Urinary tract infection (UTI) is one of the commonest reasons for people to present to Out-Patients Departments (OPD) and General Practitioners (GPs). This is an infection at any level of the system that creates and transmits urine, from the kidneys down to the external opening. UTI affects people of all ages. It is therefore necessary to provide you dear Reader with this information about urinary tract infection.
Urinary tract infections are much more common in women and girls, compared to men and boys. The reason for this will be explored. And a special paragraph will be dedicated to the less common male urinary tract infection.
Overall, these are the issues to be covered in this article:
- what causes urinary tract infection?
- symptoms of urinary tract infection
- signs of urinary tract infection
- treatment of urinary tract infection
- urinary tract infections in men
- prevention of urinary tract infections
WHAT CAUSES URINARY TRACT INFECTIONS?
The causes of urinary tract infection are mostly bacterial, especially being pus forming bacteria. However, other microorganisms such as fungi and mycobacterium (TB) can also play a role.
All-in-all, the commonest cause of UTIs are the bacteria that live in the gut. And worldwide, the commonest of these UTI-causing bacteria is the one named Escherichia coli (E. coli). To Health professionals, a UTI is due to Gram-negative gut bacteria, especially E. coli, until proved otherwise.
The reason for urinary tract infection in women to be more common than in women, is human anatomy. The tube that carries urine from the bladder to the outside, is called the urethra. It is the difference in the length of the urethra between men and women, that accounts for the difference in incidence of UTIs.
In males, the urethra extends from the bladder, through the penis to the exterior. The external opening of the urethra is therefore far from the external opening of the gut (anus). Gut bacteria, if they should ever venture into the urinary tract, have to travel a long distance indeed.
In women, the external opening of the urethra is close to the external opening of the gut. Gut bacteria therefore have a short distance to travel to cause a urinary tract infection. Consequently UTI is easier and much more frequent in females than in males.
TYPES OF URINARY TRACT INFECTION
Urinary tract infections are divided into categories based on:
There are Lower and Upper UTIs. The lower UTIs involve the bladder to the exterior and include cystitis. Upper UTIs involve the kidneys and connected tubings, and include pyelonephritis.
There are either acute or chronic urinary tract infections.
SYMPTOMS OF URINARY TRACT INFECTION
Your healthcare professional will suspect UTI when you have the any combination of following symptoms:
- burning sensation when peeing (dysuria)
- smelly urine
- cloudy or murky urine
- loin pain
- nausea ± vomiting
Loin pain, as well as nausea and vomiting, point towards an Upper UTI.
SIGNS OF URINARY TRACT INFECTION
These will be elicited by your healthcare professional.
On examination, the professional will look for:
- tenderness in the area of your bladder
- loin tenderness
“Bedside” tests on the urine include a “Urine Dipsticks” and Urine Microscopy. These are quick, easy and affordable tests that will confirm or exclude a clinical diagnosis of UTI.
It needs to be mentioned that occasionally, people are found to have urine abnormalities, when they have no symptoms. This situation is technically called “asymptomatic bacteriuria”. It is not treated, except in pregnant women.
TREATMENT OF URINARY TRACT INFECTION
Your healthcare professional will choose treatment based on a number of factors, and following the guidelines of the country in question.
- how seriously ill is the patient? How high is the temperature?
- is the patient high risk (e.g. pregnant, elderly, diabetic)
- is it a lower or upper UTI?
- is there vomiting (which will prevent oral medication)?
An untreated urinary tract infection, as well as a partially treated one, is dangerous for the patient. It can get out of hand anytime, without warning.
URINARY TRACT INFECTIONS IN MEN
Because UTIs are so unusual in males, any confirmed UTI in this gender group should lead to the suspicion of an underlying abnormality.
The abnormality can be mechanical, impeding the flow of urine and encouraging the proliferation of pathogenic organisms. A mechanical abnormality can usually be detected by radiological investigations.
The abnormality can also be one that impairs the immune system. Examples include diabetes mellitus and Human Immunodeficiency Virus (HIV).
PREVENTION OF URINARY TRACT INFECTIONS
“Prevention is better than cure”, is the old adage. This is even truer for recurrent urinary tract infections. Recurrent UTIs can cause long-term complications. They can scar the kidneys and other parts of the urinary tract.
Scarred kidneys become smaller and smaller. They gradually lose function. And eventually, when a certain critical amount of kidney tissue has been lost, kidney failure sets in.
Urinary tract infection (UTI) is a very important topic. UTIs are very common. There is a whole spectrum, from mild to severe UTIs.
And the organ system affected by UTIs, is one of the most sensitive critical systems.
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