Health Square: Urinary Tract Infections

I f you are among the many women who have had an infection of the urinary tract, you know what a painful nuisance it can be. The usual mild urge to urinate becomes a pressing matter as the nerves that tell you it's time to go to the bathroom send their signal with alarming frequency. This sudden urge can wake you up from a sound sleep several times a night. Yet after you dash to the bathroom, only a few drops come out, perhaps accompanied by a burning or stinging sensation and a strong urine smell. You may also feel a dull pain in your lower abdomen. The urine itself may look cloudy or contain blood, even if you are not having your period.

Such symptoms can be frightening. And left untreated, the infection can spread to the kidneys, causing permanent, even life-threatening damage. Fortunately, this is rare, especially if you get prompt treatment.

When you see your doctor, the first thing you'll be asked for is a urine sample, which will be cultured for bacteria. The doctor may also give you a prescription, based on your description of the symptoms, without waiting for lab results, since a fast dose of antibiotics eliminates the vast majority of urinary tract infections (UTIs). Doctors are also now starting to give their patients, particularly those plagued by repeated UTIs, prescriptions to keep at home, teaching them to treat themselves at the first sign of infection.

If you have been distressed to find the painful symptoms of a urinary tract infection returning, you are far from alone. Up to 90 percent of women will have a recurring episode at least once in their life. The chance of having repeat infection within 6 months of the first, or 3 infections within 1 year, is 15 percent. Most of the time, subsequent infections are caused by different bacteria than the first. If the original bacteria, never eliminated in the first place, are the cause, the infection will usually come back within a week or two after you have finished taking your medication.

Types of UTI

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The urinary tract is divided into two sections. The upper tract includes the two kidneys and their accompanying ureters, tubes that connect each kidney to the bladder. The lower tract is made up of the bladder and the urethra through which the bladder is emptied. Infections of the lower tract are by far the more common.

Lower UTI

If you feel a burning sensation while urinating, but no other symptoms, you probably have urethritis, an infection of the urethra. Possible causes include sexually transmitted diseases, especially gonorrhea; trauma from childbirth, surgery, or catheterization; irritation from a diaphragm; or an allergic reaction to soap, vaginal cream, spermicide, bubble bath, or some other chemical substance.

Cystitis occurs when bacteria work their way up from the urethra to infect the bladder. This is the most common UTI and it is most often found in women who have repeated infections. Urethritis and cystitis frequently occur together.

Upper UTI

If a lower UTI is left untreated, the bacteria can spread beyond the bladder, through one of the ureters, and into a kidney. This infection, known as pyelonephritis, requires immediate medical care. Symptoms are stronger than a lower UTI: back pain (since the kidneys are located there), fever, chills, nausea, and vomiting as well as the typical complaints associated with cystitis. If allowed to persist, this condition can become chronic and eventually lead to kidney damage or even kidney failure. Multiple kidney infections can cause high blood pressure.

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