Women's Services Encyclopedia

Urinary Tract Infections

Urinary tract infection or UTI refers to a bacterial infection of some part of the urinary tract. This could be an infection of the bladder, urethra or the kidneys.

There are 3 types of urinary tract infections:

• Pyelonephritis — infection of the kidney (Upper UTI)
• Cystitis — infection of the bladder (Lower UTI)
• Urethritis — infection of the urethra

UTIs are more common in females than males.

Contamination of the urinary tract can occur secondarily to contamination with stool (during wiping) or as a secondary infection with normal vaginal bacteria. Urethral infections in younger males frequently secondary to sexually transmitted disease. The elderly patient will often become seriously ill secondary to a UTI present with high fever, or a decreased level of consciousness.

Symptoms:

• Upper urinary tract infections or pyelonephritis tend to be more serious infections and cause symptoms of high fever, pain to the small of the back, and vomiting.
• Lower urinary tract infections (i.e. urethritis, cystitis) are more easily treated. In these cases, the patients tend to be less seriously ill. Common symptoms of cystitis (bladder) or urethritis include: painful urination, increased frequency of urination, and urinary urgency.
• Low back pain is a common symptom in females.
• Low grade fever may also be present while nausea and vomiting is more rare.

Diagnosis:

• Evaluation will include urinalysis to check for evidence of infection and blood tests for blood count.
• Chemistry and kidney profiles will be done in cases of suspected upper urinary tract infection.
• A urine specimen for culture will aid the physician in determining the most appropriate antibiotic choice.
• Patients with suspected kidney abnormalities (kidney stones or anatomic variations) may have an intravenous pyelogram (IVP) performed.

Treatment:

• Treatment for simple, uncomplicated bladder and urethral urinary tract infections includes oral antibiotics for 10-14 days.
• The urine needs to be rechecked later to examine the degree of eradication of the infection.
• Patients are advised to drink plenty of fluids. Cranberry juice offers the advantage of acidifying the urine and inhibiting bacterial growth (this is not adequate treatment alone).
• Fever control is necessary when appropriate.
• Treatment of upper urinary tract infections (pyelonephritis) requires more aggressive antibiotic therapy. Those younger patients able to retain fluids and medication with no underlying illness (i.e. diabetes), can be treated with an antibiotic injection, followed by a course of oral antibiotics. Close medical follow-up will be necessary. Older patients, diabetics, and those with a more “toxic” presentation will require admission to the hospital for IV antibiotics.

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