Urinary Tract Infection
What Is Urinary Tract Infection (UTI)?
Urinary tract infection or UTI occurs when bacteria is present within the urinary tract in significant numbers. 20% of women aged 20 - 65 years suffer at least one attack per year. Approximately 50% of women will experience UTI at lease once during their life span.
What Are The Symptoms Of UTI?
The onset of UTI can be associated with one or more of the following symptoms:
- Passing urine more frequently than normal
- "Burning" pain on passing urine
- The urge of having to pass urine quickly
- Passing blood-stained or cloudy urine
- Passing foul-smelling urine
- Lower abdominal or loin pain
- Fever
If you have any of the above symptoms, it is advisable to see a doctor early.
What Causes UTI?
UTI is usually caused by organisms originating from the intestines. In 80 - 90% of first infections, the bacteria Escherichia coli is involved.
What Are The Predisposing Factors?
The occurrence of UTI varies with age and sex. The incidence of UTI is 10 times higher in adolescent girls as compared with boys and this continues throughout adult life. The following are predisposing factors:
- Diabetes mellitus
- Foreign bodies (e.g. catheters, urinary tract stones)
- Recent instrumentation of the urinary tract (e.g. catheterisation, cystoscopy, after urodynamic studies)
- Neurological disorders or drugs that may cause incomplete emptying of the bladder
- Co-existing diseases involving the pelvis (e.g. tumours, inflammatory bowel disease)
- Sexual activity
What Happens If UTI Is Left Untreated?
If UTI is left untreated, the infection can spread upwards to the kidneys, causing infection in the kidneys and even renal failure. It can also spread via the blood stream (septicaemia) to affect the body in general, which may be fatal.
What Are The Investigations And Treatment?
To confirm the diagnosis of UTI, a sample of your urine will be sent to the laboratory for testing. Empirical antibiotics will usually be prescribed. You may be prescribed alternative antibiotics after the urine culture result is available. You may also be given medication to make the urine more alkaline and asked to drink more water.
Recurrent UTI
It is defined as having UTI three times or more within a year. It can be due to the same species or different bacteria.
If you have recurrent UTI, further tests such renal ultrasound, intravenous pyelogram, cystoscopy, urine for tuberculosis and cytology are necessary to identify the causes and complications of recurrent UTIs.
You may also be given prophylactic antibiotics for a period of 6 months. You will be advised on good personal hygiene and other preventive measures.
Prevention Of UTI
Although UTI can be easily treated with antibiotics, the prevention of UTIs or the avoidance of further infection is more important.
As the source of the bacteria comes from one's own bowel, it is important to wipe yourself from front to back in order to avoid faecal contamination of the urinary tract (especially during an episode of diarrhoea) after going to the toilet.
Potential irritating vaginal deodorants and bubble baths should be avoided and a high standard of personal hygiene should be maintained at all times.
This involves washing the genital area with water during bath and especially after intercourse (as intercourse is a common predisposing factor for UTI). Voiding soon after intercourse is also encouraged.
Any vaginal / lower genital tract infection should be treated, otherwise the infection may spread to the urinary tract.
In order to prevent recurrent UTI, a minimum fluid intake of 2 litres a day is recommended (more if exercising strenuously or on hot days). Oral fluids should be increased to 3 litres or more a day if symptoms of UTI are suspected, irrespective of the degree of frequency of urine. Regular and complete bladder emptying is advisable to prevent the accumulati9on of infected urine in the bladder.
Conclusion
As UTI is a common occurrence in women, one should be aware of the symptoms of UTI. Early recognition and appropriate treatment is necessary to prevent complications.