by Marshaneil Soumi D'Rozario | 21 August, 2018
UTI or urinary tract infection is the infection of the bladder (cystitis), urethra (urethritis), ureter (ureteritis) or rarely the kidneys (pyelonephritis) 80 percent of woman experience a UTI once in their life time. Dr.Mandira Singh, M.S. (OBG), D.G.O., D.N.B., F.I.C.M.C.H. Infertility Specialist & Laparoscopic Surgeon and Director, Obstetrics & Gynaecology of Virinchi hospitals, Banjarahills answers to commonly asked questions by patients
What makes women so prone to UTI?
A bundle of factors interplay to cause UTI in women. Anatomically a women's urethral meatus (opening for urination), vagina and anus are in a straight line and close to one another. Also the length of the urethra is much shorter than male being approximately 4 cm as compared to male of 20 cm. This predisposes a woman to come in contact with bacteria from the anal canal and rapid ascent through the shorter urethra. It’s not surprising to know that the most common bacteria that cause UTI like E coli are all resident of the gut. The normal vaginal medium is acidic in nature which prevents the colonization of bacteria. When this acidic medium is disturbed it makes women more prone to vaginal infections and UTIs. This is seen most commonly during menses and sexual intercourse. Sexual intercourse also causes trauma to the surrounding tissue and leads to UTI.
”Honeymoon cystitis "is a condition where newly married women develop UTI. Many of the sexually transmitted bacteria also cause UTI and unprotected sex is a major cause of UTI in women of the reproductive age group. Hence poor hygiene, sexual intercourse, menopause, associated conditions like diabetes, lowered immunity all predispose women to UTI along with other common factors like urinary stones, prolonged retention of urine or defects in the urinary tract. Urinary tract infections may be symptomatic or without any symptoms (asymptomatic).
What are the symptoms of UTI?
They most commonly present with pain or burning sensation during urination (dysuria), increased frequency of urination, and an increased urge to urinate. In severe cases it may be associated with passing of blood in the urine (Haematuria), and pain in the pelvic area( lower part of abdomen) .
If the infection spreads to the kidneys it may also be associated with fever and chills with a evening rise of temperature, cloudy appearance of the urine and foul smell. Sometimes UTI can occur frequently, in such circumstance a full work up is needed to exclude other causes as urinary stones, stricture, pyelonephritis ( kidney Infection) , vaginal infection etc
Discuss UTI in pregnant women?
UTI is a common problem faced by pregnant women. Left untreated it can cause miscarriage in early pregnancy , preterm labour in late pregnancy , intrauterine growth retardation and premature rupture of membranes. Asymptomatic bacteuria (count of 100000 bacteria or more on urine exam) requires treatment in pregnant woman along with symptomatic UTI to prevent the complications of UTI in pregnancy.
Why is UTI a common problem in older women?
The risk of UTI increases considerably throughout life but more so after menopause. This is because of the deficiency of one natural hormone called Oestrogen which decreases in the perimenopausal as well as in the postmenopausal period. Due to the deficiency of this hormone, the inner lining of the urinary tract changes and become atrophic as well as the Ph becomes less acidic. With growing age old women are unable take care of their perineal hygiene and may suffer from uncontrolled involuntary urination. Intravaginal use of estrogen cream (only under the supervision of a gynecologist) can be used in elderly women to improve the vaginal flora and to revert the atrophic changes in the urethra.
How to treat urinary tract infection?
It is important to consult your nearest specialist when one experiences the above noted symptoms. UTIs should not be treated with over the counter antibiotics given at pharmacies as this will add to the continuing problem of increased resistance to antibiotics by bacteria and the need for more antibiotics. The specialist will ask for a complete urine exam and urine for culture sensitivity and prescribe appropriate antibiotics for the required duration of time which usually lasts 5 to 7 days in uncomplicated infections. Untreated UTI or poorly treated UTI with the wrong antibiotics can lead to chronic UTI and antibiotic resistance. In case the symptoms persist even after treatment of UTI, the patient can be kept on low dose bacteriostatic antibiotic for three weeks or more along with vaginal probiotics. Good personal hygiene, adequate water intake of 3 liters /day and not withholding urination for long durations also helps in the management of UTI.
Prevention of UTI
As the good old saying goes prevention is better than cure. UTI can be prevented by
Good perineal care --Do not use soap and other chemicals while cleaning the perineum. Avoid any perfume or talcum powder. Wash vulva from forwarding direction to backward direction Dry with a clean towel/ tissue paper after washing.
Urinate before and after intercourse. Protected sex reduces the chances of UTI.
Do not hold urine for a long duration
Drink plenty of oral fluids 3 to 4 litres/day
Avoid using public restrooms
Maintain a strict control of blood glucose level in case of Diabetes
Do not self-medicate. Not every symptom maybe that of a UTI .Always consult a specialist when having symptoms of a UTI.
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