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Understanding Urinary Tract Infections

A Physician Answers Your Questions About This Common Condition

iStock 000026447250SmallWhat is a UTI? A Urinary Tract Infection or “UTI” is an overall term used to describe an infection that occurs anywhere in the body’s urinary system. The urinary tract includes the kidneys, bladder, ureters, and urethra—organs used to filter, process, store, and eliminate waste from the body in the form of urine. UTIs are often caused by bacteria that live on the outside of the body making their way into the internal organs of the urinary system (although there can be other, more complicated, reasons for UTIs, as well). There are different types of UTIs but bladder infections are, by far, the most common. People of both genders can get UTIs, although they occur more frequently in women due to the structure of their anatomy

How do I know if I have a UTI? The typical symptoms of a UTI may include:

  1. Pain or discomfort when urinating
  2. Need to urinate more frequently
  3. Cloudy or bloody urine, sometimes with a significant odor
  4. Vague discomfort in the pelvic area
  5. Sometimes, fever

It’s important to note that in the geriatric population, especially with those in nursing homes, UTIs can also manifest with much more vague symptoms. For example, a person may appear more confused, more fatigued, or more anxious/upset about things than usual. When a person’s state of wellbeing has changed and s/he is not able to give a clear history of what’s going on, the physician should consider the possibility of a UTI.

If you suspect that you have a UTI, your primary care provider will order lab tests on a sample of your urine to look at your red and white blood cell count and to determine whether there are any bacteria growing (and, if there are, what type).  

iStock 000011324214SmallHow are UTIs treated? Most UTIs respond well to treatment with antibiotics. Sometimes we can tailor the medication to the specific bacteria which is growing and, other times, we may choose to use what we call a “broad spectrum” antibiotic that will address many different types of bacteria. The course of treatment will vary depending on the patient and the type of UTI from a few days to a couple of weeks.

Some women experience frequent, recurring urinary infections. In this case, the physician may consider using “prophylaxis”—an ongoing, daily small dose of antibiotic, sometimes rotating different types of antibiotics. Many women find that this significantly decreases the frequency of their UTIs.

Do UTIs cause incontinence?
Unfortunately, UTIs can cause incontinence because they create the need to urinate frequently and urgently. Even if you normally have good bladder control, the infection can make it difficult to hold your urine. This condition is typically resolved when the infection is cured.

What about catheters?
Patients who have a urinary catheter (a tube to remove urine from the body) are at a greater risk for UTIs. The catheter increases the probability that bacteria will get into the bladder and an infection may result. For this reason, catheters should be changed regularly using proper protocols.  

Do men get UTIs? Yes, men also get urinary infections, and they are sometimes associated with prostate problems. An enlarged prostate can partially obstruct the flow of urine, creating a higher risk for bladder infections. And the symptoms of a prostate infection can mimic those of a UTI.

When should I see a doctor? If you think you have a UTI, it’s best to get in to see your doctor right away to discuss the symptoms and get a good urinary study. Now, there are some patients who have recurring infections. You know the symptoms and you know exactly which antibiotic has worked for you in the past. In certain cases, particularly when you have a good, established relationship with your physician, the doctor may be willing to treat the infection without an office visit.

(As an aside, I strongly encourage you to find a primary care provider you like and trust, someone with whom you can build a solid, long term relationship. It will serve you well throughout the years to have a clinician who knows you and your history.)

What about surgery? Some women experience significant urinary infections and incontinence because of underlying anatomical issues, specifically, considerable pelvic floor weakness. In these cases, a urologist or uro-gynecologist can help you examine surgical options that may correct the anatomical alignment and reduce the symptoms.

iStock 000024755015SmallHow can I prevent a UTI?
The best ways to protect your body from getting a UTI include:

  1. Stay hydrated. Drink plenty of water every day to flush your urinary tract.
  2. Practice good hygiene. Keep the anal/genital/perineal area clean. And women should wipe from front to back after toileting to prevent undesirable bacteria from entering the vagina or urethra. Taking showers instead of baths may also reduce the probability of bacteria entering the body.
  3. Don’t hold it. Go to the bathroom when you feel the need to urinate, and empty your bladder completely.
  4. Try cranberries. Cranberry juice or tablets can help reduce the risk of UTI recurrence.

As always, I encourage you to consult your primary care provider with any concerns and questions you may have about your health and wellness.

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