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Southern Cross Medical Library

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Urinary tract infections

 
Urinary tract infections are characterised by a painful, burning sensation when passing urine.  They will affect one in four women at some stage in their lives, and around one in twenty men.   Urinary tract infections are usually treated successfully with antibiotics prescribed by a doctor.

General information

The urinary tract consists of the kidneys, bladder, ureters and urethra. The kidneys filter waste and water from the blood to produce urine. Urine travels from the kidneys to the bladder via two narrow tubes called the ureters. Urine is stored in the bladder until it is excreted through the urethra. 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 via the urethra. UTIs are most commonly caused by bacteria that normally live in the bowel.

UTIs 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. Women are particularly as risk because the urethra is quite short and bacteria can more easily move into it. One in four women will have a UTI as some stage in their life, compared to one in 20 men. Other factors that can increase the risk of UTIs include:  

  • Being diabetic
  • 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
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.  When the kidneys are affected it is known as pyelonephritis, which can cause kidney damage if left untreated.  Cystitis is the most common type of UTI.

Symptoms

The most common symptom of a UTI is a painful, burning sensation when passing urine. Other symptoms of a UTI 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 fluid; water or cranberry juice is best
  • 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.

Urinary tract infections are usually treated successfully with antibiotics. The course of antibiotics is taken orally, usually from three to ten days (or longer) depending on circumstances. Symptoms are usually relieved within 24 to 48 hours of the first dose of antibiotics being given.

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

Anderson, K. N., Anderson, L. E. & Glanze, W. D. (Eds.) (2006) Mosby’s Medical, Nursing and Allied Health Dictionary. (6th ed.) St. Louis: The C.V. Mosby Company
Kidney Health New Zealand (2008) Urinary Tract Infections. Brochure. Kidney Health New Zealand. Christchurch.
Kidshealth (2010) UTI (urinary tract infection). The Paediatric Society of New Zealand and Starship Foundation. www.kidshealth.org.nz/uti-urinary-tract-infection
Ministry of Health (2012) Urinary Tract Infection. www.health.govt.nz/yourhealth-topics/aches-pains-and-other-symptoms/urinary-problems/urinary-tract-infection 
 
Last Reviewed – 30 November 2012 

 

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