
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?
-
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
