Posted by: wockhardthospitals | August 4, 2009

Urinary Tract Infection:Symptoms, Diagnosis, Treatment & Prevention.

Urinary Tract Infection (UTI) is a bacterial infection of the urinary tract. Urinary Tract System consists of kidneys, ureters, bladder, and urethra. UTI can affect any of these parts. UTI is the second most common type of infection in the body. Women are more prone to UTI for reasons that are not yet well understood. The short urethra in female could be a reason for often causing urinary tract infection. One in 5 women develops UTI during her lifetime. UTI in men is not as common as women but it is as serious when it occurs.

Urinary tract can be divided into two parts, the upper and the lower. The upper urinary tract is composed of the kidneys and ureters. Infection in the upper urinary tract generally affects the kidneys. The lower urinary tract consists of the bladder and the urethra. Infection in the lower urinary tract can affect the urethra or the bladder. The further up in the urinary tract the infection located the more serious it is.


Normally, urine is sterile. UTI occurs when tiny organisms, usually bacteria from the digestive tract, stick to the opening of the urethra and begin to multiply. The urethra is the tube that carries urine from the bladder to outside the body. Most infections arise from one type of bacteria, Escherichia coli, which normally lives in the colon. In most cases the bacteria first travel to Urethra. An infection limited to the urethra is called Urethritis. If bacteria move to the bladder and multiply, a bladder infection, called Cystitis, results. If the infection is not treated promptly, bacteria may then travel further up the ureters to multiply and infect the kidneys. A kidney infection is called Pyelonephritis.

The ureters and bladder normally prevent urine from backing up towards the kidneys, and the flow of urine from the bladder helps to wash bacteria out of the body. In men, the prostate gland produces secretions that slow bacterial growth. But despite these safeguards, infections still occur.


Symptoms of UTI include a frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination. Person with UTI may feel tired, shaky, washed out, can feel pain even when not urinating and have fever. Women generally feel an uncomfortable pressure above the pubic bone, and some men experience fullness in the rectum. It is common for a person with a urinary infection to complain that, despite the urge to urinate; only a small amount of urine is passed. The urine may look milky or cloudy, even reddish if blood is present.

A pain in the back or side below the ribs, nausea, or vomiting are also symptoms of infection reaching the kidneys.

When to see a doctor

Anyone who develops any of the above mentioned symptoms of a urinary tract infection needs to be evaluated by a medical professional, preferably within 24 hours. Most hospitals can test urine for infection by using a quick urine “dipstick” test.


Generally a test of “clean catch” urine sample, by washing the genital area and collecting a “midstream” sample of urine in a sterile container, for pus and bacteria can determine UTI. This method of collecting urine helps prevent bacteria around the genital area from getting into the sample and confusing the test results. The urine is examined for white and red blood cells and bacteria. Then the bacteria are grown in a culture and tested against different antibiotics to see which drug best destroys the bacteria. This last step is called a sensitivity test.

Some microbes, like Chlamydia and Mycoplasma, can be detected only with special bacterial cultures. When an infection does not clear up with treatment and is traced to the same strain of bacteria, an intravenous pyelogram which gives x-ray images of the bladder, kidneys, and ureters is used. An opaque dye visible on x-ray film is injected into a vein, and a series of x-rays is taken. The film shows an outline of the urinary tract, revealing even small changes in the structure of the tract. Part from ivp, uktra sonogrpahy n ct scan can also b usedfor diagnosing complicated infection.


UTIs are treated with antibacterial drugs. The choice of drug and length of treatment depend on the patient’s history and the urine tests that identify the offending bacteria. Mostly a UTI can be cured with 1 or 2 days of treatment if the infection is not complicated by an obstruction or other disorder. Still, doctors may ask their patients to take antibiotics for a week or two to ensure that the infection has been cured. For people who delayed treatment or have signs of a kidney infection, patients with diabetes or structural abnormalities, or men who have prostate infections a single dose treatment is not recommended. Longer treatment is also needed by patients with infections caused by Mycoplasma or Chlamydia.

Patients with kidney infections may be hospitalized and require several weeks of antibiotic treatment. Researchers at the University of Washington found that 2-week therapy with TMP/SMZ was as effective as 6 weeks of treatment with the same drug in women with kidney infections that did not involve an obstruction or nervous system disorder. In such cases, kidney infections rarely lead to kidney damage or kidney failure unless they go untreated.


  • Women should wipe from front to back (not back to front) after going to the bathroom. This helps to prevent bacteria from the anus entering the urethra.

  • Empty your bladder regularly and completely, especially after sexual intercourse.

  • Drink plenty of fluids. Cranberry juice, especially, has been shown to help prevent urinary tract infections. Studies suggest that cranberries reduce the risk of the bacteria’s adhesion to bladder cells.

Doctors Advice

Since the symptoms of a UTI can be mistaken for other conditions, you should see a doctor if you think you have a urinary tract infection. A urine test is needed to confirm that you have an infection. Self-care is not recommended.

You can help reduce the discomfort by taking the following steps:

Follow your doctor’s treatment recommendations.

  • Finish the prescribed course of medication even if you are feeling better.

  • Drink plenty of water.

  • Avoid coffee, alcohol, and spicy foods, all of which irritate the bladder.

  • Quit smoking. Smoking irritates the bladder and is known to cause bladder cancer.

Dr. Mahendra Jain, MS, M CH, DNB, Consultant Urologist, Wockhardt Hospitals


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