Questions and Answers
What is a urinary tract infection?
A UTI is a bacterial infection of the urinary tract occurring when micro-organisms, usually bacteria from the digestive tract, penetrate the urinary tract through the opening of the urethra and begin to multiply. Most infections arise from one type of bacteria, Escherichia coli (E.coli), normally living in the colon.
The urinary tract consists of the kidneys, the ureter, the bladder and the urethra. Each part of the urinary tract can be affected. In case a UTI is left untreated, a permanent damage can occure to the bladder and kidneys.
How does UTI occur?
A urinary tract infection is the consequence of spreading and reproduction of bacteria leading to:
- Cystitis (inflammation of the bladder)
- Pyelonephritis (kidney infection)
- Urethritis (inflammation of the urethra,the tube that drains the urine from the bladder)
Normally no bacteria or organism of any kind are located in the urine. Bacteria causing UTI often spread from the rectum or vagina to the urethra and than to the bladder and kidneys.
The urethra being shorter, women are more often affected by UTIs as the spreading of bacteria is favoured. In addition, the exit point of the urethra is closer to the anus.
Who has a high risk for a UTI?
Some individuals are more at risk of getting a UTI than others. The following groups of people are likely to suffer a UTI:
Sexually active women
Infections frequently occur after sexual intercourse because bacteria can spread upwards into the bladder. Moreover, the use of contraceptives such as diaphragms and spermicides can alter the bacterial environment of the urethra.
Pregnant women
During pregnancy physiological changes, both hormonal and mechanical, predispose to bacterial infection. If left untreated, this can lead to pyelonephritis (kidney infection) in up to 40%of the cases.
In case of pregnancy, a screening for asymptomatic bacteriuria is therefore indicated.
Women with frequent recurrent infections
Even among healthy women frequent UTIs (occurring at least tree times a year or twice within 6 month) have been observed.
Postmenopausal women
Elderly women encounter increasing difficulties in emptying their bladder completely. The remaining urine contains occasional bacteria which can lead to an infection. Often, however, the real cause for UTI remains unknown.
Women with obstructions
An obstruction of the urinary tract decelerates the outflow of the urine into the bladder and therefore can abet to an infection.
Women who are diabetic
Diabetes or disorders of the immune system considerably increase the risk of a UTI.
Women with catheters
Catheters and tubes placed in the bladder are a common source of infection.
Patients with indwelling catheters are at particular risk for developing a UTI. People unable to urinate or who are unconscious or critically ill often need a catheter for a long time. Especially elderly people or those with nervous system disorders lacking bladder control may even need a catheter for the rest of their life. Bacteria developing in the catheter may infect the bladder.
What are the symptoms of a UTI?
- Frequent need to urinate
- Uncontrollable urge to urinate
- Leaking of urine (incontinence)
- Pain or discomfort (burning) when urinating
- Strong smelling urine
- Change in the amount of urine, either more or less as normal
- Pain in the lower pelvis, stomach, lower back or side
- Shaking chills, fever, sweats
- Pain during sexual intercourse
How is UTI diagnosed?
After a close examination of the symptoms, your medical doctor will proceed to a urine test, an analysis based on detecting the presence of Nitrite and Leukocytes (white blood cells) and several other parameters.
How is UTI treated?
UTI is caused by bacteria and often requires antibiotic treatment. It is essential that antibiotics are taken over the indicated period even if the symptoms disappear.
Usually the symptoms of the infection disappear within 3 or 4 days.