Urinary Tract Problems

A urinary tract infection causes inflammation in the lining of the bladder and urethra. This can produce a number of different symptoms, such as:

• A sharp burning sensation when urinating (dysuria)
• A strong urge to urinate that can’t be delayed
• Passing frequent, small amounts of urine
• Urine that has a strong odour or appears cloudy
• Pink or red coloured urine, which indicates the presence of blood
• Soreness in the back, lower abdomen or sides
• Pain during sex
• If bacteria enter the ureters and spread to the kidney, you may also experience fever, chills, nausea and vomiting.
• Contact your doctor for a proper diagnosis if you have signs and symptoms of a urinary tract infection.

The urinary tract makes and stores urine, one of the waste products of your body. Urine is produced in the kidneys through the removal of waste and water from the blood, and travels down the ureters to the bladder. The bladder serves as a storage container for urine, which is then emptied by urinating through the urethra – a tube that carries urine from the bladder to outside the body. The urethra connects to the end of the penis in a male and connects to an area above the vagina in a female.

Urinary tract infections

A urinary tract infection (UTI) is an infection in any part of your urinary system. While normal urine contains no bacteria, bacteria from outside the body can sometimes get into the urinary tract and cause infection or inflammation. The infection can involve the urethra (a condition called urethritis), kidneys (a condition called pyelonephritis), or bladder (a condition called cystitis). Cystitis is the most common type of urinary tract infection.

Types of UTIs

UTIs are often categorised as:

• Uncomplicated: An uncomplicated UTI is a bacterial infection in the bladder or kidney that is not caused by a structural or medical problem of the urinary tract. Uncomplicated UTIs affect women much more often than men.
• Complicated: Complicated UTIs tend to be recurrent, more severe and more difficult to treat than uncomplicated UTIs. They are often the result of some anatomical or structural abnormality that impairs the ability of the urinary tract to clear out urine and therefore bacteria.
• Recurrent: Recurrent UTIs take place when you have three or more uncomplicated UTIs within a year. Recurrent UTIs occur due to bacterial reinfection or bacterial persistence. A bacterial reinfection is a recurrence with a different organism or the same organism more than two weeks later. Persistence means that the same bacteria have not been eradicated in the urine two weeks after treatment.

According to the American Urological Association , the two main ways to diagnose a urinary tract infection (UTI) is via urinalysis and urine culture. However, if you are experiencing fevers or persistent symptoms despite therapy, imaging tests or a cystoscopy may also be required to assess the urinary tract for injury or disease.

• Urinalysis: Urinalysis is when a sample of your urine is taken for lab analysis. The urine sample is examined under a microscope to look for bacteria, white blood cells and red blood cells. Normal urine should not have blood cells or bacteria in it. If these show up in the urine, it can indicate an infection.
• Urine culture: Urinalysis is sometimes followed by a urine culture test, which uses your urine sample to grow bacteria in a lab. This helps your doctor determine the type of bacteria causing your infection and which medications will be most effective.
• Imaging tests: If your doctor suspects that a problem in your urinary tract causes frequent infections, you may have an ultrasound or a computerised tomography (CT) scan to create images of your urinary tract. An ultrasound is a test that uses sound waves to form images of internal organs while a CT scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Another test, called an intravenous pyelogram (IVP), uses a series of X-rays of the bladder, kidneys and ureters after a special dye is injected. The dye helps to highlight structures so they show up better on the x-ray.
• Cystoscopy: If you experience recurrent UTIs, a cystoscopy may be performed by your doctor. This test uses a long, thin tube fitted with a lens (cystoscope) to see inside your bladder and urethra.

Antibiotics, medicines that kill bacteria, are used to treat urinary tract infections (UTIs). The type, dose and length of the antibiotic treatment depend on your health condition and the type of bacteria causing the infection. Commonly used antibiotics include:

• Amoxicillin
• Sulfamethoxazole/trimethoprim (Bactrim, Septra, others)
• Nitrofurantoin
• Ampicillin
• Quinolones, such as Ciprofloxacin
• Levofloxacin (Levaquin)

In most cases, symptoms clear up within a few days. However, you should complete the full course of medication prescribed for you to ensure the infection is completely gone – even if all symptoms have been relieved. Unless UTIs are fully treated, they can frequently return. You should also remember to drink plenty of liquids, especially water.

For an uncomplicated UTI that occurs when you're otherwise healthy, your doctor may recommend a shorter course of treatment, such as a three-day course of oral antibiotics.

If you have a history of frequent urinary tract infections, you may be given a prescription for antibiotics that you would take at the first onset of symptoms. Other patients may be given antibiotics to take every day, every other day, or after sexual intercourse to prevent the infection.

For severe infections, such as a kidney infection, you may need treatment in a hospital. These infections take longer to treat and antibiotics are usually given intravenously (through a tube in the vein).

There are some simple steps you can take to reduce your risk of developing urinary tract infections. These include:

• Follow good hygiene practices: After urination or a bowel movement, wipe from front to back to prevent bacteria from the anal region to spread to the urethra.
• Drink plenty of fluids: Drinking plenty of fluids, especially water, encourages you to urinate more frequently. This flushes bacteria out of your system before an infection can begin.
• Empty your bladder after intercourse: Urination soon after intercourse can flush out any bacteria that might have been introduced during sex.
• Don’t use feminine products on your genital area: Products such as douches, powders and deodorant sprays used in the genital area can irritate the urethra.
• Wear cotton underwear: Wear underwear with a cotton crotch to reduce the risk of infection.
• Empty your bladder regularly: Empty your bladder as soon as you feel the urge, or every two to three hours.
• Drink cranberry juice: Unsweetened cranberry juice or cranberry pills may decrease the risk of getting a urinary tract infection, according to the American Congress of Obstetricians and Gynecologists . The exact amount of juice needed to prevent infection is still being studied.