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Urinary Tract Infection

more about Urinary Tract Infection


UTI



  • Urinary tract infections are usually due to bacterial infections of urine, and are one of the most common infections in the United States, more common in women than in men.  It is very easily treated with antibiotics.
  • Urinary tract infections can be divided into cystitis (bladder infection), Pyelonephritis (kidney infection), prostatitis (infection of the prostate gland in men), and Epididymitis (infection of the epididymis in men).
  • Urinary tract infections, or UTIs, are relatively uncommon in children, compared to adults.  Children with UTIs are at risk for infection of other parts of the urinary system, including the kidneys.  In younger children, a diagnosis of a UTI may require further studies to see if there are congenital problems.

  • The most common symptoms are frequent urination, burning or painful urination, and urgency to urinate right away.
  • Some may have fever, nausea, vomiting, pain in the area of the bladder, and pain in the area of the kidney, pain in the area of the prostate, or pain in the testicles.  The symptoms depend on the area of the urinary tract that is infected, and the seriousness of the infection.
  • Abdominal, pelvic, or back pain
  • In potty-trained children, the inability to hold urine until reaching the bathroom

  • Urinary tract infections are usually due to a bacterial infection of the urine.
  • The infection is more common in women because a woman's anatomy is designed in such a way that it makes it easier for bacteria to enter the bladder (the urethra is short).
  • Sexual intercourse increases the risk of developing urinary tract infections.  Also, using spermicidal creams and diaphragms can increase the risk of developing the infection.
  • Any abnormality of the urinary tract (which includes the kidneys, ureter, bladder, urethra; and the prostate in men) also increases the risk of infection.
  • Kidney stones can increase the risk of infection.
  • The infection can also be carried to the urinary tract in the blood stream, or can spread from the intestines.

  • Sometimes the patient can be treated based on the symptoms alone, without any additional tests.
  • A urinalysis (in which the urine is tested for the presence of an infection) is the most common way to make the diagnosis.
  • Blood and urine cultures may also need to be done.
  • In men, a prostate exam and an examination of the testicles may be needed.
  • In women with frequent infections (more than three a year), a full examination of the urinary tract (usually by a specialist) needs to be done.  Also, it is sometimes recommended that all men who develop urinary tract infections need to be seen by a specialist.

  • Antibiotics are needed to treat the infection.  There is a wide variety of antibiotics available for the treatment of urinary tract infections.  Talk to your doctor to see which one is best for you.
  • Usually, the antibiotics can be taken orally.  However, in those who are very sick, intravenous or intramuscular antibiotics may be needed.
  • Some infections only require 3 days of antibiotics.  Other, more serious infections require 2 to 4 weeks of antibiotic therapy.  Women who have more than three urinary tract infections per year may need prophylactic therapy (this means that they are given antibiotics to prevent repeat infections).  The most common antibiotics used for prophylactic therapy are trimethoprim sulfamethoxazole, nitrofurantoin, and cephalexin.  The antibiotics are taken once a day or at the time of intercourse.
  • In children and infants, additional studies may be ordered to look for congenital abnormalities:
    1. Ultrasound
    2. Voiding cystourethrogram (VCUG): X-ray using a contrast dye to detect problems with the bladder and kidneys.
    3. If ultrasound or VCUG detects abnormalities, daily antibiotics may be used to prevent new infections.
    4. If infection has spread to the kidneys, further tests to examine kidney function may be necessary.

  • Damage to the kidneys can occur if infection reaches them.
  • Young babies are at risk for the infection's spreading to the blood, if not treated quickly.

  • Females: Wipe from front to back after urination, not from back to front.  This helps to prevent stool from being wiped into the urinary opening.
  • Keep baths short
  • Avoid bubble baths
  • Allow children to urinate on a regular basis.
  • Wear cotton underpants that can "breathe."
  • Change children out of wet swimsuits as soon as possible.
  • If congenital problems are detected in children and infants, surgery may be necessary to prevent future problems.




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