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Urinary Tract Infections

Sep 1, 2013
2013 / September 2013

Urinary tract infections, or UTIs, affect both women and men and are the second-most common type of infection. Bacteria entering the urethra is the most common cause. Normally, bacteria in the urinary tract are quickly flushed out, but sometimes they overcome the body’s defenses and cause infection. UTIs are painful, especially if you are traveling with an untreated infection.

A UTI can happen anywhere in the urinary system, which includes the kidneys, ureters, bladder and urethra. A bladder infection is called cystitis. Polynephritis is an infection of one or both kidneys. An infection of the tube that empties urine from the bladder to the outside is called urethritis. Prostatitis is an infection of the prostate gland in men.

Women tend to contract more UTIs because their urethra is shorter and closer to the anus than in men; they are more likely to get an infection after sexual activity or when using a diaphragm or spermicide for birth control. Menopause increases the risk of a UTI due to a decrease in estrogen.

Certain conditions increase the risk of UTIs: diabetes, advanced age, adults with Alzheimer’s disease or delirium, and individuals with problems emptying their bladder completely. Other risks include having a urinary catheter, bowel incontinence, an enlarged prostate, a narrowed urethra or anything that blocks the flow of urine, such as kidney stones. Remaining immobile for a long period of time, pregnancy and surgery or procedures involving the urinary tract also place you at risk.

Contact your health care provider if you experience pain or burning when you urinate, fever, tiredness or shakiness, an urge to urinate often, pressure in your lower belly, urine that smells bad or looks cloudy or reddish, nausea or back pain. Your doctor will examine you to determine whether you have a mild bladder or kidney infection or a more serious infection.

Most of the time, your doctor or nurse can diagnose an infection by analyzing a urine sample for white blood cells, red blood cells and bacteria. A urine culture can then identify the bacteria so that the correct antibiotic is ordered. Blood work can also look for infection. Your doctor will want to know whether you could be pregnant.

Antibiotics taken by mouth are usually recommended because there is a risk that the infection can spread to the kidneys. For a simple bladder infection, you will take antibiotics for three to seven days (women) or seven to 14 days (men). The urine culture may require a change in the antibiotic to one that the bacteria are not resistant to.

Finish all of the antibiotics, even if you feel better. Otherwise, the infection could return and be harder to treat. Commonly used antibiotics include Bactrim, Amoxicillin, Nitofurantoin, Ampicillin, Cipro and Levaquin. A medication such as Pyridium can relieve the burning and urgency. Contact your provider after completing the antibiotics to make sure the infection is gone. If it does not improve or you have problems with your treatment, call your provider.

If you have a UTI, drink plenty of fluids to keep the urine clear or pale yellow. Avoid caffeine, tea, carbonated beverages and alcohol; they tend to irritate the bladder. Only take over-the-counter pain medicines as directed by your provider. Some women have recurrent bladder infections. Your doctor may suggest consulting a urologist to rule out problems with your urinary tract system that may lead to recurrent UTIs or make a UTI harder to treat. If you are prone to recurrent UTIs and you are about to travel, talk to your doctor about having an antibiotic with you in case you develop symptoms.

Possible UTI complications include sepsis, a life-threatening blood infection. This risk is greater among the young, the very old and those whose bodies cannot fight infections or who have kidney damage or scarring or kidney infection.

Treatment for a UTI is directed at the underlying cause when possible. If no source of infection is found, lifestyle modifications, plus vaginal estrogen replacement for some women, are all you may need. Cranberry juice or cranberry tablets may prevent UTIs, though the research is not definitive.

A urinary tract infection is uncomfortable, but treatment is usually successful. Symptoms of a bladder infection usually disappear within 24 to 48 hours after treatment begins. For kidney infections, it may take a week or more. Sometimes a procedure or surgery is needed to repair blockage of the flow of urine. If you have repeated UTIs, you may need a low-dose antibiotic for several months.

Reduce Your Risk

  • Drink plenty of water (two to four quarts daily).
  • Urinate frequently. Avoid holding urine for long periods.
  • Wipe from front to back after urination or a bowel movement.
  • Use toilet tissue only once.
  • Take showers rather than baths; avoid bath oils.
  • Gently wash the skin around your vagina and anus daily with mild soap and water.
  • Empty your bladder before and after intercourse.
  • Clean your genital and anal areas before and after intercourse.
  • Use condoms to help prevent UTIs caused by sexually transmitted bacteria.
  • Women should use sanitary pads instead of tampons; change them with each bathroom use.
  • Do not douche or use deodorant sprays or scented feminine products in the genital area.
  • Avoid tight-fitting pants.
  • Wear cotton underwear and pantyhose and change both at least once a day.

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.

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