What is a Urinary Tract Infections (UTI)?
First, let’s talk about the urinary tract. The urinary tract begins with the kidneys, which are responsible for producing urine. Each kidney is connected to a tube called a ureter, which carries the urine from the kidney to the bladder. Urine is stored in the bladder before it is released through another tube (called the urethra) when we pee.
A urinary tract infection (UTI) is when there is a bacterial infection affecting any of the above components mentioned, most commonly the bladder. This is called “cystitis”. In rarer but more serious cases, important structures like the kidneys may be affected as well.
Urinary tract infections tend to affect women much more than men, simply because women have a shorter urethra than men. UTIs in healthy men are uncommon because the length of their urethra protects against bacteria spreading upwards.
What are the Causes of a UTI in Women?
Certain risk factors for UTIs are specific to women:
- Sexual intercourse
- Contraception (diaphragms and spermicide use)
In women of all ages, common triggers include sexual intercourse (through the introduction of bacteria due to the mechanical nature of intercourse). Certain forms of contraception such as the use of diaphragms and spermicides may increase the risk of UTIs as well. In ladies who are post-menopausal, decreased levels of estrogen result in vaginal atrophy (thinning and dryness of the vaginal lining and walls) and stress incontinence, leading to an increased risk of UTIs as well.
Other risk factors are common to both males and females alike and include:
- A weakened immune state – as may be seen in diabetes or with cancer, chemotherapy or people who are on long term immunosuppressive medications
- Structural abnormalities in the urine tract (some people may be born with abnormalities in their urinary tract which place them at increased risk of frequent UTIs from early childhood onwards and throughout their life)
- Kidney stones
- Any factors which increase the risk of urine retention – this includes constipation in the elderly, certain medications, and in older men, an enlarged prostate gland
- Foreign bodies like a urinary catheter
What are Symptoms of an UTI in Women?
Urinary tract infections can affect the urethra (urethritis), the bladder (cystitis), and the ureter and kidneys (pyelonephritis).
Common symptoms include:
- Dysuria (a stinging or burning pain when passing urine)
- Frequency and urgency (always feeling the urge to pee and going more often)
- Hematuria (blood in the urine)
- Foul smelling or cloudy urine
- Suprapubic pain (pain over the lower part of your abdomen where your bladder is located)
Symptoms of a more serious infection affecting the kidneys and upper urine tract:
- Flank pain (pain over the lower back region either on the left or right side corresponding to the kidney affected)
- Fever and chills
- Nausea, vomiting
It is best to see a doctor early, as soon as the symptoms of a UTI begin because if left untreated, there is a risk that what was initially simple cystitis or bladder infection may spread upwards to the kidney and turn into a serious and even potentially life-threatening infection that might leave permanent kidney damage.
How Will My Doctor Diagnose a UTI?
Diagnosis of a UTI begins with the history (symptoms and risk factors) you tell your doctor as well as a physical examination to see if there are any alarming red flags that suggest you have a more serious infection like pyelonephritis.
Your doctor may also ask you to provide a urine sample for a urine dipstick test in clinic – this is a simple and immediate test which can detect the presence of blood, white blood cells (infection-fighting cells which suggest ongoing inflammation), and nitrites (which are present when there is a bacterial infection) in your urine.
Another useful test that your doctor may order is a urine culture. This is when your urine sample is sent off to the lab to check for bacterial growth over the course of a few days. This is useful as it can tell your doctor which specific bacteria is responsible for your UTI, as well as what antibiotics the bacterium is susceptible to.
If you have recurrent urinary tract infections, you may benefit from additional imaging investigations, such as an ultrasound scan, to look at the structure of your urinary tract as well as look for any stones that may be triggering these infections.
How Is a UTI Treated?
Antibiotics are required to treat a UTI. Most simple cases of UTIs require only oral antibiotics, but if you have a more severe infection affecting the kidneys, you may end up having to go to hospital for intravenous antibiotics.
Medications (usually in the form of a powder that you dissolve in water and drink) that help alkalinise your urine will also be helpful in reducing your urinary discomfort while the antibiotics kick in.
What Can I Do To Reduce My Risk Of Getting a UTI?
Adequate hydration and passing urine regularly may help flush bacteria out and helps reduce your risk of kidney stones. Passing motion regularly also helps reduce the risk of urinary retention from constipation.
In women, emptying your bladder after sexual intercourse, as well as avoiding the use of diaphragms and spermicides may be helpful. Wiping from front to back after defecation also helps reduce the risk of introducing faecal bacteria.
Cranberry juice does contain a compound which inhibits bacteria from sticking to the walls of your bladder but there is no conclusive research that demonstrates cranberry juice reduces the risk of UTIs. Essentially, there is no harm in drinking cranberry juice, but it may not necessarily help as much as you hope it will.
UTIs are common and treatable! The most important thing is to see a doctor early for assessment and treatment and you’ll feel better in no time at all.