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Urinary Tract Infection

Infections of the urinary tract (UTIs) are the second most common type of infection in the body, affecting millions of men and women each year. The urinary tract is the body's filtering system for removal of liquid wastes. Women are especially susceptible to bacteria which may invade the urinary tract and cause infection for reasons that are not yet well understood. Approximately fifty percent of women will develop a UTI during her lifetime.

Although most UTIs are not serious, they can be very painful. Fortunately, they are easily treated with antibiotics that help symptoms quickly disappear. Still, some women are more prone to repeated infections than others and it can be a frustrating battle.

What causes a UTI?

Urine is normally free of bacteria, viruses, and fungi. An infection occurs when tiny organisms, usually bacteria from the digestive tract, adhere to the opening of the urethra (the tube that carries urine from the bladder to outside the body) and begin to multiply. The most common cause of UTIs is bacteria from the bowel that live on the skin near the rectum or in the vagina, which can spread and enter the urinary tract through the urethra. Once these bacteria enter, they travel upwards and cause infection in the bladder and sometimes in other parts of the urinary tract.

Another common cause of UTIs in women is sexual intercourse, during which bacteria in the vaginal area can be pushed into the urethra by the motion of the penis. A woman who has several different sexual partners or begins having intercourse more frequently may experience UTIs more often than a woman in a monogamous relationship.

Waiting too long to go to the bathroom is another cause of UTIs. The bladder is a muscle that stretches to hold urine and contracts to release it. Waiting very long past the time you first feel the need to urinate causes the bladder to stretch beyond its capacity. Over time, this can weaken the muscle and cause the bladder not to fully empty itself. Any urine left in the bladder may increase the risk of a UTI.

Other factors may also increase a woman's risk of developing a UTI, including pregnancy, having had UTIs as a child, menopause and diabetes.

What are the symptoms of a UTI?

Symptoms of a UTI may include a frequent urge to urinate, a burning sensation in the urethra when urine is released, pain in the area even when not going to the bathroom, shakiness, fatigue, and soreness in the lower abdomen, back, or sides. If a UTI is in the bladder or urethra, it usually won't cause a fever. A fever may be a sign that the infection has reached the kidneys.

How is a UTI diagnosed?

Proper diagnosis is important, as the symptoms of a UTI can also be caused by other problems, such as infections of the vagina or vulva. Only your doctor can distinguish between them and make a correct diagnosis.

To find out whether you have a UTI, your doctor will check the number of bacteria and white blood cells in your urine. Urine is examined under a microscope and cultured in a substance that promotes the growth of bacteria. Usually, the sample is sent to a laboratory, although some doctors' offices are equipped to do the testing. A pelvic exam may also be necessary.

How is a UTI treated?

If you have a UTI, your doctor will probably prescribe antibiotics, medications that eliminate the bacteria that caused the infection. Antibiotics are usually taken in the form of a pill. Most are safe for use during pregnancy and breastfeeding, although some are not. If you are pregnant, plan to become pregnant or are breastfeeding, be sure to let your doctor know before your antibiotics are prescribed. Antibiotic treatment for an infection of the urinary tract varies in duration from three to 10 days, but the period of time you'll have to take the medication depends on the type of bacteria present and the severity of the infection.

If you are healthy and not pregnant, a UTI can usually be cured in two or three days. If you have a severe infection of your upper urinary tract that involves your ureters and kidneys, however, treatment may not be so simple. In a case like this, you may need to stay in the hospital and have antibiotics delivered directly into your bloodstream. Pregnant women and those who have kidney stones or diabetes usually require longer treatment, which lasts approximately seven to 10 days.

There are several drugs available to relieve the pain of a UTI. Ibuprofen and acetaminophen are popular choices. Your doctor may also recommend using a heating pad and drinking six to eight 8-ounce glasses of water a day to help you urinate more frequently and flush any remaining bacteria from your system. He or she may also advise you to drink cranberry juice, as it increases the acidity of urine and makes it more difficult for bacteria to grow.

What about recurrent UTIs?

Most healthy women do not experience recurrent infections. However, according to the National Kidney Foundation, approximately one out of every five women who gets a UTI will develop another one at some point in her life. If you have had three or more UTIs, you are likely to continue having them. Consider talking to your doctor about the following treatment options:

  1. 1. Take low doses of an antibiotic such as TMP/SMZ or nitrofurantoin daily for 6 months or longer. If taken at bedtime, the drug remains in the bladder longer and may be more effective. NIH-supported research at the University of Washington has shown this therapy to be effective without causing serious side effects.

  2. 2. Take a single dose of an antibiotic after sexual intercourse.

  3. 3. Take a short course (1 or 2 days) of antibiotics when symptoms appear.

In addition, your doctor may suggest some additional steps you can take on your own to avoid future infections, including the following:

  • Drink plenty of water every day

  • Go to the bathroom when you feel the urge; don't hold it

  • Wipe from front to back to prevent bacteria from entering your urethra

  • Take showers instead of baths

  • Cleanse your genital area prior to sexual intercourse

  • Avoid scented feminine hygiene sprays, which may cause irritation



Featured Sites:

Cord Blood Registry
March of Dimes
Susan G. Komen

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