Your urinary tract is the system that makes urine and carries it out of your body.  It includes your bladder and kidneys and the tubes that connect them.  A urinary tract infection (UTI) is an infection that begins in your urinary system.  Your urinary system is composed of the kidneys, ureters, bladder and urethra.  Any part of your urinary system can become infected, but most infections involve the lower urinary tract – the urethra and the bladder.  In general, the farther the organ in the urinary tract from the place where the bacteria enter, the less likely the organ is to be infected.  Most urinary tract infections are bladder infections.  A bladder infection usually is not serious if it is treated right away.  If you do not take care of a bladder infection, serious consequences can occur if a urinary tract infection spreads to your kidneys.  A kidney infection is very dangerous and can cause permanent damage.  

          Women are at greater risk of developing a urinary tract infection than are men.  Scientists are not sure why women have more urinary infections than men.  It is probably because women have shorter urethras, so it is easier for the germs to move up to their bladders.  Sex can make it easier for germs to get into your urethra.  In fact, any abnormality of the urinary tract that obstructs the flow of urine (a kidney stone, for example) sets the stage for an infection.  An enlarged prostate gland also can slow the flow of urine, thus raising the risk of infection.  Another common source of infection is catheters, or tubes, placed in the bladder.  A person who cannot void, is unconscious, or is critically ill, often needs a catheter that stays in place for a long time.  Some people, especially the elderly or those with nervous system disorders who lose bladder control, may need a catheter for life.   Bacteria on the catheter can infect the bladder, so hospital staff take special care to keep the catheter sterile and remove it as soon as possible.  Research has shown that people with diabetes have a higher risk of a UTI because of changes in the immune system.  Further, any disorder that suppresses the immune system raises the risk of a urinary infection.

          Not everyone with a urinary tract infection develops recognizable signs and symptoms, but most people have some.  In general, urinary tract infection signs and symptoms develop rapidly and can include a strong, persistent urge to urinate, a burning sensation when urinating, passing frequent, small amounts of urine, blood in the urine (hematuria) or cloudy, strong-smelling urine and bacteria in the urine (bacteriuria).  Each type of urinary tract infection may result in more-specific signs and symptoms, depending on which part of your urinary tract is infected.  If your infection is in your urethra (urethritis), the most common sign is burning with urination.  Bladder infections (cystitis) can cause frequent and painful urination, low-grade fever, lower abdominal discomfort and pelvic pressure.  The more serious infection that occurs in the kidney is referred to as pyelonephritis.  These symptoms can include a high fever, shaking and chills, nausea, vomiting, blood in the urine and upper back and side (flank) pain.

          The first step in treating a UTI is to make sure there really is one.  The only certain way to know if there is a UTI is to take a sample of urine and “culture” it: try to grow bacteria from the sample.  If there are bacteria, the doctor can then test several antibiotics to see which ones kill the bacteria most efficiently.  Typical antibiotics used for UTIs include trimethoprim-sulfamethoxamole, nitrofurantoin, ciprofloxacin and certain penicillins such as amoxicillin.  In some cases, when it is apparent from the symptoms that you actually have a UTI, antibiotics will be started right after the urine culture; if the culture result shows that a different antibiotic is needed, one can always be changed.  Often there will be a repeat culture 3-5 days after starting antibiotics to make sure that the drug is killing all the bacteria, and again soon after the antibiotics are finished to make sure your particular medicine killed everything that needed killing.

          Sometimes people wonder if there are any preventative measures for a urinary tract infection (UTI).  Doctors suggest several steps one might take to avoid this type of infection, including drinking plenty of water every day, drinking cranberry juice, which in large amounts inhibits the growth of some bacteria by acidifying the urine – Vitamin C (Ascorbic Acid) supplements have the same effect and urinating when you feel the need (don’t resist the urge to urinate).  It has also been shown that wiping from front to back to prevent bacteria around the anus from entering the vagina or urethra, taking showers instead of tub baths and cleansing the genital area before sexual intercourse will help to prevent a UTI.  Finally, avoiding feminine hygiene sprays and scented douches, which may irritate the urethra, and urinating right after having sex is suggested.


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