Urinary tract infections:- Symptoms and causes
What should you know about Urinary tract infections in women ?
Female urinary tract
The urinary tract consists of the two kidneys on either side , the two ureters in which the urine flows from the kidneys to get collected in one urinary bladder and fromhere the person passes urine through the urethra . The urethra of the female is shorter as compared to the male . Infections can affect any part of this urinary tract but in this blog , only lower urinary tract infections in the femalewill be covered.
The chance that a woman will get urine infection in her lifetime is quite high and it is good to have some basic understanding of the problem.
Causes
The female urethra is short and because of its proximity to the vagina and the rectum , women are more prone for Urinary infections.
The main causes of Urinary tract infections are
1. Sexual intercourse. Urinary tract infections are more likely to affect a woman after her first exposure to sexual intercourse. Hence the term “ Honey moon cystitis “ is coined .
2. Use of spermicidal condoms
3. In woman with a past history of Urinary infection
4. Diabetes
5. Postmenopausal women. The female hormones have a protective effect on the vagina and the urinary bladder and this effect is lost in a post menopausal women . The vagina also becomes very dry and a trophic.
6. Woman who have an indwelling catheter
7. Women who holdtheir urine for longer duration for various reasons are prone to have urinary tract infections
8. Drinking less water .
Symptoms
The woman experiences pain while passing urine , frequency of urination increases, she may feel that she has not completely emptied her bladder. She could also develop high grade fever with chills . Occasionally she maybe unable to pass Urine and present with retention of urine . She may also experience passing grey coloured urine or blood in urine. She could experience some vague lower abdominal pain or at times some sort of irritation in the vagina. She could confuse this as vaginal infection. Very occasionally she may experience urgency to pass motion . So cystitis or Infection of the urinary bladder can present with various symptoms.
Should she consult her doctor?
Ideally she should consult her doctor , either her family Physician or a Gynecologist. She would be advised to do a routine urine test . If she has a Urine infection the pus cells and red blood cells in her urine sample would be higher than normal values . The white blood cells in her blood count would also increase.
If she is a case of repeated Urine infections then the doctor would advise for a urine culture and Antibiotic sensitivity test to decide on the specific antibiotic that would take care of the infection. Generally most important organism to cause Urine infection is E COLI but at times other rare organisms like Klebsiella can be the causative organism.
In cases of repeated infections , she would be advised for an Ultrasound scan of the kidneys, ureter and bladder to find out whether any pathology like a stone or any growth is a cause of the urinary infection
Cystoscopy would be advised in case of a bladder or ureteric stone .
Treatment
Treatmentof an acute attack of urinary infection would be a short course of Antibiotic, some analgesics and drinking lots of water . For a chronic infection an antibiotic would be prescribed for longer duration of 10 _30 days .
It is important to completely cure the infection or else it would recur and become chronic. These chronic infections are nasty , take quite some time to become completely okay and would require prolonged antibiotics. Hence it is advised that she completes her course of the Antibiotics and does a repeat Urine test to confirm.
If there is concomitant vaginal infection then Vaginal pessaries is also advised.
Prevention
Prevention is always better than cure..
Important points for prevention are
1. Urinate after sexual intercourse and wash the perineal area .
2. To drink plenty of water on a daily basis .
3. Cranberry juice is supposed to decrease the chances of repeated Urine infections .
4. Keep the perineal area clean and dry after passing Urine, motions and maintenance of vaginal hygiene during menstrual periods.
5. Not to hold the Urine for prolonged duration .
6. To consult a doctor in case of symptoms suggestive of Urinary infection .
7. Use of Estrogen hormonalcreams will reduce the chances of urinary infections in Postmenopausal women. They need to be taken only with a doctor ‘s prescription.