Urinary Tract Infection (UTI)

Urine is usually sterile, which means it does not have any bacteria, viruses or fungi present.

A UTI can occur when a microorganism enters the urinary system through the urethra. Most infections are caused by escherichia coli (E. coli), which is a digestive tract bacterium that lives in the colon (large intestine), and spreads to the urethra from the anus.

Other microorganisms, such as chlamydia and mycoplasma, can cause UTIs in men and women but these UTIs are usually restricted to the urethra and the reproductive system. Since these microorganisms are sexually transmitted, both partners will require treatment when infections occur.

As urinary tract infection causes pain, it is important to prevent it as much as possible by knowing the risk factors that can lead to it.

Risk Factors for UTI

• Structural abnormalities of the urinary system, urinary stones and bladder obstruction
• Diabetes as the urine contains higher amounts of sugar than usual
• Men with an enlarged prostate as they are unable to empty their bladder completely
• Babies born with abnormalities in the urinary system
• Women, as they have a shorter urethra, allowing bacteria to reach the bladder more easily. The risk is usually highest when women become sexually active or after menopause due to the dry state of the urethra and vagina. 1 in 5 women develops a UTI during her lifetime
• Urinary Stasis – Urinary stasis or incomplete bladder emptying is another risk factor for recurrent UTI.
• Pregnancy – Urinary tract and immunologic changes of pregnancy can predispose a pregnant woman to UTI.
• Sexual Intercourse

Preventing or reducing the risk of a UTI

Preventive measures, especially in women with recurrent infections, can be taken to reduce the risk of developing UTIs. These include:

• Drinking cranberry juice or taking vitamin C to help increase the acidity of the urine, which reduces bacterial growth
• Drinking plenty of water
• Not holding the bladder for a long time and urinating when needed
• Urinating immediately after sexual intercourse

UTI symptoms vary depending on the type of infection and a person's age. Some people may not have any symptoms at all. The usual symptoms of UTI include:

• Back pain
• Blood in the urine
• Cloudy urine
• Fever and chills
• Frequent and urgent need to urinate
• Incontinence (inability to control urination)
• Malaise (feeling generally unwell)
• Nausea and vomiting
• Pain in the abdomen or above the pubic bone
• Pain in the ribs
• Painful and burning sensation during urination

To diagnose your condition, your doctor will ask if you’ve experienced symptoms of UTI. To further check if you have UTI, your doctor may do the following tests and procedures:

• Urinalysis
• Urine Culture
• Ultrasound, Computerised Tomography (CT) scan or Magnetic Resonance Imaging (MRI) scan
• Cystoscopy

An antibiotic course is usually enough to treat simple UTIs. The choice and duration of antibiotic treatment depends on medical history and the type of bacteria involved.

Here are the common types of antibiotics for UTI:

• Amoxicillin
• Sulfonamides
• Nitrofurantoin
• Cephalosporins
• Trimethoprim/sulfamethoxazole
• Doxycycline
• Quinolones

You need to follow your doctor’s directions for taking the antibiotics. Even if your UTI symptoms have eased, continue taking the antibiotics. The infection may return if it is not completely treated. Taking the full course of antibiotics will ensure that you receive complete treatment.

Moreover, women with recurring UTIs may need to take antibiotics daily for 3 – 6 months or after sexual intercourse.

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• Kidney damage can occur if cystitis (bladder infection) is not treated and the infection spreads to the kidneys
• Septicaemia (serious blood infection) can occur if the bacteria enters the bloodstream
• A UTI during pregnancy can lead to premature birth and hypertension (high blood pressure)
• Recurrent infections can occur especially for those who experience more than 4 UTIs within a year
• Recurrent urethritis may lead to complications in urethral narrowing in men