What is a urinary tract infection?
Urinary Tract Infection (UTI) is usually caused by an infection caused by bacteria. It can appear in both women and men of all ages, but is more common in women.
The inflammation can be in different parts of the urinary system, but most often it is in the bladder. The inflammation can cause great discomfort, and if not treated, it can also cause health damage.
What does the urinary system consist of?
The kidneys filter the blood and excrete waste materials through the urine.
The ureters are the tubes that carry urine from the kidneys to the bladder.
The bladder is a pouch-like organ used to store urine.
The urethra is the tube that carries urine from the bladder to the outside of the body.
How does it happen that there is a urinary tract infection?
Urine in its normal state does not contain bacteria. The most common bacteria that causes urinary tract infections is E. Coli. These bacteria are naturally found in the colon and rectum, and in fact they are essential for the proper functioning of our digestive system. However, when these bacteria reach the urethra from the anus, they may enter the urinary system and cause infection and inflammation.
There are three types of urinary tract infections:
• Cystitis (Cystitis): inflammation of the bladder. This is the most common type of urinary tract infection.
• Urethritis: inflammation of the urethra.
• Pyelonephritis: inflammation of the kidney.
What are the symptoms of a urinary tract infection?
The most common symptoms of a urinary tract infection are:
• Pain, tingling or burning when urinating.
• Urinary frequency (the need to urinate often).
In addition to this, the following symptoms can also appear:
• Inability to urinate even when feeling a strong need to urinate. Alternatively, you manage to pass a small amount of urine at a time.
• A feeling that the bladder does not empty completely.
• Cloudy urine.
• Blood in the urine.
• Foul-smelling urine.
When fever, back pain and chills also appear, it should be suspected that the inflammation has reached the kidneys.
It should be noted that elderly people with urinary tract infection usually do not suffer from the symptoms of the disease, so it is more difficult to diagnose it in them.
Children with a urinary tract infection may have additional symptoms such as fever, loss of appetite and vomiting.
What are the risk factors?
There are several factors that increase the risk of urinary tract infection, including:
• Sex. In women, the urethra is much shorter than in men (2 to 3 centimeters), so for them the path of the bacteria from the anus to the bladder is relatively short.
• Menopause (stopping menstruation). After a woman's period stops, the vaginal lining becomes thin - allowing bacteria to enter through invisible cuts in the skin.
• Not drinking enough can lead to dehydration and a reduction in the amount of urine. As a result, bacteria that invade the urinary system are not washed out with the urine stream and can cause an infection.
• Having frequent intercourse or using spermicides. During penetration, the vaginal mucosa may be injured, and through the cuts in the skin (which you may not necessarily see or feel), bacteria may enter.
• Diseases such as diabetes can sometimes cause a bladder infection.
• An enlarged prostate in men causes a disturbance in the free drainage of urine. Urine (like any other fluid in the body) that does not drain tends to become contaminated easily.
• Congenital defects in the urinary tract are the common cause of urinary tract infections in babies and toddlers.
How common is the problem? It is very common! By the time they reach the age of 24, nearly 30% of women suffer at least once from a urinary tract infection; More than 50% of women suffer from a urinary tract infection at least once in their lives. It is more common in girls mainly in infancy and childhood (up to the age of 4 years), and then when they start having sex and after the cessation of menstruation, which causes changes in the texture of the vaginal mucosa. During childhood (in babies and toddlers), boys suffer slightly more than girls from urinary tract infections. But at an older age, the formations reverse, and the frequency of infections is much higher in women than in men. In old age, men suffer from urinary tract infections mainly due to chronic urinary retention usually caused by benign prostatic hyperplasia (BPH). The incidence of urinary tract infections in boys and girls is usually relatively low (1% to 2%), and if they appear, an investigation is necessary to rule out a urinary tract disorder. The most common disorder is reflux. In its severe cases, it causes significant damage to the kidneys, to the point of developing kidney failure. Is a urinary tract infection contagious? Is it possible to get infected in public toilets? In general, a urinary tract infection is not considered contagious, and you can be satisfied with the usual hygiene rules. The rumor that you can get infected in public toilets is probably not true. The risk of contracting a urinary tract infection in public toilets is very low. On the other hand, sexual intercourse can cause the transmission of bacteria that can cause urinary tract infections and other sexually transmitted diseases. When to contact the doctor? A urinary tract infection requires antibiotic treatment, so if symptoms suggestive of an infection appear, it is necessary to contact a doctor. Except for young women of reproductive age - in any suspicion of urinary tract infection, a urine culture should be sent before starting antibiotic treatment. The young women are exempt from this as their infections are usually caused by bacteria that are not resistant to antibiotics. Young women who suffer from repeated urinary tract infections are even sometimes asked to keep antibiotic medicines at home and use them on their own at the moment they feel the symptoms of the infection.
How is a urinary tract infection diagnosed?
The diagnosis is usually made according to the symptoms and according to the findings in the urine.
In the examination of the contaminated urine (general urine urinalysis) high levels of white blood cells and nitrites will usually be found. Using a urine culture, it is possible to identify the type and amount of bacteria involved and their types. This is important to decide on the appropriate type of treatment.
A urine culture is very sensitive to antibiotic treatment, so if you take even one dose of antibiotics, the likelihood of being able to identify the type of bacteria that caused the infection is greatly reduced. Therefore, a urine culture must be sent before starting the antibiotic treatment.
People who suffer from recurrent infections of the urinary tract, especially children, must undergo an investigation, including special x-rays and tests of the bladder to detect a structural defect that requires treatment, in order to prevent irreversible damage to the kidneys.
What is the immediate treatment for urinary tract infection? Are antibiotics necessary?
Urinary tract infections are treated with antibiotics appropriate for the type of bacteria that causes the infection. In most cases, pills are enough. In severe cases, when the infection spreads to the kidneys, it might be necessary to administer the drug by intravenous infusion - which requires hospitalization.
In addition to the antibiotic treatment, you should increase the amount of drinking.
You can also use painkillers and reduce fever - if necessary.
Sometimes the treatment also includes a medicine that alleviates the burning and the discomfort. It is usually a 'Sedural' drug (Phenazopyridine, Pyridium) that causes a red color to appear in the urine. Do not panic.
In most cases, the symptoms of inflammation improves within 72 hours of starting the antibiotic treatment.
The difference in treatment between men and women
Because of the differences in the anatomical structure, there are also differences in the treatment that women and men receive.
In men, urine infected with bacteria may accumulate in the bladder, and therefore a longer treatment is sometimes required: 7 to 10 days compared to 3 to 5 days of treatment for women, in some cases women can even be satisfied with a one-time antibiotic treatment. Treatment of a more severe infection may take about three weeks.
Could there be complications?
An untreated urinary tract infection can become a kidney infection. Repeated inflammations of the kidneys may cause scarring of the kidneys and damage the kidney function (to the point of kidney failure).
Untreated inflammation in pregnant women increases the risk of low birth weight newborns and premature birth.
Recurrent inflammation of the bladder (cystitis) may be a sign of a more serious problem such as bladder cancer, a disorder in the anatomical structure or a deficiency in the immune system.
How can you reduce the risk of suffering from a urinary tract infection?
There is no doubt that the best way to treat a urinary tract infection is to prevent it in the first place. Unfortunately, it is probably impossible to completely prevent urinary tract infections, but some actions can be taken that reduce the risk of suffering from a urinary tract infection.
These are the actions that can be done independently:
• Make sure to drink a lot, at least eight glasses a day. The many fluids you drink flush the entire urinary system and flush out bacteria.
• Restraint should be avoided when there is an urge to urinate.
• Women who use a diaphragm are more prone to urinary tract infections. Spermicides may also increase the risk of infection: they kill the friendly bacteria in the vagina that prevent the E. coli bacteria from multiplying.
• A common tip that works well is to urinate before having sex and after having sex. This procedure washes the bacteria out.
• It is recommended to consume cranberries. Pharmacies and pharmacy chains are full of cranberry-based products to prevent urinary tract infections. Cranberries contain a substance called Polyphenol type A that makes it difficult for E. coli bacteria to adhere to the lining of the bladder.
A review article published in 2017 that included information on almost 5,000 subjects shows that those who took cranberry products were at a reduced risk of having a urinary tract infection. However, cranberries must be consumed regularly and in large quantities to reach a sufficient amount of the active substance.
The problem: the cranberry products sold in pharmacies do not always indicate the amount of the active ingredient. In any case, if personal experience shows that these products help, there is no reason not to continue using them.
• Probiotics - the latest studies show that it does not reduce the risk of urinary tract infections, so it cannot be recommended for this purpose.
• Pharmacies offer various natural preparations that should help us prevent and treat urinary tract infections. These products - for the most part - have not been tested in studies. One of these preparations is D-Mannose.
This is a type of sugar (don't worry, it does not affect the balance of diabetes) that interferes with the attachment of bacteria to the wall of the urinary tract and thus should prevent the development of inflammation. Sounds reasonable, but the studies regarding its effectiveness still do not give an unequivocal answer. Howevet, it is a safe treatment that generally does not cause any side effects, so if you try the product and it helps - feel free to use it again.
In addition to this, there are several other medical treatments that may reduce the risk of urinary tract infections:
• For women after menopause, local preparations containing estrogen can be given regularly. Estrogen restores the vaginal mucosa to its natural protection. These preparations do not increase the level of estrogen in the blood significantly and are therefore free of the side effects of hormone replacement therapy.
• For women whose inflammation appears with high frequency after intercourse, it is possible to consider giving preventive antibiotic treatment after each time they had intercourse.
• In some cases, the doctor may recommend regular treatment with a drug such as Hyperex, which reduces the frequency of inflammation. The drug is usually taken with the addition of vitamin C and makes it difficult for the bacteria to multiply in the urinary tract.
• Sometimes preventive antibiotic treatment can be considered for a limited period of time.
I am pregnant, and the doctor sent me to do a urine culture. why?
Sometimes our urine contains bacteria even though we have no symptoms of a urinary tract infection: there is no fever, no burning sensation when urinating, but despite this, bacteria develop in the urine culture. In such a situation, it is usually not necessary to treat with antibiotics. On the contrary, we know that antibiotic treatment in such a case may later cause the development of urinary tract infections due to more resistant bacteria.
But in pregnancy the situation is different. Due to the physiological changes in the woman's body during pregnancy, there is a higher risk of developing a urinary tract infection as well as a severe urinary infection that contaminates the kidneys (pyelonephritis).
On top of that, there is a connection between the presence of bacteria in the urine and pregnancy complications. Therefore, every pregnant woman is sent for a urine culture, and if a bacterium develops in the urine culture, she should receive antibiotic treatment.