Urinary tract infection (UTI) is a colonization of bacteria in an organ of the urinary tract: the kidneys, which eliminates the waste from the blood and produces urine; the bladder, receives urine produced by the kidneys; the urethra, a canal located below the bladder that allows the evacuation of urine; and the prostate, gland located below the bladder, around the urethra. However, organs of the lower urinary tract are most often affected: cystitis (bladder infection) and pyelonephritis (kidney infection) are the most common types of urinary infection.

Although anyone can have urinary tract infection, it is more common in infants, young children and pregnant women. In addition, gender also plays a role in the development of the infection. Between ages 20 and 50, urinary tract infection is 50 times more common in women, but after 50 years the incidence in men is increasing due to prostate problems.

UTI Causes

The germs most frequently involved in the occurrence of UTI are Escherichia coli (commonly known as E. coli), Proteus mirabilis, Staphylococcus saprophyticus and Klebsiella. E. coli are the most common; this group of bacteria is accounts for nearly 75% of cases of urinary tract infection.

Depending on the causes of the infection and organ affected, there are several types of urinary tract infections:

• Cystitis – cystitis is a form of urinary tract infection characterized by inflammation of the bladder. Cystitis is the most common type of UTI, affecting mostly women. The inflammation is caused by the proliferation of the intestinal tract bacteria such as Escherichia coli, a species of bacteria naturally found in your gastrointestinal tract. Overgrowth of those microorganisms causes them to spread to the vulvar region through the bladder up to the ureter. Being a woman and bruising of the bladder during sexual intercourse (traumatic cystitis) increase your risk of developing UTI. In addition, anything that impedes the emptying of your bladder increases your risk of having cystitis.

• Urethritis – urethritis is another form of urinary tract infection. It is characterized by inflammation of the urethra, the duct that connects the urinary bladder to the urinary meatus, the external opening of the urethra, from which urine is ejected during urination and semen is ejected during ejaculation. In contrast to cystitis, urethritis is more common in men. It is a sexually transmitted infection (STI) and often caused by the bacteria Chlamydia and Gonococcus, a bacterium responsible for the sexually transmitted disease gonorrhoea.
• Pyelonephritis – pyelonephritis is a more serious form of urinary tract infection. The infection affects primarily the renal pelvis (pyelitis) or the renal parenchyma (nephritis). It is the result of an untreated or poorly treated bacterial infection or cystitis that lead to an anarchic multiplication of bacteria (mostly E. coli and Enterococcus faecalis) from the bladder to the kidneys. Pyelonephritis is more common among women, especially when they are pregnant.

UTI Risk Factors

Being Female – urinary tract infection is more common among women due to anatomical reasons. In women, the urethra is shorter than that of men which makes it closer to the anus, the siege of many bacteria species such as Escherichia coli. Due to certain pathogenic circumstances, these bacteria can trace along the urethra into the bladder and causing urinary tract infection.

Lack of liquid intake – consistent consumption of liquid (distilled water and natural juice) plays a major role in the cleansing of your body and strengthening your immune system. In the other hand, lack of fluid intake can lead to many health problems including urinary tract infection. In women, urinary tract infection is linked, in many cases, to lack of fluids intake or inadequate consumption of water.

Poor hygiene – in women, a bad genital hygiene can promote urinary tract infections. This is due not only to a lack of Intimate hygiene but also a wrong way of cleaning; for instance, wiping back to front after a bowel movement. Back to front motion can foster UTI by bringing bacteria to the urinary tract.

Sexually active – sexual intercourse tends to move the bacteria through the urethra into the bladder; excessive accumulation of these bacteria can lead to UTI. It is important to urinate after each sexual intercourse to remove the bacteria that have entered the urethra.

Diseases – Constipation is one of the factors that promote urinary tract infection. Prolonged stagnation of feces in the rectum facilitates the overgrowth of bacteria. In addition, other diseases such as diabetes, kidney problems (renal failure, kidney stones, etc.), malformation of the urinary tract and all immunosuppressive diseases can foster the development of urinary tract infection.

Urinary catheterization – prolonged use of urinary catheters can irritate or damage the urethra and cause urinary infection.

Pregnancy – Pregnancy can also promote UTI because the compression by the uterus tends to lead to a dilation or obstruction of the ureters. This blockage causes a buildup of bacteria in the tubes, which can lead to urinary tract infection if left untreated.

Menopause – menopause is always accompanied by a decreased in estrogen (a hormone manufactured by woman’s body) and other vaginal secretions (vaginal dryness). This abnormal change, without an effective hormone replacement therapy, will affect your vaginal acidity, the key to keep vaginal bacteria under control. When left untreated, this disorder will facilitate the colonization of bacteria in the vagina and urethra.

Certain birth controls – if you use spermicidal gel or diaphragm for birth control, your risk of UTI is higher than women who do not.

Male homosexuality – sex without a condom between two men increases the risk of developing UTI.

UTI Symptoms

In the genesis of the infection, you may have no symptoms; rarely, you may have urinary symptoms or a simple fever. As the infection aggravates, you will have at least one of the following symptoms:

Infection of the bladder (cystitis) and urethra (urethritis) is characterized by:

• Burning during urination
• Frequent need to urinate
• Pelvic pain or heaviness
• Pus in the urine
• Cloudy and foul-smelling urine
• Increased confusion and falls (mostly elderly)
• Micturition disorders, frequent urination which can be associated with bleeding.

Kidney infection (pyelonephritis) causes the same signs as cystitis associated with:

• High fever to 39 ° -40 °
• Vomiting
• Chills
• Night sweats
• Extreme fatigue
• Low back pain which may be bilateral.
  

Possible Complications

If you experience any of the UTI signs, it is very important to see your doctor. In case you are diagnosed with urinary tract infection, it is very important to follow an appropriate treatment which should be recommended by your physician. If the infection is not treated, the infectious agents will continue to multiply and invade your urinary tract, which can lead to:

• Kidney stones
• Sepsis
• Pyelonephritis
• Renal failure

Diagnosis

To diagnose your urinary tract infection, your urologist will do a physical examination and ask questions whose answers can reveal urinary disorders. Along with the questioning, she/he will seek the presence of fever, which may explain pyelonephritis. In addition, your doctor will do a rectal examination (in men) to rule out other prostate problems (prostate inflammation, prostate cancer, etc.) or a pelvic exam (in women) to detect vaginal infection or other vaginal issues that can cause symptoms similar to UTI.

Urine test – If signs of UTI are suspected, a urine test strip will be recommended to detect in your urine presence of glucose, ketones, leukocytes, nitrites, protein, pus or blood. This exam is an important tool in the detection of kidney disease or urinary tract infection.

Cyto Bacteriological Exam of Urine (CBEU) – CBEU is often used in the diagnosis of urinary tract infection. It allows your urologist to examine your urine and detect presence of crystals and bacteria. The CBEU confirms the diagnosis by detecting the bacteria and identifying which antibiotics the bacteria is sensitive to.

X-ray – if the infection is a pyelonephritis, or in case of recurrent urinary tract infections, your physician can recommend a radiological assessment (ultrasound exam) to rule out or confirm anatomical abnormalities.  Along with the ultrasound exam, you may be recommended to do a cystoscopy for a better analysis of the inside of your bladder.

Urinary Traction Infection (UTI) Treatment

If your infection is bacterial, your doctor will use antibiotics to treat it. In mild UTI treatment, antibiotics may treat the infection quickly. In fact, most mild urinary tract infections go away on their own without medical treatments.  However, severe infections require appropriate medications; drugs used depend primarily on the causes and the symptoms of the disease. For example, in urinary tract infection treatment caused by E. coli, your doctor may prescribe:

• Ciprofloxacin (Cipro, Cipro XR)
• Levofloxacin (Levaquin)
• Amoxicillin (Amoxil, Trimox)
• Nitrofurantoin (Macrodantin, Furadantin)
• Sulfamethoxazole (Bactrim, Septra)
• Trimethoprim (Trimpex, Proloprim, Primsol)

Taking medications as prescribed, the symptoms will be disappeared in 48 hours or less. However, even if you feel better, it is important to follow and finish the treatment as prescribed. In addition, it is necessary to talk to your doctor if you do not find any relief 48 hours after beginning the treatment.

Pregnant women – If you are diagnosed with a urinary tract infection while you are pregnant, it is important to treat the infection during pregnancy to prevent further problems. The infection can spread into your kidneys and increases the risk of premature delivery or low birth weight baby, less than 5lbs. In addition, do not take any antibiotics that may be represent a danger to the fetus; talk to your doctor about an appropriate treatment.

Severe Urinary Tract Infections – if you have a recurrent urinary infection, whether you are a man, woman or child, do your best to see an urologist (urinary system specialist); this is extremely necessary to prevent complication. The urologist will seek the root of the problem and will recommend appropriate UTI treatment. In the majority of cases, recurrence is due to an obstruction of the urinary system. Treatment of obstruction depends on the cause: prostatic hyperplasia, anatomical abnormality, kidney stones, etc.

Alternative UTI Treatment

Cranberry (vaccinium macrocarpon) – studies have shown that cranberry has beneficial effects against urinary tract infection. It is used all over the world in the naturotherapy (branch of medicine in which a variety of natural medicines and treatments are used to heal illnesses) to prevent and treat urinary tract infection. Along with a healthy diet, cranberry juice or supplements can fight effectively all non severe form of urinary tract infections. You can drink the (pure) juice along with your medications without any problem.

Urinary Traction Infection (UTI) Prevention

Fortunately, the urinary infection can be prevented in most cases. Some hygienic measures can not only help you prevent urinary traction infection but also other forms of medical conditions similar to the disease:

• Drink at least 8 glasses of water per day
• When urinate, empty your bladder completely
• Practice safe and regular intimate hygiene
• After bowel movement, wiping from front to back
• Prevent or treat constipation before it becomes chronic
• Reduce consumption of alcohol and caffeine
• Urinate immediately after intercourse;
• Avoid tight pants and underwear
• Wear 100% cotton underwear.