Home :: Urinary Tract Infection Lower

Urinary Tract Infection Lower

Cystitis and urethritis, the two forms of lower urinary tract infection (UTI), are nearly 10 times more common in women than in men and affect approximately 10% to 20% of all women at least once. Lower UTI is also a prevalent bacterial disease in children, with girls also most commonly affected.

In men and children, lower UTIs are frequently related to anatomic or physiologic abnormalities and therefore require extremely close evaluation. UTIs often respond readily to treatment, but recurrence and resistant bacterial flare-up during therapy are possible.

Causes

Normal urine is sterile and contains fluids, salts, and waste products. It is free of bacteria, viruses, and fungi. An infection occurs when microorganisms, usually bacteria from the digestive tract, cling to the opening of the urethra, the hollow tube that carries urine from the bladder to the outside of the body, and begin to multiply.

Most infections arise from Escherichia coli (E. coli) bacteria, which normally live in the colon.

Signs and symptoms

Lower UTI usually produces urgency, frequency, dysuria, cramps or spasms
of the bladder, itching, a feeling of warmth during urination, nocturia, and possibly urethral discharge in males. inflammation of the bladder wall also causes hematuria and fever.

Other common features include low back pain, malaise, nausea, vomiting, abdominal pain or tenderness over the bladder area, chills, and flank pain.

Diagnosis

Test strips dipped into a urine sample can detect indirect signs of infection such as blood, protein, white blood cells and nitrites (most common bacteria convert nitrate, which is a chemical normally present in urine into nitrites, which are not usually present).

A clean midstream urine sample should be sent to the laboratory for a microscopy examination. A level of 100,000 bacteria per millilitre of urine is regarded as a significant infection, especially if found together with pus or white blood cells (leucocytes) on microscopy. Any infecting bacteria are cultured in the laboratory to assess their sensitivity to common antibiotics.

Treatment

Appropriate antimicrobials are the treatment of choice for most initial lower UTIs. A 7- to 10-day course of antibiotic therapy is standard, but recent studies suggest that a single dose of an antibiotic or a 3- to 5-day antibiotic regimen may be sufficient to render the urine sterile. After 3 days of antibiotic therapy, urine culture should show no organisms.

If the urine is not sterile, bacterial resistance has probably occurred, making the use of a different antimicrobial necessary. Single-dose antibiotic therapy with amoxicillin or co-trimoxazole may be effective in women with acute, non­complicated UTI. A urine culture taken 1 to 2 weeks later indicates whether the infection has been eradicated.

Recurrent infections due to infected renal calculi, chronic prostatitis, or structural abnormality may necessitate surgery; prostatitis also requires long­term antibiotic therapy. In patients without these predisposing conditions, long-term, low-dosage antibiotic therapy is the treatment of choice.

Prevention

• Keep your genital area clean.
• Wipe from front to back.
• Drink plenty of fluids.
• Don't hold your urine. Urinate when you feel like you need to.
• Urinate after sexual intercourse.
• Avoid fluids that irritate the bladder, like alcohol and caffeine.
• Drink cranberry juice, but NOT if you have a personal or family history of kidney stones.
• DO NOT douche or use similar feminine hygiene products.
• Wear cloth undergarments.

If you are prone to UTIs, your doctor may recommend taking antibiotics more regularly to prevent infection.