More than likely, if you have had a urinary tract infection (UTI), you knew it. The stinging pain with urination is enough to make anyone run to her doctor. A UTI occurs when bacteria from the outside travels up your urethra into your bladder causing an infection. The most common bacteria include e.coli, klebsiella, s. aureus (staph), and the strep family. This bacteria may come from your vaginal area, anal area, or external sources.
How does it happen?
Women are probably familiar with the usual "after sex" reason; however other common causes include prolapsed uterus, cystocele in the vagina, diabetes, or catheter use. Typical symptoms are pain with urination, frequency of urination, urgency, feeling pressure in the lower abdomen not relieved with urination, back pain, fever, and blood in the urine. A more severe concern is pyelonephritis, where bacteria travel up into the kidney.
Diagnosis is made on symptom history and urinalysis where you urinate into a cup and then this is tested for a variety of markers such as white blood cells, red blood cells, and nitrites. The urine can then be further cultured in order to determine exactly which bacteria are involved. This is very helpful in determining the appropriate treatment.
Treatment often requires a short term course of antibiotics to kill off the bacteria, however many women with experience are able to recognize the early signs of an impending infection and can utilize unsweetened cranberry juice, water, and probiotics to prevent a full-blown problem. Basic hygiene is also important such as wiping from front to back after using the bathroom, urinating after intercourse, washing hands and scrubbing fingernails of both partners before intercourse, and staying very hydrated. For someone with a prolapsed uterus or a cystocele, talk with your health care provider about corrective options available that might help with recurrent infections.
Make sure you don’t assume every pain with urination or lower pelvic pressure is a urinary tract infection. Be sure to rule out kidney stone, sexually transmitted infections (like Chlamydia or gonorrhea), interstitial cystitis, vaginal infections (such as yeast or bacterial), and pelvic causes (uterine or ovarian reasons). These require additional work-up besides a urine test such as a vaginal swab for infection or ultrasound of the pelvic organs. Women with recurrent urinary tract infections may need specialty evaluation by a urologist or uro-gynecologist to determine if there are issues with the urinary organs themselves.
References:
1) Urinary Tract Infections: Contemporary Management: Pathophysiology.
http://www.medscape.com/viewarticle/583060
2) Probiotics May Help Prevent Urinary Tract Infection
http://www.medscape.com/viewarticle/741144
Reviewed July 8, 2011
by Michele Blacksberg R.N.
Edited by Alison Stanton