Urinary Tract Infection: Clinical Perspectives on Urinary Tract Infection Hardcover
by Abhay Rane (Editor), Ranan Dasgupta (Editor)
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From the Back Cover
The causative organisms of Urinary Tract Infection are dynamic in terms of their virulence and resistance patterns, leading to challenges in the prevention and treatment of urinary infection. This is of relevance in both primary and secondary care, and many of the challenges are similar in both developed and developing countries alike. UTI is also associated with considerable cost in terms of morbidity, economic and research expenditure.
Written by an exceptional and well-known team of clinical experts, the purpose of Urinary Tract Infections addresses key questions facing physicians about this condition. This book is written primarily for general physicians who wish to have a broad understanding of a number of important issues concerning infection in parts of the urinary tract. Specialists may also find the book useful as a quick reference guide.

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Urinary Tract Infections

It was only third period, but Tracy had already visited the bathroom
six times that morning. Sometimes she barely had time to ask the teacher
for permission because the urge to pee was so intense. Did she drink
too much orange juice for breakfast? Nope — although she really had to
go, only a little urine came out each time. And every time she peed, she
felt a burning sensation. What was going on?

Tracy's experience is not unusual. Her problem, a urinary tract infection, is one of the most common reasons that teens — especially girls — visit a doctor.




What Is a Urinary Tract Infection?



A bacterial urinary tract infection (UTI) is the most common kind of infection affecting the urinary tract.
Urine, or pee, is the fluid that is filtered out of the bloodstream by
the kidneys. Urine contains salts and waste products, but it doesn't
normally contain bacteria. When bacteria get into the bladder or kidney
and multiply in the urine, a UTI can result.

There are three main types of UTI. Bacteria that infect only the urethra (the short tube that delivers urine from the bladder to the outside of the body) cause urethritis (pronounced: yur-ih-threye-tis). Bacteria can also cause a bladder infection, which is called cystitis (pronounced: sis-tie-tis). Another, more serious, kind of UTI is infection of the kidney itself, known as pyelonephritis (pronounced: pie-low-nih-fry-tis). With this type of UTI, a person often has back pain, high fever, and vomiting.

The most common type of UTI, the bladder infection, causes mostly
just discomfort and inconvenience. Bladder infections can be quickly and
easily treated. And it's important to get treatment promptly to avoid
the more serious infection that reaches the kidneys.

Bacteria Are to Blame

UTIs are usually caused by E. coli, bacteria that are normally found in the digestive tract and on the skin around the rectal and vaginal areas. When the bacteria enter the urethra, they can make their way up into the bladder and cause an infection.

Girls get urinary tract infections much more frequently than guys, most likely due to differences in the shape and length of the urethra. Girls have shorter urethras than guys, and the opening lies closer to the rectum and vagina where bacteria are likely to be. Some people seem to get frequent UTIs, but they often have other problems that make them more prone to infection, like an abnormality in the urinary tract structures or function. The most common functional problem of the urinary tract is called vesicoureteral reflux (pronounced: veh-zi-coe-you-ree-tur-al), a condition in which some urine flows backward, or refluxes, from the bladder into the ureters and even up to the kidneys.

There are several ways bacteria can get into the urethra. During sexual intercourse, the bacteria in the vaginal area may be pushed into the urethra and eventually end up in the bladder, where urine provides a good environment for the bacteria to grow. This is the reason why females who are sexually active often get UTIs (UTIs are not contagious, so you can't catch a urinary tract infection from someone else). Bacteria may also be introduced into a girl's bladder by wiping from back to front after a bowel movement, which can contaminate the urethral opening. The use of spermicides (including condoms treated with spermicide) and diaphragms as contraceptives may also increase the risk of getting a urinary tract infection.

Sexually transmitted diseases (STDs) may cause UTI-like symptoms, such as pain with urination. This is due to the inflammation and irritation of the urethra or vagina that's sometimes associated with chlamydia and other STDs. If untreated, STDs may lead to serious long-term problems, including pelvic inflammatory disease (PID) and infertility. Unlike UTIs, STDs are contagious.
Symptoms of UTIs



There are a number of symptoms associated with UTIs. With bladder infections, symptoms may include:

• frequent urination
  
• burning or pain during urination
  
• the feeling of having to pee even though little or no urine actually comes out
  
• pain in the lower abdomen
  
• pain above the pubic bone (in women)
  
• a full feeling in the rectum (in men)
  
• bloody or foul-smelling urine
  
• mild fever
  
• a general feeling of shakiness and fatigue
  

A kidney infection may involve more serious symptoms, including:

• high fever
  
• chills
  
• nausea and vomiting
  
• abdominal pain
  
• cloudy or bloody urine
  
• pain in the back, just above the waist
  

If you have any symptoms of a urinary tract infection, you'll need to
go to a doctor right away. The symptoms won't go away if you ignore
them — they'll only become worse. The more quickly you begin treatment,
the less uncomfortable it will be.

Call your doctor's office or clinic immediately. If you can't reach
your doctor, you can visit an urgent care center or hospital emergency
room. The most important thing is to take action as soon as possible.Battling the Bacteria

Only your health care provider can treat urinary tract infections.
The first thing a doctor will do is confirm that a person has a UTI by
taking a clean-catch urine specimen. At the doctor's office, you'll be
asked to clean your genital area with disposable wipes and then urinate
into a sterile (bacteria-free) cup.

If an infection is suspected when the specimen is examined, a doctor
will probably prescribe antibiotics. Because there are many different
antibiotics available, the doctor may send the urine specimen for a
urine culture, which is a test to identify the exact type of bacteria
causing your infection. It takes about 48 hours to get results from a
urine culture, and a doctor may ask patients to switch antibiotics
depending on the results.

Although antibiotics begin fighting the infection right away, they
can't stop all the symptoms immediately. If someone has a lot of pain
from a UTI, the doctor may recommend a medication to help relieve the
spasm and pain in the bladder. This will turn urine a bright orange
color, but it's harmless and will usually make a person much more
comfortable within hours. In the case of a kidney infection, a doctor
may prescribe pain medication.

For some infections, a person may only have to take antibiotics for 3
days, but usually people with UTIs stay on medication for 7 to 14 days.
It's important to take the antibiotics until the prescription is
finished. Many people stop taking medication when they begin to feel
better, but that doesn't allow the antibiotics to completely kill the
bacteria, which increases the risk that the infection will reappear. If
you've been diagnosed with a UTI and symptoms continue after you've used
up all your medication or if your symptoms aren't much better after 2
to 3 days of treatment, contact your doctor.

It's important to drink lots of water during and after treatment
because each time you urinate, the bladder cleanses itself a little bit
more. Cranberry juice may also be helpful. People with UTIs should avoid
coffee and spicy foods. And, while it's always a good idea to quit smooking, this is especially true for people who have a UTI or are prone to getting UTIs because smoking is linked to bladder problems.

People who get a doctor's help for a UTI right away should be clear
of symptoms within a week. For a more serious kidney infection, most
people have to return to the doctor's office for a follow-up visit to
ensure that the infection has responded completely to the medication.

In either case, a doctor may tell people with UTIs to avoid sexual
intercourse for a week or so, which allows the inflammation to disappear
completely.Preventing UTIs



There are several ways people may be able to prevent urinary tract infections. After urination, girls should wipe from front to back
with toilet paper. After bowel movements, be sure to wipe from front to
back to avoid spreading bacteria from the rectal area to the urethra.

Another thing both girls and guys can do to prevent UTIs is to go to
the bathroom frequently. Avoid holding urine for long periods of time.

Males and females should also keep the genital area clean and dry. Girls should change their tampons and pads regularly during their periods.
Frequent bubble baths can cause irritation of the vaginal area, so
girls should take showers or plain baths. Avoid prolonged exposure to
moisture in the genital area by not wearing nylon underwear or wet
swimsuits. Wearing underwear with cotton crotches is also helpful. And
girls should skip using feminine hygiene sprays or douches — these
products can irritate the urethra.

If you are sexually active, go to the bathroom both before and within
15 minutes after intercourse. After sex, gently wash the genital area
to remove any bacteria. Avoid sexual positions that irritate or hurt the
urethra or bladder. Couples who use lubrication during sex should use a
water-soluble lubricant such as K-Y Jelly.

Finally, drinking lots of water each day keeps the bladder active and bacteria free.

Remember that although urinary tract infections are uncomfortable and
often painful, they are very common and easily treated. The sooner you
contact your doctor, the sooner you'll be able to get rid of the
problem.
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