Urinary Infections

Urinary Tract Infections

Your urinary tract produces and removes urine, and it comprises of your kidneys, ureters (the tubes that connect your kidneys and bladder), bladder and urethra (the tube that transports urine from your bladder out of the body). Urinary tract infections (UTI) usually occur when bacteria enter your urinary tract via your urethra, and although they are much more common in women, men can also develop UTIs. Women should always seeks medical advice the first time they get an infection of their urinary tract or if they have problems with recurrent infections, though men should always seek guidance with urinary tract infections, as they can have a more serious cause.

Signs of Urinary Tract Infections

Whether you have an infection in your lower urinary tract (your bladder or urethra) or your upper urinary tract (your kidneys or ureters) determines the symptoms you develop with urinary tract infections. The most common symptoms of lower UTIs you may experience are:

• Increased frequency and urgency of urination
• Pain on urination
• Cloudy urine with an unpleasant smell; you may also be able to see traces of blood
• Abdominal, pelvic or back pain
• Feeling unwell

However, with upper UTIs you can expect the following:

• Raised temperature and shivering
• Nausea and vomiting
• Diarrhoea
• Pain in your groin, back or side, which may worsen on urination

Causes of Urinary Tract Infections

In the majority of cases bacteria from your digestive system trigger urinary tract infections. Women are more susceptible to this due to the closeness of their urethra and anus, and that the urethra is much shorter in women, so bacteria can easily reach their bladder. Women who are sexually active are also more prone to UTIs, particularly if they use a diaphragm or spermicide for contraception. However, both men and women are at greater risk of these infections if any of the following apply:

• You have an obstruction in the urinary tract, as may occur with kidney stones.
• You are unable to fully empty your bladder, which is a consequence of various neurological conditions, an enlarged prostate, bladder stones, constipation and taking certain medications.
• Your immune system is compromised, which may result from illness such as diabetes, or following chemotherapy, organ transplantation or if you have HIV.
• You use a catheter to drain urine from your bladder.
• You are not drinking enough fluids to stay well hydrated

Diagnosis of Urinary Tract Infections

It is always important to ensure that urinary tract infection is correctly diagnosed, and medical advice should be sought about possible urinary infection. Women with recurrent infection or similar symptoms around menopause need investigations to rule out other causes, and men should always consult a doctor. It is also essential that any occurrence of visible blood in the urine is reported immediately in case of a serious underlying cause, for which urgent investigations may be necessary. To diagnose an infection of your urinary tract your urine is checked for the presence of bacteria. This helps to show which antibiotics will be most effective in treating your urinary tract infection. However, it may be necessary to undergo further tests to check for an underlying cause of your urinary tract infections. For instance, an ultrasound scan may be done to identify a structural abnormality of the urinary tract. Also you may need a cystoscopy, which provides a clear view of your urethra and bladder with the aid of a narrow, flexible telescope, known as a cystoscope. With this procedure, a local anaesthetic gel is used for the procedure to be relatively painless and allow easy passage of the cystoscope.

Treating Urinary Tract Infections

With lower urinary tract infections, you will receive a course of antibiotics to clear the infection, which will last up to seven days. You can also take painkillers to relieve any discomfort caused by the UTI. However, if the infection affects your upper urinary tract, you will usually need longer treatment with a different antibiotic, as these require more aggressive treatment. Sometimes you may need hospital admission to manage an upper UTI if you are at increased risk of complications; this may be the case if you are elderly, have diabetes, cancer, HIV, have a blockage in your urinary tract or you have severe symptoms. In hospital you will receive intravenous antibiotics and intravenous fluids as needed.

Complications of Urinary Tract Infections

Although complications of urinary tract infections are rare, they are serious, which is why you should seek medical advice about UTIs if you are male, have recurrent UTIs or an underlying health problem. For instance, you may develop a kidney infection, which can cause lasting damage if you don't receive prompt treatment. An even more serious complication is kidney failure, where your kidneys stop functioning. Finally, if bacteria move from your kidneys into your blood, this can cause blood poisoning, allowing the infection to spread to your other organs. This is a medical emergency and requires intravenous antibiotics to control the infection. If you suffer from urinary tract infections and would like to find out their underlying cause, or have had blood in the urine, book a consultation with Mr Mark Feneley.