Urinary tract infections are one of the most common infections afflicting both males and females.
The urinary tract consists of kidneys, ureters, urinary bladder, prostate, and the urethra and any of these organs can be involved. Infection of the kidney is called pyelonephritis, infection of the bladder is called cystitis, infection of the prostate is called prostatitis and infection of the urethra is called urethritis.
They can occur in any age but certain age groups are more predisposed. In males, the most common age group is in the elderly which is after the age of 50. This is the age in which prostate enlargement is seen and is responsible for UTIs.
In the females, there is a bimodal distribution with a surge in infections with the first surge occurring after the onset of sexual intercourse and after marriage. This goes by the name of ‘ honeymoon cystitis’. The second surge in the females is in their forties and fifties with the onset of menopause where hormonal changes at menopause increase the incidence of UTIs.
UTIs are seen in children too where they could be associated with congenital abnormalities of the urinary tract like PUJ obstruction, vesicoureteric refux, megaureter, posterior urethral valves etc.
The most troublesome infections are seen in females where they could be recurrent. This leads to a situation where some suffer from urine infections regularly despite antibiotics.
Symptoms of UTI: The most common symptom is dysuria which is the medical term for burning urination. The next most common symptom is increased urine frequency where the person has to visit the toilet very often in both day and night. This could be associated with urgency in urination and sometimes urine leak. The other common symptom is a pain in the lower abdomen (suprapubic region) and low backache. The patient may feel feverish and fatigued but usually, in infections of the urinary bladder, the fever is of low grade whereas, in kidney infections, the fever is high grade and associated with chills.
Investigations: The most important test is a urine examination. It is a simple and affordable test which can give a diagnosis in a few minutes. The doctor can start the treatment immediately. Urine can be sent for culture and sensitivity but the results will be ready only after 3 days. Complete Blood Count can establish if the urine infection has spread to the bloodstream. In complicated infections, an ultrasound abdomen will help in finding out if any other abnormality is present. Depending upon the complexity of the infection, more tests like CT scan may be needed which will be decided by the treating doctor. Treatment: The mainstay of the treatment is antibiotics. Most of the times, oral antibiotics are enough. However, in kidney infections, injection antibiotics are needed. In case it is severe, the patient may need hospitalization for observation and treatment. The antibiotics need to be taken for a minimum of three days and in severe infections may need to be continued for 15 days. Rest and hydration are important too so that the person recovers fast. There are many supportive treatments like cranberry extracts and alkaline solutions. However, they are mostly supportive but not the mainstay in treatment. Alkaline solutions are very popular and help in reducing the acidity of the urine so that the burning sensation may reduce. Cranberry capsules may help in long term prevention of infections but the evidence is not strong.