Women's Issues

A variety of topics ranging from adolescence to menopause

UTIs usually start when bacteria enter the tract from outside. In 90% of cases, the bacteria causing UTIs are E coli, which are normally found in the lower intestine. E coli leave the body through the rectum, but sometimes they re-enter the body through the urethra. If they find their way up to the bladder, they can multiply rapidly and cause an infection.

The most common UTIs occur in the lower urinary tract. An infection of the urethra is called urethtitis; if bacteria work their way up from the urethra to infect the bladder, it is called cystitis. The two frequently occur together.

If a UTI is left untreated, the infection can spread into the kidney (pyelonephritis), a less common but usually more serious medical condition.

Q. What are the symptoms of a lower UTI?
A. Urethritis causes a burning sensation upon urination, but no other symptoms. Cystitis, the more common UTI, causes a dull pain in the abdomen and pelvis and may make you feel an urgent need to urinate often. When you do urinate, however, you may produce only a few drops of urine, and you may feel a burning sensation. You may even experience a lack of control, and some urine may leak onto your clothing. The urine may be cloudy or contain blood and have an unpleasant odor. Occasionally, cystitis may cause low back pain, fever, or chills.

Q. What are the symptoms of a kidney infection (upper UTI)?
A. Symptoms of an upper UTI are stronger than a lower UTI and include fever and back pain, chills, nausea, vomiting, and the typical complaints associated with cystitis. An untreated upper UTI infection can lead to kidney damage, kidney failure, or other life-threatening conditions.

Q. How can I find out for sure if I have a UTI?
A. Your doctor will analyze your urine specimen (urinalysis). Pus or bacteria in the urine will indicate that there is an infection. If the doctor wants to find out exactly which bacteria are causing the infection to better tailor the medication prescribed, a urine culture will be ordered. It may take 2 to 3 days to get results. If there is an infection, the doctor will begin treating you immediately. However, once the results of a urine culture are in, the physician may need to switch medications.

Q. How are UTIs treated?
A. Most of the time cystitis can be cured with either a single oral dose of an antibiotic or 3 to 5 days of antibiotic therapy. Treatment may be longer and require different medications if the urine culture shows more than one kind of bacteria or if the type of bacteria found is hard to kill. It is important to take the medicine prescribed until the prescription is completely finished, and not to stop taking them if symptoms improve before then. Unless UTIs are fully treated, they frequently return.

Doctors are now starting to give their patients who are troubled by repeat UTIs prescriptions to keep on hand and are teaching them to treat themselves at the first sign of infection. Starting treatment at the first sign of infection reduces pain and begins to kill bacteria right away.

Q. How did I get a UTI?
A. UTIs can result from several factors:
-Wiping from back to front after urination or a bowel movement allows bacteria to enter the urethra. Bacteria can also live in your underwear and find their way to the vaginal area during exercise.
- Sexual intercourse can spread bacteria in the genital area. The thrusting of intercourse also has an effect on the urethra that can leave it more open to infection. Many women who have repeated UTIs find that the pain begins 12 to 24 hours after sex.
- The conceptive diaphragm can press on the urethra and irritate vaginal and urinary tissue, creating an environment ripe for infection. Also, spen-nicide creams used with diaphragms kill beneficial vaginal bacteria, encouraging cystitis-causing bacteria to multiply.
- Having diabetes or urinary tract abnormalities can also predispose you to getting UTIs.
- Hormonal changes of pregnancy cause urinary tract muscles to relax, allowing the retention of urine in the bladder and ureters. Fifteen percent of pregnant women get UTIs without knowing it. It is very impor tant to immediately treat a UTI during pregnancy because it may cause preterm labor.
- The bladder becomes less elastic with age and may not empty completely. This creates an environment that is beneficial to the growth of bacteria.

Q. What can I do to prevent recurrences of UTIs?
A. There are steps you can take to avoid getting UTIs:
-Try to urinate every 2 to 3 hours; never postpone urination. After the flow of urine has stopped, lean forward and gently squeeze out the last few drops. Be sure to wipe from front to back after bowel movements. Wash your entire genital area daily with a mild, unscented soap, then rinse and pat dry with a clean, soft towel.
-Do not use oils, sprays, or talcum powders in the genital area. Change your sanitary napkins or tampons frequently.
- Urinate and drink a glass of water before having intercourse. Urinate again within 10 minutes after sex to flush out any bacteria in the vagina. If you use a diaphragm, make sure it is fitted correctly. If you use a diaphragm is contributing to recurrent UTIS, consider alternative contraceptive methods.
- You should drink plenty of water: 6 to 8 glasses daily. Cut down on your intake of alcohol and caffeine. Some women find that cutting back on refined starches and sugars, vegetable fats, onions, beans, and chocolate helps prevent UTIs.
- Avoid nylon-crotch underwear and pantyhose and tight jeans, which create a bacteria-friendly environment. Wear only cotton-crotch underwear and pantyhose, and change them once daily. Use mild laundry detergent and rinse your clothes and linens well. After swimming, change into a dry bathing suit.