Urinary Tract Infections

What is urinary tract infection?

A urinary tract infection (UTI) is the infection of the urinary system, which includes the kidneys, ureters, bladder, prostate (in men) and urethra. Urinary tract infections develop when bacteria develop in the urinary system. Lower urinary tract infection or cystitis is bacterial infection that is confined only to the bladder and urethra, while upper urinary tract infection or pyelonephritis is a bacterial infection of the kidneys. For women, the risk of having a UTI is greater than men. This is probably because of a shorter urethra, so it is easier for the bacteria to move up to bladder.

What causes urinary tract infection?

Normal urine contains no bacteria (germs). Bacteria can get into the urine and the urinary tract from the skin around the rectum and genitals by travelling up the urethra into the bladder and finally to the kidneys through the ureters. Bacteria are more likely to get into the urinary tract following sexual intercourse, use of a diaphragm for birth control or after menopause.

What are the risk factors that could predispose you to UTI?

The following risk factors increase the likelihood of having a urinary tract infection:

• Diabetes
• Advanced age
• Urinary incontinence
• Urinary retention (difficulty fully emptying the bladder)
• Having urinary tract abnormalities that block the flow of urine
• Bowel incontinence (loss of bowel control)
• Kidney stones
• Surgical procedures involving urinary tract

What are the common symptoms of UTI?

If you have a cystitis or bladder infection, you may experience an intense urge to pass urine, pain or burning sensation when urinating, and urine may look cloudy, bloody or have a foul smell. If you have pyelonephritis or kidney infection you may have fever with chills, flushed, reddened skin, pain in the back, nausea and vomiting.

How does your doctor diagnose UTI?

Your doctor will ask you about your symptoms and order the following tests if a UTI is suspected:

• Urine test: A sample of urine is collected and analysed in the laboratory to determine if pus, red blood cells or bacteria are present.
• Ultrasound scan: An ultrasound scan is a non-invasive, painless scan performed to view abnormalities in your urinary tract, such as obstruction of the ureters or bladder, bladder stone or kidney stone.
• Di-mercaptosuccinic acid (DMSA) scan: This is a scan that is used to assess the function of the kidney. During this procedure, DMSA is injected into your body and a series of pictures of your kidneys are taken with a gamma camera.
• Micturatingcystourethrogram (MCUG): This test is used to study the bladder and check for vesico-ureteral reflux. A contrast agent is injected into the bladder through a catheter and X-ray images will be taken as the contrast agent passes out of your bladder. If the X-ray film shows that the contrast agent is leaking back up the ureters to the kidneys from the bladder then vesico-ureteral reflux is diagnosed.

Antibiotics are usually used to manage urinary tract infections. Depending on the type of infection present antibiotic therapy may be given either by mouth, IV or both. Your doctor may also prescribe medications to relieve burning pain and urge to urinate. Surgery may be needed if anatomical abnormalities in the urinary tract are causing UTI.

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