- A urinary tract infection (UTI) is an infection in any part of the urinary system — kidneys, ureters, bladder and urethra.
- Most commonly it involves the bladder and urethra.
- Kidney infections are more serious.
- Women are affected more commonly than men. These infections are typically treated with antibiotics along with other surgical intervention if required.
Symptoms
- Burning micturition
- Frequent urination
- Lower abdominal pain
- Passing cloudy foul smelling urine
- Persistent urge to pass urine
- Passing blood in urine
UTI types
| Organ involved | Symptoms |
| Kidney (acute pyelonephritis/renal abscess/pyonephrosis/emphysematous pyelonephritis) | Flank pain on involved side Fever with chills Nausea Vomiting Tenderness on palpation |
| Bladder (cystitis) | Lower abdominal pain Frequent small volume urination Burning micturition Blood in urine |
| Prostate (Prostatitis/abscess) | Fever with chills Burning micturition Pus in urine |
| Urethra (Urethritis) | Pus discharge Burning micturition |
Causes of UTI
- Main portal of microbial entry causing UTI is through the urethra.
- Kidney infections sometimes occur secondary to bloodstream infections.
- Women are more prone to infections due to close proximity of urethra to anus and short urethra length.
Risk factors leading to UTI
- Chronic indwelling catheter
- Poorly controlled diabetes mellitus
- Women gender
- Urinary tract abnormality
- Any recent urological surgery
- Stone disease
Prevention
- Daily fluid intake of 2.5-3.0 litre.
- Drinking cranberry juice prevents UTI.
- After passing urine or bowel movement, women should clean from front to back.
- Empty the bladder after intercourse.
- Person developing infection after sexual intercourse should use barrier method.
Diagnosis
- Urine routine test
- Urine culture and sensitivity test- this test tells us which bacteria is causing the infection and which medicine will be most appropriate for that bacterial infection.
- Imaging test in form of Ultrasound/CT scan as per need.
- Cystoscopy – in case of recurrent UTI of lower tract (bladder, urethra), to look for the source of infection.
Treatment
- Antibiotics are mainstay of treatment for urinary tract infections.
- Simple uncomplicated infections such as urethritis, cystitis are usually treated with oral antibiotics such as fosfomycin, cephalexin trimethoprim/sulfamethoxazole etc. Other supportive medicines for burning and frequent urination are often prescribed.
- For complicated infections such as acute pyelonephritis, renal abscess, emphysematous pyelonephritis, hospitalisation intravenous antibiotics are often required.
- Surgical intervention such as pus drainage with pigtail, DJ stent placement in kidneys etc may be required.
Recurrent infections
- Low dose long term oral antibiotic may be required.
- Single dose oral antibiotic after sexual intercourse, if your infections seems to related to sexual activity.
- Vaginal estrogens in postmenopausal women.
Dr Varinder Attri - Urologist, Andrologist and Laparoscopic surgeon 