Wee Week: 19 to 25 July 2010 - Promoting Urinary Tract Health
Proudly sponsored by The Cranberry Institute
- Urinary Tract Infections are common, particularly with increasing age
- Women are more likely to get a UTI than men
- About 1 in 3 women and 1 in 20 men will get a UTI in their lifetime
- Nearly 1 in 3 women will have a UTI needing treatment before the age of 24
All about Urinary Tract Infections (UTI's)
How does your urinary system work?
Your urinary system is made up of the kidneys, ureters, bladder and urethra. Your kidneys do many important jobs. One is to remove waste and extra fluid from the blood to make urine. Narrow tubes called ureters carry urine from the kidneys to the bladder. Urine is stored in your bladder and emptied through the urethra. The urethra is the tube that drains the bladder.
What are Urinary Tract Infections?
Urinary Tract Infections (UTIs) are one of the most common reasons for visiting a doctor about an infection. About 1 in 3 adult women will get a UTI in their lifetime.
A UTI can range from an infection of the bladder to an infection of the kidney. If the infection is in the urethra, it is called urethritis and infection in the vagina is called vaginitis. Pyelonephritis describes an upper urinary tract infection, which is very serious as it may affect the kidneys. If it is in the bladder, it is called cystitis. Cystitis is the most common lower urinary tract infection and causes the bladder lining to become raw and inflamed. While it is painful and annoying, it isn’t contagious and the infection can’t be passed on to your partner during sex. However, if left untreated, the infection can ‘backtrack’ deeper into the urinary system and reach the kidneys. A kidney infection is serious and needs prompt medical attention.
It is important to see a doctor if a kidney infection or kidney stones are suspected. If these conditions are left untreated, they can become more serious. Click here to view Bladder Infection, Urinary Tract Infection and Kidney Stones - excellent 3D overviews of these conditions. Virtual Renal Centre WA
What causes Urinary Tract Infections?
Bacteria do not normally live in the urinary tract. When bacteria enter the urinary tract and multiply, they can cause a UTI. There are many germs that can cause urine infections or cystitis. Germs are also called bacterium or microorganisms.
- The most common germ causing Urinary Tract Infections (UTIs) is found in your digestive system, Esherichia coli (E.coli). It can easily spread to the urethra and sticks to the lining of your urinary system.
- Other germs such as Mycoplasma and Chlamydia can cause urethritis in both men and women. These germs can be passed on during sexual intercourse so both partners need medical treatment to avoid re-infection.
- Some people may be more susceptible to infections because the urinary flow is blocked or the urine is backed up as it flows from the bladder to the kidneys.
Why are they more common in women?
UTIs are common, particularly with increasing age. Women are more likely to get a UTI than men. About 1 in 3 women and 1 in 20 men will get a UTI in their lifetime. Nearly 1 in 3 women will have a UTI needing treatment before the age of 24.
Reference: Meta-analyses in Prevention and Treatment of Urinary Tract Infections
Volume 23, Issue 2, Pages 355-385 (June 2009) PMID: 19393914 [PubMed - indexed for MEDLINE]
Philip Masson, MBChB, BA (Hons), MA (Oxon), MRCP (UK)a , Sandra Matheson, BSc (Hons), MPHb, Angela C. Webster, MBBS, MM (Clin Epi), PhD, MRCP (UK)c, Jonathan C. Craig, MBChB, DCh, MM (Clin Epi), PhD, FRACP
- Women get more UTIs than men because of the length of their urethra. The longer the urethra, the more protection you have. In women the urethra is fairly short and straight, making it easier for germs to travel into the bladder.
- Sometimes UTIs relate to changes in female hormonal levels - some women are more likely to get an infection during certain times in their menstrual cycle, such as just before a period or in pregnancy.
- In older women - the tissues of the urethra and bladder become thinner and drier with age as well as after menopause or a hysterectomy. This can be linked to increased UTIs. If you are taking hormone replacement therapy in tablet or patch form, you may wish to speak to your doctor about using a hormone replacement therapy cream as a supplement in the genital area for relief of dryness.
- During pregnancy - the drainage system from the kidney to the bladder widens so urine does not drain as quickly. This makes it easier to get a UTI and sometimes germs can move from the bladder to the kidney causing a kidney infection. UTIs during pregnancy can result in increased blood pressure and a smaller, premature baby so it is very important to have them treated promptly. See Finding problems before your baby is born
Women are more at risk of repeated UTIs if they have:
- Used spermicide jelly or diaphragm for contraception
- Had a new sexual partner in the last year. UTIs caused by bacteria are not usually passed on during sex. However an increase in sexual activity may trigger symptoms of a UTI in some women.
- Their first UTI at or before 15 years of age
- A mother with a history of UTIs
- Suffer from constipation
Do men get UTIs?
1 in 20 men will get a UTI in their lifetime. Men can get UTIs particularly if they have trouble with urine flow. Older men who experience prostatitis (an inflammation of the prostate) are in a higher risk group. If the bladder is not emptying properly, the residual urine makes it harder to cure the infection but is not itself a cause. Read Transurethral Resection of the Prostate. A small number of young men may get a urinary tract infection. In males, urethritis is usually the result of a sexually transmitted disease (STD).
What is the link with Diabetes?
UTIs are more common in women than men and more likely in women with diabetes. A high level of glucose, a type of sugar, in the blood or urine is a clear sign of diabetes. Diabetes may also change your body’s defence system making it harder to fight a UTI. The higher your blood sugar, the less effectively your white blood cells work. See Diabetic Kidney Disease
Why are older people more at risk?
With age, both men and women are more likely to get a UTI. Chronic conditions, some medications and problems with urinary incontinence put older people in a higher risk group. People using bladder catheters including the elderly and those with spinal cord injuries, are more likely to develop a UTI. A catheter is a soft plastic tube inserted into your urethra. The longer the catheter is in place, the higher the risk of a UTI.
Do babies and young children get UTIs?
Babies and children are also more at risk of UTIs. These infections always need to be investigated as they may indicate a serious underlying condition such as urinary reflux. Reflux is caused by a bladder valve problem allowing urine to flow back into the kidneys from the bladder. Reflux can cause the urine to stay inside the body and may become a pool for infection. Infections may lead to kidney scarring, which in turn leads to high blood pressure and sometimes kidney problems. It is important to have children tested as early as possible if another family member has reflux. An ultrasound is often used to examine the kidney and urinary tract. Circumcision can help to protect male babies under six months of age against UTIs. Research is ongoing. See Finding problems before your baby is born and Urinary reflux in children.
What are the symptoms of a UTI?
Bacteria can be present in a urine sample without causing any symptoms. This is more common in women who have diabetes, repeated UTIs or the elderly. This type of UTI may not always need treatment except in special situations, such as in pregnant women. UTIs with symptoms are most common among sexually active women.
How can Urinary Tract Infections be treated?
A faint prickly feeling during urination is usually the first sign of a urinary tract infection. Sometimes mild cystitis can be treated by:
Common symptoms include:
- Burning sensation when passing urine
- Wanting to urinate more often, if only to pass a few drops
- Cloudy, bloody or very smelly urine
- Pain in the lower part of your body
Signs of UTIs in children can also include:
- Low fever
- Irritability
- New day or night wetting in a child who has been dry
- Feeding problems in babies
If the infection moves to the kidneys, you may also have a high fever, back pain and vomiting. It is important to see a doctor if a kidney infection or kidney stones are suspected because lasting damage or even kidney failure can occur, if these conditions are left untreated. Infection which has spread from cystitis or pyelonephritis is a much more serious condition.
Women can lower their risk of having a urinary tract infection by:
- Drinking plenty of fluids, particularly water
- Taking a commercial urinary alkaliser or one teaspoon of baking soda or bicarbonate of soda in water. This may help to alleviate the discomfort of burning and scalding when passing urine. It is important to refer to your doctor if symptoms persist. These treatments may reduce symptoms but an infection can still be present and need different treatment.
- Avoid acidic food or drinks (caffeine, acidic foods, spices, citrus fruits, tomatoes, alcohol and chocolate) as these foods may increase your discomfort and can aggravate the burning sensation when passing urine. They also cancel out the effect of the urinary alkaniser.
Medical advice is needed if self-help treatments aren't working.
The doctor usually tests the urine to check for blood, white blood cells and acidity. UTIs respond well to antibiotics. If a UTI comes back again, your doctor can order a ‘culture’. A ‘culture’ is a test to see which germs are present in your urine. The identification of the germ assists with the choice of antibiotic to treat the infection. Sometimes a low dose antibiotic may be prescribed for long-term use if the UTI is persistent. Test results may not always be reliable as there is a chance of a false negative result.
Regular and severe attacks should be investigated, because an underlying disorder such as kidney stones may be the trigger. If the UTI does not improve or are frequently recurring it may be a good idea to get a referral to a specialist from your GP. Men should see a doctor if they have trouble with the urine stream or problems starting and stopping urine flow; it may point to an enlargement of the prostate. As urine infections are less common in men, their doctor should review all men who have had a urine infection. See Informed consent for medical testing and Making the most of your visit to the doctor
How can UTIs be avoided?
- Drinking lots of fluid, particularly water, to wash bacteria from the bladder and urinary tract. If you are unsure about how much to drink, ask your doctor. See our webpage Drink water instead
- Quickly treating a vaginal infection, such as thrush or trichomoniasis.
- Avoiding spermicide-containing products, particularly with a diaphragm.
- Avoid constipation.
Some women have found the following tips helpful although there is no research to support them:
- Do not delay going to the toilet when you need to
- Wipe from front to back after urinating or using the toilet
- Wear only cotton underwear rather than nylon
- Avoid wearing tight nylon pantyhose, tight pants or tight jeans
- Use only warm water when washing between your legs and do this every day and as needed
- Don’t use perfumed soaps, talcum powder or any type of deodorant around the genitals
- Avoid bubble baths and spas
- Wash between your legs using only warm water before having sexual intercourse and encourage your partner to do the same
- Urinate immediately after sexual intercourse
It is important to remember that getting UTIs is not because of lack of cleanliness. Self-help treatments such as vaginal douching do not change the likelihood of getting UTIs.
Randomised controlled trials.
The daily intake of cranberry juice or capsules can reduce the incidence of symptomatic UTIs. Cranberry and blueberry juice appears to lower the ability of E. coli to stick to the urinary tract lining cells. Let your doctor know if you are drinking cranberry juice as it can alter the effectiveness of some antibiotics.
See Cochrane Review - Evidence for cranberries and blueberries in UTI prevention
Jepson RG, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD001321. DOI: 10.1002/14651858.CD001321.pub4.
Cranberry Awareness and Usage Study Australia, Galaxy Research, January 2008
Epidemiology of urinary tract infections: incidence, morbidity, and economic costs - Foxman B, Am J Med 2002 Jul 8;113 Suppl 1A:5S-13S
www.cranberries.com.au or www.cranberryinstitute.org
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Updated 3 February 2010
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