Urinary Tract Infections in women
Urinary Tract Infection ( UTI ) is defined as the infection of any part of the Urinary system i.e the Urethra, Urinary bladder, Ureters or the Kidneys. These infections are quite common in women because of the short length of the urethra & the proximity of the urethral opening to vagina & anal opening in females.
How does Urinary Tract Infection develop ?
Causes of UTI :
UTI develops when infective organisms invade the various parts of the Urinary tract . To begin with, they may affect the urethra, and if the infection remains uncontrolled, they may ascend upwards to invade the Urinary bladder, ureters or even the Kidneys. The factors which aggravate the risk of UTI’s in women include:
- Female anatomy– As discussed above, the close association between the female urethra, vagina & anal region increases the likelihood of spread of bacteria from vaginal or gastro-intestinal tract to the urinary Moreover, the short urethra in women decreases the distance that the bacteria need to travel in order to reach the urinary bladder . Thus, the incidence of UTI’s is more in women as compared to men.
- Sexual activity – Sexual activity increases the chances of UTI especially, if there are multiple sexual Women are more prone to sexually transmitted infections & the organisms may be transmitted from the genital region to the urethra by the contact with fingers/genitals/other devices.
- Certain contraceptive measures – Certain birth control measures such as using the Diaphragm or spermicidal agents can increase the chances of UTI.
- Pregnancy- UTI’s are common in pregnancy, the risk begins at 6 weeks & peaks at about 22-24 weeks of The reason is the relaxation of smooth muscles in response to pregnancy hormones and the resultant increase in volume of urinary bladder, accompanied by urinary stasis ( decreased urinary flow rate ). This also leads to increased episodes of urinary reflux i.e backward flow of urine from the bladder into the ureters or even kidneys occasionally. All these factors increase the chances of development of UTI in pregnancy.
- Menopause- After menopause, the circulating levels of Oestrogen in the body decrease and this leads to changes in the mucosal lining of the urinary & genital tract that increases the chances of infections.
- Obstruction to urinary flow – This maybe due to certain abnormalities of the urinary tract or presence of stones ( calculus) in urinary tract, which may prevent smooth forward flow of urine and may predispose to infections.
- Low Immunity – A decreased immunity, for eg in women with Diabetes or HIV infection, increases the chances of UTI.
- Recent Urinary / Genital procedure- Any surgical or interventional procedure involving the urinary tract or sometimes the genital tract also may increase the possibility of UTI.
- Others- Other causes like a neurological condition , history of previous urinary infections may also increase a woman’s chances of developing UTI.
How do I know if I have UTI ?
Symptoms of Urinary Tract Infections :
Urinary tract infections may sometimes cause no symptoms but mostly, a woman gets one or more of the following signs/symptoms :
- Urgency- There may be a strong urge to urinate, which may sometimes be uncontrollable.
- Frequency- You may soon feel the need to urinate again even though you have passed urine recently.
- Dysuria- There may be pain in urethral region or pelvis while urinating.
- Odour- The urine may be foul smelling.
- Colour- Sometimes, the urine may appear cloudy or maybe blood Consult your doctor if the urine appears blood stained.
- Pelvic pain- When the infection reaches the bladder, it may lead to pelvic pain or pain felt in the lower part of the abdomen.
- Flank pain- Pain in the upper back & sides may be a sign of infection in the kidneys and it maybe accompanied by fever, chills, Consult your doctor immediately if you develop any of these.
The gold standard for diagnosing a Urinary Tract Infection is a Urine test for routine microscopy and a Culture/Sensitivity test to check for the presence of specific infective organisms and their sensitivity to various antibiotics. A culture/sensitivity test guides your doctor to prescribe the most effective antibiotic for the organism causing your UTI.
How can UTI be treated ?
Urinary Tract Infection Treatment :
The best cure for a urinary tract infection is to take relevant antibiotics for the prescribed period of time as advised by your doctor. However, there are other supportive measures that need to be followed in order to facilitate relief of symptoms & complete cure . Antibiotics usually lead to a quick relief of symptoms, however, you must continue the medications for the complete prescribed duration or else it may lead to incomplete cure of UTI which may then flare up again after a few days and thus may lead to recurrent , resistant infections .
You can also take certain supportive measures to ease your discomfort when you have UTI :
- Drink plenty of water : Drink at least 8-10 glasses of water in a Water helps to dilute the urine and hence decreases the irritation & pain in the urinart tract. It also helps to flush out the toxins & organisms causing the UTI.
- Avoid Coffee/ tea or other liquids that may irritate your bladder.
- Urinary alkalinisers may sometimes be prescribed by your doctor & help decrease the discomfort.
- Avoid sexual activity when you have active UTI.
- Cranberry juice, Barley water, etc help ease the discomfort but the exact benefit afforded by these is still controversial.
- Use warm heating pads on lower abdomen & back to relieve the However, make sure that the pads are not excessively hot.
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What are the complications of UTI ?
Usually, if treated properly, UTI does not cause any long term complications. However, if treated incompletely, or in a person with compromised immunity , it may lead to the following complications:
- Recurrent infections- Recurrent UTI is defined as the occurrence of UTI 3 times or more in a year . Partially treated infections or in cases where the cause for the primary infection persists & is not eradicated, may lead to recurrent infections.
- Kidney damage- Persistent infection or a very acute & severe episode of UTI may sometimes lead to permanent kidney damage which may necessitate a prolonged course of treatment.
- Preterm birth – Untreated UTI may lead to onset of preterm labour & delivery leading to low birth weight & compromised baby who may need Nursery care or admission to NICU.
- Sepsis- Spread of infection all over the body may lead to serious complications & sepsis which may require hospital/ICU admission .
How can UTI be prevented ?
Prevention of Urinary Tract Infection :
UTI can be prevented by following measures :
- Drink plenty of liquids – at least 8-10 glasses a day.
- After urinating or passing stools, wipe from front to back, to prevent spread of organisms from anal region towards urethra.
- Avoid use of spermicidal jellies or diaphragms for contraception.
- Avoid multiple sexual partners.
- Ensure that you take a complete treatment for the first episode of UTI as prescribed by your doctor.
The Author, Dr. Smita Vats is practising as a Consultant Gynaecologist and Laparoscopic Surgeon in Gurgaon.She is one of the Best Gynaecologist in Gurgaon and a visiting consultant at various esteemed Hospitals in Gurgaon including Artemis Hospital, Cloud nine Hospital, Paras Hospital & GNH Hospital Gurgaon.