Dr. G.Thirumalai Ganesan

MS, M.Ch, FRCS(Glasg), FRCS (Urol)(UK)

Sarayu Medical Center, Q-39, 6th Avenue
Anna Nagar, Chennai-40 (Near K4 Police Station)
Tel: +91-44-45550367/68/69,
+91-97909-60550, +91-98412-33777
Email: endouro@gmail.com

Urinary Tract Infections

Urinary tract infections (UTIs) are among the most common of bacterial infections. They occur in people of all ages, women significantly more than men.

Overview

urinary tract infectionsThe urinary system consists of the kidneys, ureters, bladder, and urethra. Urine is formed in the kidneys, waste-filtering organs located in the mid-back, just below the rib cage. Urine leaves the kidneys and flows down the ureters, two thin tubes that empty into the bladder, the hollow, muscular organ that holds urine. The urethra is the tube that transports urine out of the body from the bladder. Most UTIs arise from bacteria that normally live in the colon and rectum, and are present in bowel movements. These bacteria cling to the opening of the urethra, begin to multiply, and travel up to the bladder. The flow of urine from the bladder usually washes bacteria out of the body. However, because women have a shorter urethra than men, bacteria can reach the bladder more easily and settle in the bladder wall. Much less often, bacteria spread to the kidney from the bloodstream.

There are four types of urinary tract infection:

  • Cystitis, the most common UTI, is an inflammation of the bladder. It almost always occurs in women. In most cases, the infection affects only the surface of the bladder and is brief and acute.
  • Pyelonephritis, more commonly known as a kidney infection, usually occurs when a lower UTI spreads to the upper tract. Occasionally, bacteria will spread to the kidney from the bloodstream. Kidney infections are much less common, but often more serious than bladder infections.
  • Urethritis is an inflammation of the urethra. Men commonly contract urethritis through sexual intercourse with an infected partner. Urethritis may also result from trauma to the area or from a medical procedure involving a catheter, a tube inserted through the urethra to the bladder to drain the urine.
  • Prostatitis is the infection or inflammation of the prostate gland.

Symptoms may include a frequent urge to urinate, regardless of whether the bladder is full or empty, and pain and burning with urination. The urine itself may look milky or cloudy, or have a strong smell. Women often feel an uncomfortable pressure in the pelvic area, and some men experience a feeling of fullness in the rectum. Fever may mean the infection has reached the kidneys. Other symptoms of kidney infection include pain in the back or side below the ribs, nausea, or vomiting.


Diagnosis

Most Urinary Tract Infections (UTIs) can be diagnosed with urinalysis, a test to check for bacteria in the urine. Some UTIs may require evaluation by intravenous pyelogram (IVP), which uses dye that shows up on x-ray:

  • The dye is injected through a vein and is processed by the kidneys.
  • X-rays are taken of the kidneys, ureter, and bladder as the dye passes through them. These provide a dynamic picture of the relationship between the patient's urinary system and urinary functioning.

Treatment Options

Urinary tract infections are easiest to treat when they are caught early and have not spread beyond the lower urinary tract. A course of oral antibiotics is the most common treatment for UTIs. Recurrent UTI's may warrant some investigations to find out the cause such as blockage or stones. UTI may disappear once the offending agent is tackled. Sometimes patients may have to be on long term low dose antibiotic treatment.