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Urinary Tract Infections
Background
Urinary tract infections (UTI's) arise secondary to bacteria ascending through the urethra into the
bladder. Women have very short urethras as compared to men, thus UTI's are much more
common in women than men. Most bacteria responsible for UTI's arise from the intestinal tract.
The best defense mechanism against developing urinary tract infections is the ability to empty
the bladder, thus washing out any bacteria from the urethra.
Symptoms
The most common symptoms include burning with urination as well as urgent and frequent
urination. Other symptoms may include lower abdominal discomfort as well as foul smelling
urine. Back pain and side pain may also occur and are non-specific symptoms. This may or may
not indicate that the infection not only involves the bladder (cystitis) but may also involve the kidney
(pyelonephritis).
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Diagnosis
A fresh urine sample given in the office is examined under the microscope. If the findings in the
urine specimen are not consistent with an infection, yet clinically the suspicion exists, then a urine
culture may be obtained. A urine culture is the definite test for an urinary tract infection. A
negative urine culture may result despite the presence of an infection in patients who have been
on antibiotics. Urine cultures are also obtained in patients with a recurrent infection. This helps to
determine if the infections are the result of the same bacteria, different bacteria, or a bacteria
which is not susceptible to the usual antibiotics that are used in the treatment of UTIs.
Treatment
A course of antibiotics, anywhere from 1 to 10 days, will cure most typical bladder infections. If
the bacteria have settled up into the kidneys, a longer course of treatment may be required.
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Evaluation
If the above measures fail to improve the urinary symptoms or infections become recurrent,
evaluation consisting of kidney x-rays such as an intravenous pyelogram (IVP) or a kidney
ultrasound along with cystoscopy (looking into the bladder with a scope) may need to be done.
This may reveal the presence of urinary tract stones, abscesses, kidney obstruction, or
poor bladder emptying.
For general information about urinary tract infections, click on this link: Urinary tract infections.
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