Urinary Tract Infection - Bladder Infection

Introduction

Urinary Tract Infections (UTIs) are a common condition.  Most UTIs result from infection caused by bacteria that enters the urinary tract system.  UTIs can be quite uncomfortable and lead to problems with urination.  Fortunately, most UTIs respond well to prescription medication in a short amount of time. 

Anatomy

Your urinary tract system consists of your kidneys, ureters, bladder, and urethra.  Your kidneys are a pair of bean shaped organs located around your lower back.  They filter waste products and extra fluids from your blood and turn them into urine.  Urine is composed of mainly water and metabolic waste products.  The urine travels through two tubes, called ureters, to your bladder.

Your bladder holds and collects the urine from your kidneys.  When a certain level of urine has accumulated in your bladder, your body signals you to urinate.  Your urethra is the tube that carries the urine from your bladder to outside of your body.  The female urethra is shorter than the male urethra.

Causes

Bacteria that enter the urethra cause the majority of UTIs.  Bacteria normally live in your colon or bowels.  They are also in your stools or bowel movements.  The bacteria can move from your anal area to the opening of your urethra.  This can occur because of poor hygiene and sexual intercourse.

Usually, if bacteria enter the urethra, they are flushed away and removed during urination.  However, if there are too many bacterium, they may not be removed, but instead remain and grow.  The bacteria may cause an infection and travel throughout the urinary tract system.
An infection in the urethra or bladder is termed a “lower urinary tract infection.”  An infection in the urethra is called “urethritis.”  An infection in the bladder is called “cystitis.”  The infection may spread through the urinary tract to the ureters and kidneys.  An infection in this area is termed an “upper urinary tract infection.”  An infection of the kidneys is called “pyelonephritis.”  In general, the higher the location of the infection, such as the kidneys, the more serious it is.

UTIs are categorized as simple infections or complicated infections.  Simple infections can be treated with medications.  They do not spread to other parts of the body.  They may be caused by an abnormality in the urinary tract system.  Complicated infections may spread to other parts of the body.  They can be difficult to treat.  The infection may be resistant to some medications. 

Symptoms

UTIs can cause pain and difficulty with urination.  You may feel pressure or aching over your bladder in your lower pelvic area.  You may have low back and flank pain.  It may hurt, sting, or burn when you urinate.  Your urine may appear cloudy or have blood in it.  Your urine may smell bad or have a strong urine odor.  You may feel like you need to urinate very frequently; however, you may only pass small amounts of urine at a time.  You may urinate several times during the night. 

Diagnosis

Your doctor can diagnose a UTI after reviewing your medical history and your symptoms.  Your doctor will also conduct a physical examination and some tests.  In some cases, doctors may order additional tests to rule out other conditions that may cause symptoms similar to a UTI, such as sexually transmitted diseases, an enlarged prostate gland, or a kidney stone.

Your urine will be examined for the presence of blood, abnormal cells, and bacteria.  This procedure is called a urinalysis.  The test is simple to conduct.  You will provide your doctor with a urine sample.  Your urine will be tested, and your doctor will interpret the results.  In some cases, the urine may be cultured.  This additional test can specify the type of bacteria that is causing the infection and help determine the best medication to treat it. 

Treatment

Most UTIs are treated with antibiotics.  There are several types of antibiotics.  The type of medication you receive depends on the severity, type, and location of your infection.  Medication type and duration may also be dependent on your other health conditions, such as diabetes or pregnancy.  In addition to treating the infection, your doctor can prescribe medication to relieve bladder pain and pain associated with urination.  It is helpful to drink plenty of water.  Most simple UTIs respond well to prescription medication in a short amount of time.

Prevention

There are several ways you can prevent UTIs.  You should keep your genital area clean and wear clean, dry cotton underwear.  You should wipe from front to back after urinating or a bowel movement.  You should drink plenty of fluids.  Drinking cranberry juice may be helpful.

Women prone to UTIs should avoid using birth control methods such as a contraceptive diaphragm and spermicidal jelly.  Women should not douche or using similar feminine hygiene products.  Women and girls should avoid bubble bath products.  Bubble baths do not cause a UTI, but they can irritate the urinary tract. 

You should urinate after sexual intercourse.  Some women consistently develop UTIs after sexual intercourse.  In these cases, doctors can prescribe an antibiotic that is taken after sexual intercourse as a preventive measure.

Am I at Risk

Certain people appear more likely to get UTIs than others.  Females are more susceptible to UTIs than males because their urethra is shorter and located near their anal area.  UTIs are especially common in women between the ages of 20 and 50 years old.  Sedentary or immobile people, such as people in a nursing home or some people of older age are at higher risk for developing UTIs.  Some children develop UTIs.  Girls tend to get UTIs around age three, during the toilet training period.  

Risk factors may increase your likelihood of developing a UTI.  People with all of the risk factors may never develop a UTI; however, the chance of developing a UTI increases with the more risk factors you have.  You should tell your doctor about your risk factors and discuss your concerns.

Risk factors for UTIs:

_____ Women that are pregnant or experiencing menopause are more likely to develop a UTI.
_____ Elderly men and women are more likely to develop a UTI.
_____ People that are immobile or do not move much. For example, people in a nursing home have an increased risk for
developing a UTI.
_____ People with neurological conditions that affect the bladder’s nerve conduction including diabetes, multiple sclerosis, and
spinal cord injuries are more prone to developing UTIs.
_____ People that use a catheter, a tube placed in the body that drains the urine from the bladder to a collection bag, are more
likely to develop infections.
_____ People with a urine blockage, such as from a kidney stone, narrowed urethra, tumor, or enlarged prostate gland are prone to getting UTIs.
_____ People with bowel incontinence, the inability to control when they have a bowel movement, are more likely to develop UTIs.
_____ Not drinking enough liquids can lead to development of a UTI.
_____ Sexual intercourse can increase the risk of getting a UTI, especially in women. Birth control such as a contraceptive diaphragm or spermicides can cause irritation.
_____ Men that participate in anal intercourse have an increased risk for UTIs.
_____ Men that have never been circumcised are at risk for developing UTIs.
_____ People with HIV have a greater risk of getting UTIs.
_____ People with multiple sex partners or who get certain sexually transmitted diseases, such as Chlamydia and mycoplasma, have recently been linked with bladder infections.

Complications

Complicated UTIs can cause a kidney infection.  Kidney infections can be serious and require prompt treatment.  In some cases, the infection can enter the bloodstream and cause sepsis.  Sepsis is a blood infection that can affect your other organs.  This condition also requires prompt treatment.

UTIs can cause complications for pregnant women.  UTIs increase a woman’s risk of delivering her baby early.  Babies that are born early carry the risks associated with prematurity.  Pregnant women susceptible to UTIs may be tested regularly and are sometimes treated with preventative antibiotics.

Some people develop chronic or recurrent UTIs.  This is defined as UTIs that occur twice within a six-month period or at least three times in one year.  Some UTIs may be resistant to antibiotics and difficult to treat.  If you experience recurrent UTIs your doctor may order tests to help determine the best treatments for you.