General Health

Preventing complications of urinary tract infections in women

A urinary tract infection (UTI) is an infection that can involve any part of the urinary system — kidneys, ureters, urinary bladder or urethra; however, most UTIs usually involve the lower urinary tract i.e., the urinary bladder and the urethra. Women are more prone to UTIs compared to men. UTIs usually occur when bacteria enter the urinary tract through the urethra and multiply in the urinary bladder to grow into a full-blown infection in the urinary tract and are usually treated with antibiotics.

Symptoms

UTIs don’t always cause symptoms and signs but can include the following:

  1. A strong and persistent urge to urinate
  2. Burning sensation when urinating
  3. Frequent urination with small amounts of urine
  4. Cloudy urine
  5. Strong-smelling urine
  6. Urine coloured red, bright pink or cola-coloured – a sign of presence of blood in urine
  7. Pain or pressure in your back or lower abdomen
  8. Fever or chills (a sign indicating that UTI may have reached your kidneys)

Types of urinary tract infections

1.     Acute pyelonephritis. This UTI affects the kidneys. Signs and symptoms include back pain or side (flank) pain, high fever, shaking and chills, nausea and vomiting.

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2.     Cystitis. This UTI affects the urinary bladder and is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. Other types of bacteria causing UTIs include Proteus mirabilis, Enterococcus faecalis, Staphylococcus saprophyticus and Klebsiella pneumoniaae. Sex can lead to cystitis, but a woman doesn’t have to be sexually active to develop it. All women are at risk of cystitis because of the female anatomy — the short distance from the urethra to the anus and the urethral opening to the bladder. Signs and symptoms include pelvic pressure, lower abdomen discomfort, frequent, painful urination and cloudy urine or blood in the urine.

3.     Urethritis. This UTI affects the urethra. Signs and symptoms include burning with urination and discharge. This type of UTI occurs when GI bacteria spread from the anus to the urethra and since the female urethra is close to the vagina, sexually transmitted infections (STIs) such as gonorrhea, herpes, mycoplasma and chlamydia can cause urethritis.

Risk factors

1.     Female anatomy. A female has a shorter urethra compared to a male which reduces the distance needed to be travelled by bacteria to reach the urinary bladder.

  1. Sexual intercourse. Sexually active females have more UTIs than females who aren’t sexually active. Having a new sexual partner also increases the risk of a UTI.
  2. Birth control measures. Females who use birth control measures such as diaphragms and/or spermicidal agents may be at an increased risk of UTI.
  3. Menopause. After menopause, diminished estrogen levels cause changes in the urinary tract that make increase UTI susceptibility.
  4. Urinary tract abnormalities. Infants born with urinary tract abnormalities that don’t allow urine to leave the body normally or cause urine to back up in the urethra are at an increased risk of UTIs.
  5. Blockages in the urinary tract.  Kidney stones can block urinary flow and block urine in the bladder thereby increasing UTI risk.
  6. Suppressed immunity.  Women with diabetes and other diseases that suppress the immune system can increase UTI risk.
  7. Use of catheters. People who can’t urinate on their own and use catheters for urination are at an increased risk of UTIs. Such individuals are usually hospitalized, paralyzed or suffer from neurological disorders that make it difficult to control their ability to urinate.
  8. A recent urinary procedure. Urinary surgery or urinary tract examination involving the use of medical instruments can increase your risk of developing a urinary tract infection.

Complications

  1. Permanent renal damage from acute or chronic pyelonephritis due to an untreated UTI.
  2. Increased risk of delivering low birth weight or premature infants in pregnant women.
  3. Urethral narrowing or strictures in men from recurrent urethritis, previously seen with gonococcal urethritis.
  4. Potentially life-threatening sepsis, particularly if the infection works its way up the urinary tract to the kidneys.

Diagnosis

Usually, a urinary examination is performed for UTI detection. In addition, an ultrasound, a CT scan, MRI scan or cystoscopy may be performed.

Prevention

  1. Increase fluid intake, particularly water. Drinking water helps in urine dilution and increases the frequency of urination thereby enabling bacteria to be flushed from your urinary tract before the development of a UTI. Drinking cranberry juice may also help.
  2. Wipe from front to back. Doing so post-urination and post-bowel movements helps in the prevention of bacteria spreading from the anal region to the vagina and urethra.
  3. You must empty your bladder soon after sexual intercourse. In addition, drink a full glass of water to help flush out the bacteria.
  4. Avoid potentially irritating feminine products. Using deodorant sprays or other products, such as powders and douches, in the genital area can potentially irritate the urethra and therefore, should be avoided.
  5. Change the birth control method. Spermicide-treated or unlubricated condoms and diaphragms can contribute to the growth of bacteria in the urinary system.
  6. Take showers: The Centers for Disease Control and Prevention (CDC) suggests taking showers instead of baths and avoiding douching as a preventive measure.

Author

Pooja Toshniwal Paharia

Dr. Pooja Toshniwal Paharia is a Consultant Oral and Maxillofacial Physician and Radiologist, M.DS (Oral Medicine and Radiology) from Mumbai. She strongly believes in evidence-based radiodiagnosis and therapeutic regimens for benign, potentially malignant, or malignant lesions and conditions either arising from the oral and maxillofacial structures or manifesting in the associated regions.

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