URINARY TRACT INFECTIONS

Urinary tract infections

Most urinary tract infections (UTIs) are caused by bacteria that live in the digestive system. These bacteria can move into the urinary tract which is usually sterile and multiply there causing an infection.

Infections can involve the urethra (urethritis), bladder (cystitis), kidneys (pyelonephritis).  This needs urgent treatment to prevent the infection spreading and the patient becoming unwell.

Symptoms of a cystitis and urethritis can include:

• Needing to urinate more often, a constant, dull pain in the pubic region and pain when urinating (dysuria)
• Cloudy urine or blood in your urine (haematuria)
• Urine that smells unusually unpleasant
• Back pain
• A general sense of feeling unwell

Symptoms of pyelonephritis can include:

• A high temperature (fever) of 38ºC (100.4ºF) or above, uncontrollable shivering, nausea (feeling sick), vomiting and diarrhoea.

Who's at risk of getting a UTI?

Women are more likely than men to have a UTI. This is because in women:

• The urethra is closer to the anus
• The urethra is much shorter in women

You are also more likely to develop a UTI if:

• Your bladder does not empty completely
• You have kidney stones
• You are sexually active
• You have gone through the menopause and the vaginal tissues are thinned
• You have poor fluid intake
• Your immune system is poor
• You have a urinary catheter.
•  

Investigations are required:

• In ALL men with a proven UTI - usually related to poor bladder emptying.
• Recurrent infections in women
• Failure to clear infections with antibiotics
• Blood noted in the urine
• UTIs complicated by pyelonephritis - i.e. loin pain and a high temperature.
• Urinary symptoms in between infections.
•  

Investigations can include:

• Urine culture
• Kidney and bladder ultrasound
• Cystoscopy
•  

To prevent UTIs

• Maintain a good fluid intake spaced out equally throughout the day
• Pass urine regularly
• Avoid constipation
• Empty the bladder before and after intercourse
• Oestrogen cream topically if the vaginal lining is sore
• Cranberry juice/tablets
• D Mannose tablets if the infections are with E coli.
• Prophylactic antibiotics