BN Doctors’ Lounge: Urinary Tract Infections

The urinary tract of the human body is built like a sophisticated water treatment plant, complete with a series of filters, reservoirs, pipes and pumps, and its major function is to regulate the chemical constituency of the blood and ensure that it is kept within healthy limits.

The urinary tract (closely related to the genital tract and often jointly referred to as the genito-urinary system) comprises of a set of paired filters; the Left and Right Kidneys, an expandable storage tank and powerful prime pump; the Bladder as well as a network of pipes and drainage systems; the paired Ureters and a single Urethra.

A bacterial infection of any one of these structures is generally known as a Urinary Tract Infection or UTI.

Infections in each specific part however, go by a different name. A kidney infection is known as Pyelonephritis, a bladder infection is called Cystitis and a urethral infection is referred to as Urethritis.

So How Do I Know I Have A UTI?
Symptoms of a UTI are varied depending on the severity and location. Generally, patients describe pain or difficulty in passing urine (dysuria), a burning sensation at the tip of the urinary opening as well as an increased need to pee (frequency). Sometimes a patient describes a scenario where the need to pee is so overwhelming that they feel that if they don’t go soon, they would wet themselves (urgency). Often times though, on arriving at the toilet, they find that there’s not much urine to pass.

More serious symptoms are pain in the sides, a high temperature (fever), involuntary shaking (chills and rigors) or a blotchy rash on any part of the skin. If you have these symptoms, put down your Blackberry or iPad, get off your desktop or laptop, and please GET TO A HOSPITAL, NOW!

How Can The Doctor Be Certain I Have A UTI?
Healthy urine is sterile and there shouldn’t be any bacteria in it. (Doesn’t mean you should drink it though). To confirm a diagnosis of UTI, your doctor will ask for a sample of your urine and examine it under the microscope to look for bacteria and also culture it to see if any bacteria grow from it. He could also ask you to do an Ultrasound Scan to look directly at your kidneys, ureters and bladder.

How Can It Be Treated?
Uncomplicated cases of UTI are treated with oral antibiotics which your doctor will prescribe based on the results of the microscopy and culture tests. More severe cases of UTI will require admission to the hospital ward and administration of intravenous antibiotics through a vein. Drinking Cranberry juice is said to reduce reinfection in patients who have recurrent UTIs.

Can I Prevent It?
The most common cause of a UTI is what is known as an ascending infection which simply means that bacteria from around the urinary opening find their way into the urethra and manage to climb upstream into the bladder or even as high as the kidneys.
Now, swimming upwards against the powerful urinary stream as it exits the bladder would require a really ‘strong’ bacteria right? Well not really. Even simple skin commensals (S. aureus) and faecal organisms (E. coli) can colonize the urinary tract if given the right opportunity to do so.

UTIs are twice as common in women as in men and this is in part because women have a shorter urethra than men and the pesky critters that could invade the urinary system have a shorter distance to travel before they reach the bladder.

It could also be because women don’t pass urine as often as men. This is probably because men are more likely to find a corner and whip out their hoses to pee, whereas women notoriously hold in their pee until they find a comfortable clean place to do their business. Fair enough, a man peeing in the street is disgusting, but hey, at least they don’t get UTIs as often right?

Finally, another reason females may be more prone to UTIs is the anatomical proximity of the anal opening in women to the urethral opening. Wiping in the wrong direction and sexual intercourse can transfer faecal bacteria from the back passage to the urinary tract.

How Do I Prevent UTIs?

• Gentlemen, Be clean. Shower regularly, wear clean underwear. A high level of personal hygiene will reduce most occurrences of UTI by half.
• Ladies, don’t hold in your pee. The longer the time between bladder voiding, the higher the chances of bacteria ascending.
• Drink more water. More water means more urination. More urination means less chance of infection.
• Pee immediately after sex
• Wipe from front to back!

In A Nutshell
Urinary tract infections are caused by bacteria ascending into the urethra and swimming up the urinary tract. They are twice as common in women as in men but can easily be prevented and in uncomplicated cases are also relatively easy to treat. If you suspect you have a UTI, please see a physician.

Did You Know?
Within the first few weeks after a couple get married the woman develops a type of UTI called Honeymoon Cystitis. This is simply an infection of the bladder caused by bacteria transferred from the back passage to the urinary tract due to either inexperienced or overzealous sexual intercourse. Chief bridesmaids in Europe are known to add a low dose (doctor prescribed) antibiotic to their hen night favours for the bride.

Disclaimer: This article is written for patient education. It is not intended to diagnose or prescribe treatment and does not replace the advice of your physician. It in no means attempts to cover the full medical scope of this condition.

Photo Credit:123rf.com
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David Olamide Craig is a Physician, Pastor, Photographer, Poet and Playwright. He graduated Bachelor of Medicine and Bachelor of Surgery from the University of Ibadan and holds a Masters in Occupational Health from the Institute of Occupational and Environmental Medicine, University of Birmingham. He is passionate about healthy living and sustainable energy.When he is not seeing patients, Dr. Craig spends his time stretched out on his favourite couch, reading books, magazines, and blogs.
Catch him on www.ijgb.com.ng and follow him on Twitter @RevDrCraig