By The Bladder Health Council
The Bladder Health Council is one of six Health Education Councils of the A.F. U.D. The men and women who make up these councils are responsible for the high quality and accuracy of Foundation patient information.
Urinary tract infections are very common. In the United States, as many as ten million visits are made to physicians each year to seek treatment for urinary tract infections. In most cases, these infections are easy to cure, as long as the patient follows the doctor's advice. This article is designed to answer your questions about urinary tract infections - what they are, what causes them, how they are treated, what you can do to get the most benefit from the treatment your doctor recommends, and what you can do to prevent future infections.
What is a Urinary Tract Infection?
The urinary tract makes and stores urine, one of your body's liquid waste products. The kidneys produce one and a half to two quarts of urine every day by removing waste and water from the blood. The urine travels from the kidneys down two narrow tubes, the ureters. It is then stored in a balloon like container, the bladder.
In an adult, the bladder can hold ten to twenty ounces of urine (about as much liquid as in one can of soda). When the bladder is about half full, you may begin to feel the need to empty it by urinating. Urine is carried out of the body through the urethra, a tube at the bottom of the bladder. The opening of the urethra is at the end of the penis in men and in front of the vagina in women.
Normal urine contains no bacteria, but bacteria do cover your skin and are present in large numbers in the rectal area and in your bowel movements. Bacteria may, at times, get into the urinary tract and the urine and may travel up the urethra into the bladder. When this happens, the bacteria cause infection and inflammation of the bladder. In other words, they multiply, causing redness, swelling, and pain. Bladder infection, also called cystitis, is the most common urinary tract infection.
If the bacteria travel upward from the bladder through the ureters and reach the kidneys, you may develop
kidney infection, also known as pyelonephritis. Kidney infections are much less common but often more serious than bladder infections.
What Are the Signs of a Urinary Tract Infection?
When you have a urinary tract infection, the lining of the bladder and urethra becomes red and irritated, just as the inside of your nose and throat does when you have a cold. The irritation can cause pain in your abdomen and pelvic area and may make you feel the need to empty your bladder often.
Your need to urinate may seem urgent; but, when you try to do so, you may only produce a few drops of urine. In addition, you may feel a burning sensation as the urine comes out. It may even be hard to control; in fact, some urine may leak out onto your clothing. You may notice that the urine has an unpleasant odor or a cloudy look. At times, bladder infections may also cause low back pain, fever, or chills.
Kidney infections produce fever and back pain much more commonly than do bladder infections. If a kidney infection is not treated promptly, the bacteria may spread to the blood and cause a life-threatening situation.
In an infant or young child, the signs of a urinary tract infection may not be clear, especially if the child is too young to tell you just how he or she feels. Instead, the child may be irritable, not eat as much as usual, have a fever or loose bowel movements, or just not seem healthy. If the symptoms last more than a day, they may signal the need to see a doctor.
How Do You Find Out Whether You Have a Urinary Tract Infection?
Only by consulting a doctor can you find out for certain whether you or your child has a urinary tract infection. If you think that such an infection might be present, check with your doctor. If you see blood in the urine, you should see your doctor right away. Because bloody urine is not normally caused by an infection, it may mean that you have a different urinary tract problem.
Your doctor will try to find out whether you have a urinary tract infection by examining samples of your urine under a microscope. If an infection is present, the physician may be able to see bacteria and pus. The doctor may also perform a urine culture, a process in which bacteria from infected urine are grown in a laboratory. The germs can then be identified and tested to see which drugs will provide the most effective treatment. It often takes a day or two to complete this testing.
How Are These Infections Treated?
Urinary tract infections are treated with antibiotics (infection-fighting drugs), which are generally taken orally. Your doctor will choose a drug that treats the bacteria most likely causing your infection. Once the test results are in, however, the physician may switch you to another antibiotic - one that is more effective against the particular bacteria found in your urine.
The number of days you must take medication and the number of doses you must take each day depend, in part, on the type of infection you have and how severe it is. Usually, you will have to take the medicine for at least two to three days and possibly for as long as several weeks. The daily treatment schedule your doctor recommends depends on the specific drug prescribed - it may call for a single dose each day or up to four doses daily.
A few doses of the antibiotic may relieve you of the need to urinate often and most of the pain from a bladder infection. It may be several days, however, before the bladder infection and its symptoms vanish completely. In any case, it is important to take the medicines as prescribed by your doctor and not to stop them simply because the symptoms have gone away. Unless urinary tract infections are fully treated, they frequently return.
When you have a urinary tract infection, you should drink fluids whenever you are thirsty. It is not necessary to drink large amounts, but you should make certain that your body has the liquid it needs.
If the urinary tract infection is severe, it may involve the kidneys. In that case, antibiotic drugs may have to be injected. Hospital treatment with medication given intravenously is sometimes necessary.
Why Do You Get a Urinary Tract Infection?
Some people, mainly women, develop urinary tract infections because they are prone to such infections the way other people are prone to getting coughs or colds. Urinary tract infections are much less common in men and children than in adult women.
In an adult, the bladder can hold ten to twenty ounces of urine (about as much liquid as in one can of soda).
A number of factors may increase a person's risk of getting a urinary tract infection. Some of these factors include:
• Having certain diseases (such as diabetes) or an abnormal urinary system
• Recently having had a medical instrument inserted into the urethra
• Sexual contact
A urinary tract infection in a man or child may be the sign of an abnormal urinary tract. For this reason, when men or children are found to have a urinary tract infection, they may be
referred to a urologist (a specialist in diseases of the urinary system and the male reproductive system) for additional tests and x-rays.
Will You Need Further Tests After the Infection is Gone?
Once your infection has cleared, your doctor may recommend that you have additional tests. These tests are performed to assure that there are no abnormalities in the urinary tract that might result in kidney damage from urinary tract infections. Certain types of patients are most likely to need these additional tests; these types include:
• Young children
• Men
• People who have urinary tract infections that are frequent or that won't go away with treatment
• People who have had fever with infection
• People who have had blood in the urine
What Else May Feel Like a Urinary Tract Infection?
The symptoms of a urinary tract infection may resemble those of other urinary tract diseases. If no infection can be found or the infection won't go away, your doctor may refer you to a urologist to find out why. Other problems that the urologist may look for are described below:
• Urethritis may be either an inflammation or an infection in the urethra. When infection is present in the urethra, the condition is often due to bacteria passed by sexual contact.
• Interstitial cystitis is a bladder irritation found mainly in adult women, with symptoms including urinary frequency, urgency, and bladder pain.
• Urinary stones sometimes develop within the bladder, they cause irritating symptoms similar to those of a urinary infection. Stones can have bacteria inside them that can trigger hard-to-cure infections.
• Bladder tumors (cancer or noncancerous growths), when present, may irritate the bladder. The symptoms often include a frequent need to urinate and, possibly, blood in the urine.
• Prostatitis is an inflammation or infection in the male gland, the prostate, which surrounds the urethra just below the bladder. In adult males, prostate disorders may cause symptoms that resemble those of urinary tract infections.
Do Urinary Tract Infections Have Long term Effects?
Urinary tract infections in most adults can be successfully treated without causing any long-term problems.
Young children have the greatest risk for kidney damage from urinary tract infections. Such damage may lead to poor kidney function, high blood pressure, and other problems. For this reason, it is important that children with urinary tract infections receive prompt treatment and careful checkups.
Pregnant women with a history of repeated urinary tract infections should have their urine tested often. Urinary tract infections during pregnancy can cause serious kidney infections in the mother and possible risks for the baby.
What Steps Can You Take to Help Prevent These Infections?
The following are steps you can take to reduce your risk of getting a urinary tract infection
• Don't postpone - urinate when you feel the urge
• Don't rush - take the time when you urinate to empty your bladder completely
• Respond to your body's signals of thirst by drinking plenty of liquids every day
• Urinate after having sex.
Consult your doctor at the first sign of a problem. Urinary tract infections are very common and they are easiest to treat if caught before they become severe or spread beyond the bladder.
Volumn VI Issue 2 -FAMILY UROLOGY 23
