Located on level 2 of the Granada Medical Centre

URINARY TRACT INFECTIONS

 

What is a UTI?

• A UTI is an infection which can involve any part of the urogenital tract (kidney, ureter, bladder, urethra, prostate, testicles/epididymis)

• Usually when people refer to a UTI, they mean infection of the bladder (cystitis)

• The infection may ascend to the kidney (pyelonephritis), which is more severe

• The infection may also spread to the prostate (prostatitis) or testicles/epididymis (epididymo-orchitis) in men

 

What causes a UTI?

• If bacteria which normally live in the genital area are introduced into the urinary tract via the urethra (water pipe), they can multiply and cause an infection

• Female urethras are much shorter, which explains why UTIs are more common in women

• The most common bacteria causing UTIs is E.Coli

• In many young women sexual intercourse may cause UTIs on occasion

 

Some conditions may increase the risk of UTIs including:

• Obesity

• Diabetes

• Immunosuppression (from medications such as prednisolone, methotrexate, etc)

• Increase age and post-menopausal state

• Anatomical abnormalities in the urinary tract

• Incomplete bladder emptying (high post-void residuals)

• Kidney/bladder stones

 

What are the symptoms of a UTI?

• Burning/stinging when passing urine (dysuria)

• Frequent passage of urine (frequency)

• Strong urge to pass urine (urgency)

• Bladder/lower abdominal pain

• Fever

• Blood in urine (haematuria)

• Smelly or cloudy urine

• Flank pain – if the infections spreads to the kidney(s) (pyelonephritis)

 

How are recurrent UTIs evaluated?

• Urine culture – to prove infection exists or is cleared after antibiotics

• Blood tests – including kidney function

• Imaging with kidney tract ultrasound or CT scan to look for:

  • Post void residual volume – remaining urine volume in bladder after voiding

  • Rule out bladder, kidney stones and other anatomical abnormalities (eg. cancer)

• Flow rate/bladder scan – performed in the office at Geelong urology

• Cystoscopy – to look for anatomical abnormalities in the urethra and bladder

 

How can recurrent UTIs be prevented/treated?

1. Antibiotics – best if based on a specific culture result to ensure the bacteria are sensitive to this antibiotic

   • A longer course is usually required for recurrent cases (up to 2 weeks)

 

   2. Conservative measures

• Increasing fluid (water) intake (>2.5L per day) – to keep flushing the urinary tract and any bacteria present (please check if you have any medical conditions, for which fluid restriction is required)

• Good genital hygiene (eg. wiping front to back, not using soap)

• Voiding after intercourse

• Ensure the bladder does not get too full (timed voiding)

 

    3. Medications/supplements

• Cranberry tablets/juice

• Hipprex – a urinary antiseptic

• Antibiotics

  • Self-start antibiotic course at first sign of UTI

    • Important to send a culture before the first dose

  • Post-coital prophylaxis (if UTIs appear to be related to sex)

  • Prophylactic course (3-6 months) of low daily dose of antibiotic

• Vaginal pessaries – for post-menopausal women with atrophic vaginitis