Urinary Tract Infection

What are urinary tract infections?

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In health, bacteria is only found at the lower end of the urethra and the remainder of the urinary tract is sterile. If bacteria grow on any other part of the urinary tract and causes symptoms, a urinary tract infection (UTI) is said to occur.

UTI is very common in females. Up to 50% of women have a UTI at some time. In males UTI is uncommon, except in the first year of life and in men over 60.

Urine is an excellent culture medium for bacteria. In women, due to their shorter urethra, the ascent of organisms into the bladder is easier than in men. Sexual intercourse may cause minor urethral trauma and transfer bacteria from the outside into the bladder. Passing instruments like catheters into the bladder may also introduce organisms.

What are the symptoms?

Typical features of bladder and urethral infections include:

• Sudden onset of increased frequency of urination and urgency to pass urine

• Scalding pain in the urethra during urination

• Pain above the pubic bone during and after urination

• Intense desire to pass more urine after urination

• Urine that may appear cloudy and have an unpleasant odour

• Blood in the urine

What treatments work?

Antibiotics are recommended in all cases of proven UTI. The doctor may start treatment while waiting for lab results to determine the actual organism causing the UTI. They may either continue with the treatment if it’s effective or change the antibiotics based on the organism involved.

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What will happen to me?

UTI may keep coming back even after treatment, especially in the presence of an underlying cause e.g. a bladder outflow obstruction, diabetes mellitus or presence of foreign bodies such as a urethral catheter. In this case, permanent kidney damage may occur.

 

If the underlying cause cannot be removed, the doctor may prescribe suppressive antibiotic therapy to reduce the rate of recurrence to prevent kidney damage.