Urinary Tract Infections

Urinary tract infections (UTIs) account for nearly 10 million doctor visits each year. At least one in every five women will have one urinary tract infection in her lifetime. Other names for UTIs are cystitis or bladder infections. A UTI occurs when bacteria get into the bladder and multiply. About 80 to 90 percent of UTIs are caused by the bacteria E. coli, which normally lives in your intestines.

Common symptoms of UTIs are: a strong, persistent urge to urinate; a burning sensation when urinating; passing frequent, small amounts of urine; urine that appears cloudy; urine that appears red, bright pink or cola-colored—a sign of blood in the urine; strong-smelling urine, and pelvic pain, in women—especially in the center of the pelvis and around the area of the pubic bone.

Risk factors specific to women for UTIs include:

• Female anatomy: A woman has a shorter urethra than a man does, which shortens the distance that bacteria must travel to reach the bladder.

• Sexual activity: Sexually active women tend to have more UTIs than do women who aren’t sexually active. Having a new sexual partner also increases your risk.

• Certain types of birth control: Women who use diaphragms for birth control may be at higher risk, as well as women who use spermicidal agents.

• Menopause: After menopause, a decline in circulating estrogen causes changes in the urinary tract that make you more vulnerable to infection.

• Urinary tract abnormalities: Babies born with urinary tract abnormalities that don’t allow urine to leave the body normally or cause urine to back up in the urethra have an increased risk of UTIs.

• Blockages in the urinary tract: Kidney stones or an enlarged prostate can trap urine in the bladder and increase the risk of UTIs.

• A suppressed immune system: Diabetes and other diseases that impair the immune system—the body’s defense against germs—can increase the risk of UTIs.

• Catheter use: People who can’t urinate on their own and use a tube (catheter) to urinate have an increased risk of UTIs. This may include people who are hospitalized, people with neurological problems that make it difficult to control their ability to urinate, and people who are paralyzed.

• A recent urinary procedure: Urinary surgery or an exam of your urinary tract that involves medical instruments can both increase your risk of developing a urinary tract infection.

When treated promptly and properly, lower urinary tract infections rarely lead to complications. But if left untreated, a urinary tract infection can have serious consequences. Common complications may be recurrent urinary tract infections, permanent kidney damage if the bacteria travel up to the kidneys, increased risk for pregnant women to deliver low birth weight or premature babies, and possible sepsis which can be life-threatening.

There are steps that a person can take to prevent urinary tract infections. Drinking plenty of water, which dilutes your urine, ensures that you will urinate more frequently and flush the bacteria from the urinary tract before an infection can begin. Wiping from front to back after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the urethra. Empty your bladder soon after intercourse to ensure that the vaginal bacteria do not get into the urinary tract system. Avoid potentially irritating feminine products, such as douches and powders in the genital area that can irritate the urethra. Lastly, change your birth control method from diaphragms or spermicides that can contribute to bacterial growth.

Antibiotics usually are the first line treatment for urinary tract infections. Which drugs are prescribed and for how long depend on your health condition and the type of bacteria found in your urine. Often symptoms clear up within a few days of treatment. But you may need to continue antibiotics for a week or more. For an uncomplicated UTI that occurs when you’re otherwise healthy, your doctor may recommend a shorter course of treatment, such as taking an antibiotic for one to three days. But whether this short course of treatment is enough to treat your infection depends on your particular symptoms and medical history.

Your doctor may also prescribe a pain medication (analgesic) that numbs your bladder and urethra to relieve burning while urinating, but pain usually is relieved soon after starting an antibiotic. If you have frequent UTIs, your doctor may make certain treatment recommendations, such as:

• Low-dose antibiotics, initially for six months but sometimes longer

• Self-diagnosis and treatment, if you stay in touch with your doctor

• A single dose of antibiotic after sexual intercourse if your infections are related to sexual activity

• Vaginal estrogen therapy if you’re postmenopausal

For a severe UTI, you may need treatment with intravenous antibiotics in a hospital. The most important thing to remember is to complete your medication as directed so your infection completely resolves and you can avoid any other complications. 

Melissa Waddell, WHNP. is a nurse practitioner at Atlantic Ob/Gyn located in Va. Beach and Chesapeake. Please call 757-463-1234 or visit www.atlanticobgyn.com.

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