Urinary Tract Infections (UTI)

Urinary tract infections (UTIs) are infections that can occur in any part of the urinary part, including the urethra, ureters, kidneys, and bladder. UTIs are a common health problem affecting millions of people annually. The chances of getting a urinary tract infection are higher in women. Experts find that 1 in 2 women will at least get one infection in their lifetime, with many women having repeat infections.

UTIs occur when bacteria find their way to the urinary tract through the bladder and then begin to multiply to an unhealthy level. And while the urinary system has its own ways of keeping out such invaders, sometimes those defenses fail. When that is the case, bacteria may take hold and grow into a full-blown infection. The most common UTIs affect the urethra and the bladder.

A UTI may cause:

Urethritis: The urethra is the tube that transports urine from the bladder to the outside of the body. When the bladder is infected, the condition is known as urethritis.

Cystitis: This is an infection that affects the bladder and usually occurs when the urethra has been infested by germs or bacteria Escherichia coli (E. coli), commonly found in the gastrointestinal tract, especially the colon.

Pyelonephritis: When an infection has spread up the urinary tract, or the tract has been blocked, the kidneys can also be affected. Typically, urine backflows into the kidneys and ureters when the urinary tract is obstructed.

Abscess: When any part of the urinary tract has been infected, pus may collect along the affected area.

UTIs can be categorized as either simple or complicated. Simple UTI usually affects individuals with normal urinary tracts. This type of UTI occurs most frequently in women. Complicated UTIs, on the other hand, occur in people with abnormal urinary tracts or individuals who have other medical conditions that increase the chances of treatment failure. Complicated UTIs are more likely to affect men and children.

Causes of UTIs in Women

Normal urine is sterile and contains waste products, salts, and fluids. It doesn’t contain viruses, bacteria, or fungi. Urinary tract infections are the primary reason we’re usually told to wipe from front to back following a bowel movement. This is due to the fact that the urethra is located close to the anus. Bacteria from the gastrointestinal tract (mostly E. coli) are in the perfect position to leave the anus, find their way to the urethra and start multiplying. From there, they can move up to the bladder or continue on to infect the kidneys if the infection isn’t treated promptly.

While UTIs are not transmitted from one person to another like STDs, bacteria may enter the urethra during sexual activity when bacteria from your partner’s fingers, anus, genitals, or sex toys get pushed into your urethra. The risk also increases when you have a new sexual partner. However, you don’t have to be sexually active to develop a UTI. A urinary tract infection can be caused by anything that brings bacteria in contact with your urethra.

All women are at risk of developing a UTI because of their anatomy. A woman has a shorter urethra than a man, which shorten that distance from the urethral opening to the rectum, where bacteria that cause UTI are known to dwell. The short distance allows bacteria to easily travel to reach the bladder. In addition, because the urethra is close to the vagina, STDs such as gonorrhea, herpes, mycoplasma, and chlamydia can cause urethritis.

Certain types of birth controls (contraceptives), such as diaphragms and spermicidal agents, may increase the risk of developing a UTI. Another risk factor specific to women for UTIs is menopause. When menopause kicks in, the levels of circulating estrogen decline, causing changes that increase vulnerability to infection.

Other risk factors for developing UTIs include:

  • A suppressed immune system: The risk of UTIs can increase if you have diabetes or another disease that compromises the immune system and weakens the body’s defense against bacteria and germs.

  • Blockages in the urinary tract: Enlarged prostate or kidney stones can make it hard to empty the bladder completely, which can cause a UTI if the urine remains in the bladder for too long.

  • Structural abnormalities in the genitourinary tract: Abnormalities in the urinary tract may cause urine to back up in the urethra or not leave the body normally, predisposing someone to UTIs.

  • Catheter use: Individuals who use a catheter to drain urine have an increased risk of UTIs. This may include individuals who are paralyzed, those who are hospitalized, or those with neurological problems that make it difficult to control the ability to urinate.

  • A urinary procedure: Surgery in the genitourinary tract or a urinary tract exam involving medical instruments may introduce bacteria into the urinary tract and can predispose someone to UTIs.

  • Use of douches and feminine hygiene powders or sprays

  • Urinary incontinence

  • Previous urinary tract infection

  • An extended period of immobility such as during recovery from illness or injury

  • Retaining urine for an abnormally prolonged period

  • Multiple sclerosis

  • Spinal cord injuries

  • Nerve damages around the bladder

  • Parkinson’s disease

Complications of a UTI

When treated properly and promptly, lower UTIs rarely lead to serious problems since they are simple and easy to treat. But if left untreated, a UTI can have serious consequences. When a UTI gets complicated, that means that it can’t be completely cured with regular treatment. As such, the regular treatment with antibiotics may bit be enough to help someone get better. The most common UTI complications include:

  • Permanent kidney damage due to acute or chronic kidney infection. This can affect the way the kidneys work and lead to high blood pressure, kidney scars, and other issues. This can also be life-threatening.

  • Urethral narrowing from recurrent urethritis

  • Recurrent infections including two or more UTIs within 6 months or four or more infections within a year

  • Increased risk in pregnant women giving birth to premature or low birth weight infants. Pregnant women also face the risk of anemia and high blood pressure.

  • If the infection moves from the urinary tract to the kidneys, it may cause sepsis- a potentially life-threatening complication. When there’s an infection, the body releases chemicals into the bloodstream to fight it. But if the body’s response to the chemicals is out of balance, there may be changes that can lead to multiple organ failure. In some serious cases, the condition may progress to septic shock, sepsis, multi-organ failure, or even death.

Symptoms of a UTI

Signs and symptoms of a UTI include:

  • Frequent urination

  • Pain or burning when urinating

  • Sudden, intense, and persistent urge to urinate (bladder spasm), even though little comes out when you go

  • Foul odor to the urine

  • Pain, soreness, cramps, or pressure in your lower abdomen, mid-back, or sides

  • A sense of incomplete emptying of the bladder

  • Urine that is cloudy, reddish, milky, or dark in color

  • Loss of bladder control (urinary incontinence)

  • Fever or chills

  • Feeling tired or shaky

  • Fatigue

  • Pain during intercourse

  • Vaginal irritation

  • Pus discharge from the urethra

  • The general feeling of being unwell

If a bladder infection has migrated to the kidneys, pyelonephritis may cause systemic symptoms that are frequently debilitating. Symptoms may include:

  • Body chills

  • A high fever

  • Nausea or vomiting

  • Rigors (sweating and shivering accompanied by a rise in temperature)

  • Flank pain- deep and high in the back or sides, or the upper abdomen

  • Abnormal rapid heart rate

  • Difficulty breathing

Symptoms of a UTI are also common with other infections such as vaginitis or STDs. It’s important to see a doctor right away to have the condition diagnosed and treated immediately to prevent worsening or developing kidney infections.

How Urinary Tract Infections Are Diagnosed

While UTIs can cause a great deal of discomfort and pain, the first step in finding relief is seeking a diagnosis. What’s more, prompt diagnosis and treatment can help prevent potentially serious complications of urinary tract infections. There are different tests and procedures that can be used to diagnose UTIs, including:

Urine tests: If your doctor suspects a possible UTI, you’ll most like be requested to provide a urine sample to analyze red blood cells, white blood cells, bacteria, the presence of nitrites, or a lot of protein. To avoid potential contamination of the sample, the urine of often collected according to “the clean catch method.” You may be instructed to use an antiseptic cleansing pad to clean your genital area before providing the urine. Unlike many other tests, there usually no need to follow other special instructions.

The urine sample can be used to perform urinalysis, which is the physical, microscopic, and chemical examination of urine. Urinalysis can diagnose infection in most cases. A urine bacteria culture test may be used as a follow-up to the lab analysis of the urine. This can help identify the specific bacteria as well as isolated bacterial organisms causing the urinary tract infection and which medication will be the most effective.

Imaging: If the infection becomes a repeated problem that your doctor thinks may be as a result of a urinary tract abnormality, further testing can be done to see if that’s the case. Imaging techniques such as ultrasounds, magnetic resonance imaging (MRI), or a computerized tomography (CT) scan can be used to provide images of your urinary tract. The images can help determine the shape and size of your kidneys and bladder, and check for cysts, kidney stones, a mass, or other abnormalities or blockages. Your doctor may use a contrast dye injected into a vein to highlight the urinary tract structures. This also checks blood flow in the kidneys.

Cystoscopy: In this test, a long, thin instrument (cystoscope) is used to look inside your urethra. Cystoscopy is recommended for women who have recurrent UTIs. The cystoscope features a lens at one end, a tube in the middle, and an eyepiece at the opposite end. The cystoscope is gently inserted in the urethra to examine the bladder and the lining of the urethra. It provides detailed images of the urinary tract and can help determine if there are blockages or structural changes, such as stones or tumors.

How Urinary Tract Infections Are Treated

Since UTIs are commonly caused by bacteria, antibiotics or antimicrobials are the most common treatment options. The type of medication and the length of treatment will be based on your age, your medical history and overall health, and the symptoms and severity of your condition. The full course of treatment for UTIs should be completed to reduce the risk of antibiotic resistance and makes sure that the infection is completely gone. This is important because the symptoms can disappear before the infection is fully clear.

The medication and dose prescribed will also depend on whether the UTI is complicated or uncomplicated. An uncomplicated UTI occurs in a person who’d be considered healthy with a normal urinary tract. This type of UTI can typically be cured with 2 to 3 days of treatment with antibiotics. A complicated UTI occurs in a person with another condition that weakens the body, such as heart transplant or pregnancy. This tends to require longer periods of treatment, typically between 7 to 14 days. In-office treatment with intravenous, high-dose antibiotics may be necessary for severe UTI or pyelonephritis. Also, a person may need to be admitted to a hospital if seriously ill. This helps make sure that they receive the right medication and take in sufficient fluids. If there’s an underlying issue within the urinary system that’s responsible for the UTI, it should be found and corrected to cure the infection and prevent potential UTI complications.

If you have recurrent infections, you may be advised to take a single, daily dose of an antibiotic for about six months or a single dose after sexual contact. You may also have to take a 2 to 3-day course if symptoms reappear. Those who have already had menopause may be required to undergo vaginal estrogen therapy.

In addition to treatment with antibiotics, it’s important to drink lots of fluid and frequently urinate to help flush out the bacteria. Applying a heating pad to the abdomen and back as well as taking pain relief medication may help alleviate pain. You may also need to make lifestyle changes such as quitting smoking and avoiding alcohol, coffee, and spicy foods.

Find an OB-GYN Near Me

If you have any symptoms of a UTI or are feeling discomfort or pain contact Los Angeles OBGYN to schedule an appointment with one of our expert obstetricians. Call 310-375-8446 Today!