Urinary Tract Infections

The urinary system is a group of organs that filter blood and remove waste products from the body in the form of urine. Urine is excreted from the body by going through a series of tubes and channels that lead to the external environment. This series of tubes make up the urinary tract, which is comprised of the following:

• Right and left kidneys, which filter the blood and make the urine
• Right and left ureters, which carry the urine from the kidneys to the bladder
• Urinary bladder, which stores the urine until it can be expelled from the body
• Urethra, which carries the urine from the bladder to the external environment

An infection in any of these organs is considered urinary tract infection or UTI.

UTI is usually due to a bacterial infection of the urinary tract, but it can also be caused by fungal or other parasitic agents. The most common causative agents of UTI are bacteria common to the stools, which find their way into the urethra, then to anywhere in the urinary tract. Because of the proximity or closeness of the urethral opening to the anal opening in females, women, especially those who are sexually active, are more prone to develop UTI than men.

Symptoms

The symptoms of UTI vary depending on the part of the urinary tract that is infected.

Infection of the urinary bladder or cystitis is characterized by the following symptoms:

• Dysuria: Painful urination or a burning sensation during urination
• Frequency: Frequent but often scanty urine
• Urgency: Difficulty in controlling the urge to urinate
• Cloudy or bloody urine
• Foul-smelling urine
• Pain in the lower abdomen

Infection of the kidneys or pyelonephritis is characterized by the following symptoms:

• Fever and chills
• Back pain
• Nausea or vomiting

In infants or younger children who are still unable to communicate, the symptoms can be nonspecific which include:

• Fever and chills
• Vomiting
• Irritability or fussiness
• Bed-wetting
• Loss of appetite

Diagnosis

On top of history and physical examination, a physician might request for a urinalysis, which is a microscopic examination of the urine. The patient will be asked to provide a clean sample of urine, which will be checked for the presence of bacteria, blood, or pus. In some cases, a urine culture might be done to identify the exact organism that caused the infection so that treatment can be better directed.

In children, how the urine is collected will depend on the child’s age. Older children who are able to, will urinate into a cup. If still in diapers, a plastic collection bag may be placed over the genital area and sealed with an adhesive strip until the child has urinated. An infant’s urine sample may be collected using a catheter, which is a thin tube that is gently inserted through the urethra and into the bladder so that the urine can be collected into a container.

Treatment

The cornerstone of treatment for UTI is antibiotics. Most cases of cystitis are treated with antibiotics for 5-7 days. Pyelonephritis, on the other hand, might require 7-14 days of antibiotic therapy. In severe cases of pyelonephritis, admission into the hospital for intravenous antibiotic administration might be necessary. Those who experience a lot of pain and burning with a UTI may be prescribed a pain medication or an antispasmodic as well.

In general, patients feel better after 1 to 2 days of antibiotic intake but this should not encourage patients to discontinue the antibiotics. Complete compliance with medications is very important in all cases of UTI. The prescribed length of antibiotic regimen should be completed to prevent the chances of inadequate treatment or recurrence of infection and the development of possible sepsis.

Prevention

UTI is a very common condition that affects many women and children not just once in their lifetime. The following are recommendations that will help prevent the recurrence of UTIs:

• Drink plenty of water: Drinking plenty of water allows the urinary tract to be “flushed” frequently, thereby flushing out the harmful organisms that might colonize it.
• Urinate after intercourse: Urinating after intercourse can help flush out the microorganisms that could have entered the urethra during intercourse.
• Avoid spermicides: The use of spermicides has been linked to higher instances of UTI. Find another way of contraception other than spermicides.
• Perineal hygiene: After moving your bowel, wash the anal opening in a direction that goes from front to back to prevent the spread of bacteria towards the urethral opening.
• Using vaginal estrogen therapy: Postmenopausal women can lower their risk by using vaginal estrogen therapy.
• Single dose antibiotics after sex: If frequent infections are related to sexual activity, a single dose of antibiotic to take after sex may be prescribed.
• Consult your doctor: If a person is having repeated episodes of UTI, a consult with a physician is necessary. The physician can help the patient identify the reason for the repeated episodes of infection. In children, some anatomic abnormalities might predispose them to recurrent UTIs. These anatomic problems should be detected and addressed early on to prevent long-term complications as they grow.

Can cranberry juice or other cranberry products prevent bladder infections?

There is currently no evidence confirming that cranberry juice or supplements can prevent urinary tract infections. Even still, there is no harm in trying but if symptoms persist a visit to the clinic is necessary.