Urinary Tract Infections (UTIs) in Women

What are UTIs?

Urinary tract infections (UTIs) are one of the most common infections that occur in women. It is also the most common urinary problem that women experience. The urinary tract comprises the urethra, bladder, ureters and kidneys. Urine is produced in the kidney, passed down into the ureter where it is stored in the bladder. From here it is passed out through the urethra into the environment during voiding. Most of the time the infection is isolated to the urethra and bladder but should it spread upwards to the kidneys then the consequences can be much more severe.

Causes of Urinary Tract Infections

Most urinary tract infections are due to bacteria invading the tract. These bacteria can adhere to the lining of the tract where it causes injury and leads to inflammation. It may enter the urethra through the external orifice and spread upwards into the bladder and less commonly even to the ureter or kidney. This is known as an ascending infection. Alternatively microorganisms may reach the kidney through the blood (hematogenous spread) or from neighboring sites of infection.

The most commonly involved bacteria is Escherichia coli (E.coli) from the rectum. Other species of bacteria are less commonly involved. Sometimes other microorganisms like viruses which may be transmitted through sexual contact can also cause urinary tract infections apart from infecting the genital tract. Women are at greater risk of urinary tract infections because of a shorter urethra. This allows the microorganisms to quickly reach the bladder where it can multiply further. Women who are sexually active are also at greater risk as well as those using diaphragms, with urethral abnormalities, undergoing menopause, having a suppressed immune system or with kidney stones.

Signs and Symptoms

The most common symptoms are burning upon urination, a constant urge to urinate and frequent urination. It is not uncommon for the urine to have a foul odor. There may be a persistent discomfort or dull pain at the lower abdominal region which may be worse with movement, when the bladder becomes distended with urine and just after urinating. The urine may also appear cloudy which is due to the presence of pus or pink or brown in color which may be due to blood.  It is not common for a fever to be present when the infection is isolated to the lower urinary tract but if the kidney is infected, a high fever may be present. Urethral discharge may also be present but not in every case.

Diagnosis and Treatment

 The most common tests are a urine dipstick and cytology and culture. A dipstick test can be done quickly in the doctor’s rooms and will be able to confirm an infection. A cytology and culture will be able to give a more detailed analysis and even identify the causative bacteria. Since most UTIs are bacterial infections, antibiotics are needed. It is important to consult with a doctor and commence with the correct type of antibiotic as certain types are more effective than others. Other measures may be needed for treating sexually transmitted diseases, correcting anatomical anomalies or removing bladder/kidney stones.

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