control. Menopause also increases the risk of a
UTI.
The following also increase your
chances of developing a UTI:
- Diabetes
- Advanced age
(especially people with illnesses common in older
adults, such as Alzheimer's
disease and delirium)
- Problems emptying
your bladder completely (urinary retention)
- A tube called a urinary
catheter inserted into your urinary tract
- Bowel
incontinence
- Enlarged
prostate, narrowed
urethra, or anything that blocks the flow of urine
- Kidney stones
- Staying still
(immobile) for a long period of time (for example, while you are
recovering from a hip fracture)
- Pregnancy
- Surgery or other procedure involving the urinary tract
Symptoms
of UTI:
Symptoms
of UTI depend upon what part of the urinary tract is infected.
Lower UTIs are infections of the
urethra and bladder. Their symptoms include:
- burning with
urination
- increased
frequency of urination with scant amounts of urine being passed
- bloody urine
- cloudy urine
- urine that looks
like cola or tea
- strong odor to
urine
- pelvic pain
(women)
- rectal pain (men)
- pain and
tenderness in the upper back
and sides
- chills
- fever
- nausea
- vomiting
Women who are pregnant and have
symptoms of UTI should see their doctor right away. UTIs during pregnancy can
cause premature delivery and high blood pressure. UTIs during pregnancy are
also more likely to spread to the kidneys.
Signs and tests:
A urine sample is usually collected
to perform the following tests:
- Urinalysis
is done to look for white blood cells, red blood cells, bacteria, and to
test for certain chemicals, such as nitrites in the urine. Most of the
time, your doctor or nurse can diagnose an infection using a urinalysis.
- Urine
culture - clean catch may be done to identify the bacteria in the
urine to make sure the correct antibiotic is being used for treatment.
CBC and
a blood
culture may be done.
The following tests may be done to
help rule out problems in your urinary system that might lead to infection or
make a UTI harder to treat:
- CT
scan of the abdomen
- Intravenous
pyelogram (IVP)
- Kidney
scan
- Kidney ultrasound
- Voiding cystourethrogram
Diagnosis of UTI:
- ultrasound
- intravenous
pyelogram (IVP) – this injected dye allows doctors to see your entire
urinary tract
- cystoscopy, which
uses a small camera to examine the bladder
During a cystoscopy, your doctor may
remove a small piece of bladder tissue.
This is called a biopsy. A biopsy can be used to rule out bladder cancer
Treatment
of UTI: Antibiotics are used to treat UTIs. Lower UTIs can be treated with oral
antibiotics. Upper UTIs require intravenous antibiotics.
Sometimes, bacteria develop resistance to
antibiotics. Urine cultures can help your doctor select an effective antibiotic
treatment.
Expectations
(prognosis): A urinary tract
infection is uncomfortable, but treatment is usually successful. Symptoms of a
bladder infection usually disappear within 24 - 48 hours after treatment
begins. If you have a kidney infection, it may take 1 week or longer for your
symptoms to go away.
Complications:
- Life-threatening
blood infection (sepsis)
- risk is greater among the young, very old adults, and those whose bodies
cannot fight infections (for example, due to HIV or cancer chemotherapy)
- Kidney damage or
scarring
- Kidney infection
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