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Infection of the urinary tract is one of the most common problems treated by doctors. Here are some answers to some frequently asked questions about urinary tract infections (UTIs).
Q: What is a urinary tract infection?
A: A UTI is an inflammation caused by bacteria invading the kidneys, bladder, or urinary passageways. You may have heard urinary tract infections by different names such as "bladder infection," "cystitis," "kidney infection" or "pyelonephritis."
Q: What are the symptoms of a UTI?
A: There may be no symptoms whatsoever. When there are symptoms, the most common are: pain and burning during urination; a sense of having an urgent need to pass urine frequently though the volume of urine maybe small; having to get up frequently at night to pass urine; and cloudy, bloody, or foul-smelling urine. In some cases, there maybe a sudden onset of fever and shaking chills, with or without pain in the back below the ribs. Children may have somewhat different symptoms.
Q: Do these symptoms always mean UTI?
A: No. Many people who have symptoms of pain or burning when they urinate, or who have to urinate frequently, don't have a urinary infection at all. Things such as smoking, drinking, lots of coffee, or just nerves seem to play a role.
Q: How do I know I have a UTI?
A: You may suspect a UTI based on some of these symptoms. But these same symptoms can be caused by other conditions. Some patients who have a urinary infection have no symptoms. Therefore, the only way you or your doctor can be sure whether there is a UTI is to examine the urine to see if it contains bacteria. This can easily be done by a urine analysis and/or urine culture.
Q: What causes UTIs?
A: Normally the urine is sterile (contains no bacteria). A UTI occurs when bacteria get into the urine through the urethra (the tube draining the bladder to the outside). Then, bacteria move upstream into the bladder and sometimes into the kidneys. In a small number of patients, blockage of urine flow, reflux (return of urine from the bladder back into the kidneys), or sources of chronic irritation such as kidney or bladder stones permit infection to occur.
Q: How are UTIs treated?
A: After your doctor has determined that you have a UTI, an antibiotic will usually be prescribed. Sometimes, a medicine to reduce the pain and urgency will also be prescribed while the antibiotic takes effect. Generally, the doctor will want to see you again to be sure the infection has been cured.
Q: Are there different kinds of UTIs?
A: Yes. Most UTIs are limited to the bladder and don't involve the kidneys. These bladder infections (cystitis) can be quite uncomfortable since they may be accompanied by burning or stinging during urination. Infection of the kidney (pyelonephritis) is less common, but more serious. There may be fever, nausea or vomiting, and pain in the back or below the ribs.
Q: Are X-rays or other tests needed?
A: Sometimes. When a child has a urinary tract infection, there is a high likelihood of urinary tract blockage or reflux. Therefore, doctors usually take kidney X-rays, and then sometimes have to examine the bladder with special instruments. Frequent urinary or kidney infections in adults may require similar tests. The first bladder infection usually needs only a urine analysis.
Q: Why do some women seem to have such frequent UTIs?
A: Women are much more susceptible to UTIs than men because a woman's urethra is much shorter than a man's and bacteria have less distance to travel. Other factors that make UTI more likely in women are pregnancy, entry of bacteria into the urethra during sexual relations, and lack of hormones after menopause. Often, however, there is no obvious reason for the infection. It may be reassuring to a woman with frequent UTIs to know that if the X-ray (Intravenous Pyleogram) and other tests are normal, there is very little chance a UTI will lead to kidney damage or other health related problems.
Q: Is there any way for a woman to prevent repeated UTIs?
A: Yes, there are many things which seem to help. Women should be sure to wipe themselves from front to back after urinating. this helps to prevent the spread of germs from the vagina or anus into the urinary opening. Voiding and gently wiping from front to back after sexual relations, can also prevent UTIs. Some patients troubled by frequent UTis do better if they take a medicine to reduce bacterial growth in the urinary tract. Women after menopause may be helped by vaginal hormone creams.
Q: What about men -- do they get UTIs?
A: Yes, men also get UTIs, though much less often than women. In younger men, this is usually a result of inflammation or infection of the prostate gland (prostatitis). In older men, it is often due to the enlargement of the prostate gland which blocks the flow of urine.
Q: Do children get UTIs?
A: Yes, although less often than adults. Girls, especially between the ages of 4 and 8, are more likely to have UTIs that boys. When a child has a UTI with a fever, there is usually some form of blockage or reflux and special tests should be done.
Q: How can a parent know if a child has a UTI?
A: Older children may complain of the same symptoms as adults, but younger children may not be able to describe what is wrong. The child may have a fever, be fussy or irritable. The urine on diapers may smell strong or foul, or the parent may notice blood or pus in the front of thediaper. Preschool or grade school children may complain of pain around the belly button. Those who have completed toilet training may wet the bed at night again. Each of these symptoms could be due to other things, but a child who has these symptoms should be checked by a doctor.
Q: Do kidney infections lead to kidney failure?
A: Very rarely. Several careful studies have shown that even repeated infections in patients with normal urinary tracts almost never lead to kidney damage or failure. However, if a person has a urinary tract blockage, reflux, or some other similar abnormality of the urinary tract, then infection may contribute to progressive damage to the kidneys.
Q: How can I find out more about UTIs?
A: Your doctor can answer any specific questions or problems you or your family have about urinary tract infections or symptoms. He/She can order the urine examinations needed to find out if an infection exists, and plan any other needed test or treatment. For other UTI information, contact us.
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