Urinary Tract Infection (UTI)

What is a Urinary Tract Infection?

A urinary tract infection (UTI) occurs when foreign microorganisms, frequently from the bowel or vagina, invade the urinary tract; this can cause tissue damage.  A bladder infection is called "cystitis" and a kidney infection is termed "pyelonephritis".

Although both men and women can experience UTIs, this condition occurs more frequently among women because of the relatively short tube from the bladder to the urethral opening (where urine comes out of the body).  This opening is in close proximity to the vagina and rectum.  Sexually active women may experience a marked increase in UTIs.  This is often caused by the transfer of bacteria during intercourse from the vaginal or bowel area into the urethral opening and then to the bladder.  In men, the urethral tube is longer and its opening is further removed from the rectum, thus resulting in a lower frequency of UTIs.

Symptoms:

UTI symptoms generally develop quickly.  The symptoms may include; but are not limited to:

1. Frequent urination
2. Burning sensation on urination
3. A sensation of incomplete emptying after urination
4. Pain often referred to as back pain
5. Blood in the urine
6. Lower abdominal discomfort
7. Nocturia or urinating at night

Diagnosis:

The diagnosis is usually based on a microscopic examination of the urine (urinalysis).  In addition, a urine sample may be incubated and examined for identification of the causative microorganisms and their sensitivity to various antibiotics.  This is called a culture and sensitivity and usually takes three days.

There is a charge for the urinalysis, and an additional charge if a culture and sensitivity are deemed necessary by your health care provider.

Treatment:

Treatment for bacterial UTIs is usually with antibiotics that are taken for a period of one to ten days.  An additional medication, Pyridium, may be given for pain relief.  Pyridium will color the urine an orange-red.  This discoloration is not a cause for alarm.  However, you may wish to wear pantyliners during this time if staining of undergarments is a concern.  The urine will return to its normal color once the drug is eliminated from the body.  It is occasionally necessary to re-examine the urine at the end of treatment to assure complete cure.

Preventive Measures:

1. Drink plenty of fluids each day.  A healthy adult, at rest and when not sweating, needs seven or more large glasses of water daily.  Hot weather and/or increased perspiration necessitates even more intake.
2. Urinate frequently.  Drinking the recommended amount of fluids will increase urination.  A person who urinates only two to four times a day may be prone to recurrent urinary tract infections.  Voiding every two to three hours is recommended to decrease the bladder's susceptibility to infection.

For Women:

1. Urinate before and after intercourse - pre and post-coital flush.  Women experiencing frequent infections following intercourse are encouraged to empty the bladder shortly before and after intercourse.  In addition, drinking several glasses of water each day also serves to flush the bladder of bacteria.
2. Wipe front to back after urinating or a bowel movement.  To prevent bacterial contamination of the vaginal area from the anal area, wipe with toilet paper from front to back after urinating or defecating.  Cleansing the vaginal and rectal area with soap and water also decreases the potential for bacterial transfer.  Washing the area following each use of the toilet is helpful, especially for women with recurrent infections.  You may find Tucks Wipes or a squirt bottle filled with warm H2O helpful for cleansing between showers and baths.
3. Limit frequency of intercourse.  In women, frequent intercourse in a short period of time may traumatize both bladder and urethra.  Thus, having intercourse only once in a 24-hour period is often advised for women who experience multiple or recurrent UTIs.  The use of Macrodantin or a sulfa antibiotic at night or prior to intercourse may be prescribed for women with many recurrences.

Need for Further Studies:

X-rays of the kidneys, ureters, and bladder, as well as cystoscopy (viewing the bladder through a tubular instrument) may be recommended to rule out abnormalities of function or structure in the urinary tract.  Women may need a gynecological examination to rule out vaginal infections or pelvic disorders that may contribute to urinary tract infections.  Since vaginal infections may present symptoms suggestive of urinary tract infections, a gynecological examination should be done if there is no response to treatment in 48 hours.