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Urinary tract infections - causes, symptoms, treatment


The most common symptom of urinary tract infection is a painful, burning sensation when passing urine; they are usually treated successfully with antibiotics prescribed by a doctor.  Urinary tract infections are quite common, especially among women and children. Some people, regardless of age or gender, are more susceptible than others, just as some people are with coughs and colds.

Causes

Normal urine is sterile and contains no germs such as bacteria, viruses or fungi.  Urinary tract infections (UTIs) occur when bacteria enter the urinary tract. UTIs are most commonly caused by bacteria that normally live in the bowel.
 

Women are particularly at risk because bacteria can more easily move into their urinary tracts.  Other factors that can increase the risk of UTIs include:

  • Diabetes
  • Pregnancy
  • Structural abnormalities of the urinary tract
  • Any factor that obstructs urine flow eg: kidney stones, an enlarged prostate.
  • Having a catheter inserted into the bladder
  • Poor personal hygiene
  • Being post-menopausal
  • Using a diaphragm for contraception.
The urinary tract consists of the kidneys, bladder, ureters and urethra.  A UTI can be classified by the area of the urinary tract that it affects. When only the urethra is affected it is known as urethritis. When the bladder is affected it is known as cystitis (the most common form of UTI).  When the kidneys are affected it is known as pyelonephritis, which can cause kidney damage if left untreated. 

Symptoms

The most common symptom of a UTI is a painful, burning sensation when passing urine. Other symptoms include: 

  • Pain in the abdomen or pelvic area
  • A frequent or constant urge to urinate
  • Cloudy or smelly urine.

 When the kidneys are affected other symptoms experienced can include: 

  • Back pain
  • Fever and chills
  • Nausea and vomiting
  • Blood-stained urine.

Some people with a UTI may have no symptoms at all, while some people who have these symptoms may not have a UTI.   Symptoms in children may be less clear: 

  • Being generally unsettled
  • Fever
  • Abdominal pain
  • Vomiting or diarrhoea
If your child is toilet trained and suddenly starts to wet their pants again, or doesn't want to pass urine because of pain, it could be a sign of a UTI. 

Diagnosis and treatment

If a UTI is suspected it is important to consult a doctor as soon as practicable so that an accurate diagnosis can be made and appropriate treatment given. Prompt treatment is important to prevent infection of the kidneys from developing. Until a doctor can be consulted, initial treatment measures include:  

  • Drinking lots of water 
  • Avoiding fluids that may irritate the bladder (eg. fizzy drinks, alcohol, coffee and tea)
  • Treating pain or fever with medications such as paracetamol.
Diagnosis of a UTI can usually be made by assessing symptoms and by testing the urine for the presence of bacteria and blood cells.

UTIs are usually treated successfully with antibiotics. The course of antibiotics is taken orally, usually from three to ten days depending on circumstances. Symptoms are usually relieved within 24 to 48 hours of the first dose of antibiotics being given, but it is important to finish the full course of antibiotics as prescribed.

With more complicated and repeated infections there may be an underlying cause (eg: urinary reflux in children). If an underlying cause is suspected it needs to be identified and appropriately treated where possible. Diagnostic tests that may be used include ultrasound scans and specialised x-rays of the urinary tract.

If there is a history of repeated UTIs due to a known underlying cause, low-dose antibiotics may be given daily for a period of weeks or months to prevent UTIs developing.  If kidney infection develops, hospitalisation may be required so that antibiotics can be administered through a drip.

Prevention

The following general steps can help prevent a UTI developing:  

  • Drink plenty of water each day
  • Pass urine when needed. Do not delay
  • Urinate soon after sexual intercourse
  • After toileting always wipe the bottom from front to back
  • Shower rather than use a bath
  • Do not use sprays, powders or douches of the genital area
  • See a doctor as soon as possible if symptoms of a UTI are experienced.

References

O’Toole, M.T. (Ed.) (2013). Urinary tract infection (UTI). Mosby’s Dictionary of Medicine, Nursing & Health Professions (9th ed.). St Louis, MI: Elsevier Mosby.
Kidshealth (2016). Urinary tract infection (UTI) (Web Page). Auckland: Paediatric Society of New Zealand and Starship Foundation. http://www.kidshealth.org.nz/urinary-tract-infection-uti [Accessed: 20/12/16]
Mayo Clinic (2016). Diseases and Conditions: Urinary tract infection (UTI) (Web Page). Rochester, MN: Mayo Foundation for Education and Research. http://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/basics/definition/con-20037892 [Accessed: 20/12/16]
Ministry of Health (2016). Urinary Tract Infection (Web Page). Wellington: Ministry of Health. http://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/urinary-problems/urinary-tract-infection [Accessed: 20/12/16]
 
Last Reviewed – December 2016 

 

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