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Article title: Urinary Tract Infections: NWHIC
What parts of the urinary
tract are prone to infection?
What are the causes of urinary tract infections?
Who is at risk for UTIs?
Do you develop more urinary tract infections during pregnancy?
What are some symptoms of urinary tract infection to watch out for?
How is a UTI diagnosed?
Once you get a UTI, can you ever get rid of it entirely?
Are there steps I can take to avoid getting a urinary tract infection?
The urinary tract is composed of four parts -- the kidneys, the ureters (tubes connecting the kidneys to the bladder), the bladder, and the urethra (the tube through which the bladder empties). Most often, infections begin in the urethra and move up the urinary tract to the kidneys.
Normal urine is sterile. It contains fluids, salts, and waste products, but it is free of bacteria, viruses, and fungi. A urinary tract infection (UTI) occurs when microorganisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. Most infections arise from one type of bacteria, Escherichia coli (E. coli), which normally live in the colon. In most cases, bacteria first begin growing in the urethra and often move on to the bladder, causing a bladder infection (cystitis). If the infection is not treated promptly, bacteria may then go up the ureters to infect the kidneys (pyelonephritis). Microorganisms called chlamydia and mycoplasma may also cause UTIs in both women and men, but these infections tend to remain limited to the urethra and reproductive system. Unlike E. coli, chlamydia and mycoplasma may be sexually transmitted, and infections require treatment of both partners.
Some people are more prone to getting a UTI than others. Any abnormality of the urinary tract that obstructs the flow of urine (a kidney stone, for example) sets the stage for an infection. A common source of infection is catheters, or tubes placed in the bladder to aid in urination for people unconscious or critically ill. Bacteria on the catheter can infect the bladder, so hospital staff take special care to keep the catheter sterile and to remove it as soon as possible. People with diabetes have a higher risk of a UTI because of changes in the immune system. Any disorder that suppresses the immune system raises the risk of a urinary infection. Women may have more urinary infections than men because the womanís urethra is relatively short, allowing bacteria quicker access to the bladder. Further, a womanís urethral opening is near sources of bacteria from the anus and vagina. One in five women develops a UTI during her lifetime. For many women, sexual intercourse seems to trigger an infection, although the reasons for this linkage are unclear. According to several studies, women who use a diaphragm are more likely to develop a UTI than women who use other forms of birth control. In addition, women whose partners use condoms tend to have growth of E. coli bacteria in the vagina, which may increase the risk of a UTI. Further, in women, the rate of UTIs gradually increases with age.
Pregnant women seem no more prone to UTIs than other women. However, when a UTI does occur during pregnancy, it is more likely to travel to the kidneys. About 2-4 percent of pregnant women develop a UTI. Hormonal changes and shifts in the position of the urinary tract during pregnancy may make it easier for bacteria to travel up the ureters to the kidneys. For this reason, many doctors recommend periodic testing of urine. A pregnant woman who develops a UTI should be treated promptly to avoid premature delivery and other UTI-related risks such as high blood pressure.
Not everyone with a UTI has symptoms, but most people do. Symptoms may include a frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination. It is not unusual to feel bad, tired, shaky, washed-out, and to feel pain even when not urinating. Often, women feel an uncomfortable pressure above the pubic bone, and some men experience a fullness in the rectum. It is common for a person with a UTI to complain that, despite the urge to urinate, only a small amount of urine is passed. The urine itself may look milky or cloudy, even reddish if blood is present. A fever may mean that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting.
Your doctor will test a urine sample for pus and bacteria. Although your doctor may begin treatment before the bacterial cultures are back from the lab, the cultures will confirm the diagnosis and may cause a change in the antibiotic chosen. Occasionally when a treatment fails to clear up an infection, the doctor may order a test that makes an image of the urinary tract to identify whether there are structural changes contributing to the infection or impeding treatment.
Many women suffer from frequent UTIs. Nearly 20 percent of women who have a UTI will have another, and 30 percent of those will have yet another. Of the last group, 80 percent will have recurrences. About four out of five women who have a UTI get another in 18 months. Many women have them even more often. A woman who has frequent recurrences (three or more in a year) should ask her doctor about treatment options.
Drink plenty of water every day. Some doctors suggest drinking cranberry juice, which in large amounts inhibits the growth of some bacteria by acidifying the urine. Vitamin C (ascorbic acid) supplements have the same effect. Urinate when you feel the need; donít resist the urge to urinate. Wipe from front to back to prevent bacteria from the anal area from entering the vagina or urethra. Take showers instead of tub baths. Cleanse the genital area before sexual intercourse. Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.
You can find out more about urinary tract infections by contacting the following organizations:
This information was abstracted from the booklet Urinary Tract Infection in Adults, National Institute of Diabetes and Digestive and Kidney Diseases, NIH.
All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the sources is appreciated.
Publication date: 1998
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