Our expert: Dr Nokukhanya Khanyile is a medical doctor at Nelson Mandela Children’s Hospital.
Urinary Tract Infections In Women
According to the Journal of South African Family Practice, at least half of women will experience a urinary tract infection (UTI) in their lifetime. If not managed early, it can cause significant discomfort and complications. It is, however, an easily treatable and preventable condition. We take a look at everything you need to know about urinary tract infections.
What is the urinary tract?
The urinary tract involves all structures related to the production and expulsion of urine from the body including the kidneys, ureters, bladder and urethra. It is normally tercile, meaning that it doesn’t have any bacteria or other organisms inside of it.
What does it mean when you have a UTI?
According to Medscape, a UTI is diagnosed when you have symptoms of cystitis (a bladder infection) or pyelonephritis (an upper urinary tract infection) in the presence of bacteria or organisms in the urine seen on a urine test. This implies that bacteria have moved from the surface of the urethra and up into the urinary tract.
What causes UTIs?
Bacteria are the most common causes for UTIs which is why the treatment is most commonly an antibiotic. A yeast such as Candida can also be a common cause.
What are the risk factors for getting a UTI?
- Women are more likely to get a UTI than men because of the short length of the urethra, where the urine comes out of the body, as well as the close proximity it has to the vagina which houses many bacteria.
- Poor hygiene is also a leading cause as an overgrowth of bacteria increases its chance of spread into the urinary tract.
- While it is not always necessary, urinating after sexual intercourse decreases the number of bacteria near the urethra which minimises infection.
- A weakened immune system due to diabetes, use of steroids or immunosuppressive drugs, poorly controlled HIV infection or increased stress levels.
- Infrequent urination or incomplete voiding of the bladder, especially seen in people who have bladder diseases or neurological injuries that require them to insert a catheter to urinate.
- Foreign bodies in the UT such as a urinary catheter, kidney stones, stents, etc. as these provide a source for the organisms to attach and grow.
- If you’ve had a UTI before, you are at increased risk of having another one.
The symptoms that might point to a UTI
The most common reported symptoms are those of a cystitis (bladder infection) and include:
- Pain or burning when urinating
- Lower abdominal pain
- Increased frequency in urination
- A feeling or urgency or that you’re about to wet yourself when needing to go to the toilet
- Passing small amounts of urine more often
- Bloody discolouration or cloudiness of the urine
Symptoms of a pyelonephritis, or upper UTI, include those mentioned above with:
- Flank pain
- Pain in the middle of your back on either side of your spine
- Nausea and vomiting
How will your doctor diagnose a UTI?
Healthcare practitioners use two kinds of urine tests to diagnose a UTI:
- Urine dipstix test: You will be asked to provide a clean catch specimen of urine in a sterile bottle into which a strip will be inserted into the fluid. After about 60 seconds, the test will be interpreted to see if there is any blood, white blood cells or nitrites in the urine which suggest an infection.
- Laboratory sample: Your doctor will then send the specimen off to the lab to check for the kind of bacteria or yeast that is growing in the urine as well as the kind of medication that can be used to treat it. This test result can take 48-72 hours to come back.
How is a UTI treated?
The most common course of treatment is antibiotics or antifungal therapy depending on the cause of the UTI. It is very important that the full duration of the course of treatment is completed even if the symptoms go away because the bacteria may still be present if you don’t feel any problems. This can be seven days for the first episode of an uncomplicated UTI, or as many as 14 to 21 days for a complicated or fungal UTI. You may need some intravenous antibiotics as well.
It is also important to make sure that you:
- Drink fluids regularly to ensure that you are urinating at least twice a day.
- Do not hold your urine in for long periods of time, this is especially important for young children.
- When going to the toilet, wipe from front to back to avoid bringing bacteria that is found around the anus and vagina to the urethra.
- Urinate after sexual intercourse, or if you don’t feel the need to, use a clean cloth and warm water to wipe away any excess secretions from the urethra.