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Urinary Tract Infection

A urinary tract infection, or UTI, can occur at different points in the urinary tract, including:

  • Bladder -- An infection in the bladder is also called cystitis or a bladder infection.

  • Kidneys -- An infection of one or both kidneys is called pyelonephritis or a kidney infection.

  • Ureters -- The tubes that take urine from each kidney to the bladder are rarely the only site of infection.

  • Urethra -- An infection of the tube that empties urine from the bladder to the outside is called urethritis.

 

Causes

Most UTIs are caused by bacteria that enter the urethra and then the bladder. The infection most commonly develops in the bladder, but can spread to the kidneys. Most of the time, your body can get rid of these bacteria. However, certain conditions increase the risk for having UTIs.

Women tend to get them more often because their urethra is shorter and closer to the anus than in men. Because of this, women are more likely to get an infection after sexual activity or when using a diaphragm for birth control. Menopause also increases the risk for a UTI.

The following also increase your chances of developing a UTI:

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Symptoms

The symptoms of a bladder infection include:

  • Cloudy or bloody urine, which may have a foul or strong odor

  • Low grade fever in some people

  • Pain or burning with urination

  • Pressure or cramping in the lower abdomen or back

  • Strong need to urinate often, even right after the bladder has been emptied

 

If the infection spreads to your kidneys, symptoms may include:

  • Fever above 101°F (38.3°C)

  • Pain in the side, back, or groin

  • Chills and shaking or night sweats

  • Fatigue and a general ill feeling

  • Flushed, warm, or reddened skin

  • Nausea and vomiting

  • Very bad abdominal pain (sometimes)

 

Exams and Tests

Most of the time, you will need to provide a urine sample for the following tests:

  • Urinalysis -- This test is done to look for white blood cells, red blood cells, bacteria, and to test chemicals such as nitrites in the urine. This test can diagnose an infection most of the time.

  • Urine culture -- This test may be done to identify the bacteria and determine the best antibiotic for treatment.

  • Blood tests such as complete blood count (CBC) and a blood culture & KFT may be done as well.

 

You may also need the following tests to help rule out other problems in your urinary system:

 

Treatment

Your health care provider must first decide if the infection is just in the bladder, or if it has spread to the kidneys and how severe it is.

 

MILD BLADDER AND KIDNEY INFECTIONS

  • Most of the time, you will need to take an antibiotic to prevent the infection from spreading to the kidneys.

  • For a simple bladder infection, you will take antibiotics for 3 days (women) or 7 to 14 days (men).

  • If you are pregnant or have diabetes, or have a mild kidney infection, you will most often take antibiotics for 7 to 14 days.

  • Finish all of the antibiotics, even if you feel better. If you do not finish the whole dose of medicine, the infection may return and be harder to treat later.

  • Always drink plenty of water when you have a bladder or kidney infection.

  • Tell your provider if you might be pregnant before taking these drugs.

 

MORE SEVERE KIDNEY INFECTIONS

You may need to go into the hospital if you are very sick and cannot take medicines by mouth or drink enough fluids. You may also be admitted to the hospital if you:

  • Are an older adult

  • Have kidney stones or changes in the anatomy of your urinary tract

  • Have recently had urinary tract surgery

  • Have cancer, diabetes, multiple sclerosis, spinal cord injury, or other medical problems

  • Are pregnant and have a fever or are otherwise ill

At the hospital, you will receive fluids and antibiotics through a vein.

Some people have UTIs that do not go away with treatment or keep coming back. These are called chronic UTIs. If you have a chronic UTI, you may need stronger antibiotics or to take medicine for a longer time.

You may need surgery if the infection is caused by a problem with the structure of the urinary tract.

 

Outlook (Prognosis)

Most UTIs can be cured. Bladder infection symptoms most often go away within 24 to 48 hours after treatment begins. If you have a kidney infection, it may take 1 week or longer for symptoms to go away.

 

Possible Complications

  • Life-threatening blood infection (sepsis) -- The risk is greater among the young, very old adults, and people whose bodies cannot fight infections (for example, due to HIV or cancer chemotherapy).

  • Kidney damage or scarring.

  • Kidney infection.

 

Recurrent or Persistent UTI: Some people, esp women may get UTI's again and again, even several times a year. This may need detailed investigations and longer term treatment.

 

DO NOT NEGLECT UTI

DO NOT SELF MEDICATE

 

 

Blood in the Urine

(Hematuria )

 

What is hematuria?

Hematuria is the presence of blood in a person’s urine. It is one of the most worrying thing to happen to anyone.

 

What causes hematuria?

Common reasons why people may have blood in the urine are;

· UTI or infection in the bladder, kidney, or prostate. UTI is more common in women

· Kidney stones

· Enlarged prostate (BPH) in men.

· Injury, most commonly to the urethra in males.

· vigorous exercise

· sexual activity

· menstruation, when blood may get mixed with urine.

More serious reasons people may have hematuria include;

· bladder, kidney or prostate cancer

· patients who are on blood thinners

· blood-clotting disorders, such as hemophilia

· polycystic kidney disease—a genetic disorder in which many cysts grow on a person’s kidneys

 

What are the symptoms of hematuria?

People with hematuria have urine that is pink, red, or brown. Even a small amount of blood in the urine can cause urine to change colour. People with hematuria that includes blood clots in the urine may have bladder pain or pain in the back.

 

How is hematuria diagnosed?

A Urologist diagnoses the cause of the hematuria with

  • a medical history

  • a physical exam

  • urinalysis

  • additional testing

 

Medical History

Hematuria may be associated with;

Fever, burning sensation in urine & increased frequency of urination in UTI.

Some may have pain in the back which may be severe. This is seen commonly with kidney stones.

Painless hematuria, esp in elderly may be a sign of cancer.

 

Physical Examination

During a physical exam the urologist most often taps on the abdomen and back, checking for pain or tenderness in the bladder and kidney area.

He may perform a digital rectal exam on a man to look for any prostate problems.

He may perform a pelvic exam on a woman to look for the source of possible red blood cells in the urine.

 

TESTS :

Urinalysis

Routine Examination (RE) will confirm blood in urine and may show additional findings like pus cells, bacteria etc

Urine Culture test to see if there is any infection (UTI)

Additional Testing

  • KFT

  • Ultrasound of the KUB & Prostate region.

  • Computed tomography (CT) scan. It can help a doctordiagnose stones in the urinary tract, obstructions, infections, cysts, tumors, and traumatic injuries, when ultrasound is inconclusive OR when more information is needed before starting treatment.

  • Cystoscopy. Cystoscopy is a procedure that a urologist performs to see inside the patient’s bladder and urethra using a cystoscope, a tubelike instrument. A cystoscopy can detect cancer in a patient’s bladder.

  • Sometimes an MRI or PET scan may be needed to get more clarity esp in case cancer is the cause of blood in urine.

How is hematuria treated?

Urologists treat hematuria by treating its underlying cause, for example ; antibiotics for UTI depending on urine culture report, or removal of Kidney stones etc.

 

SUMMARY OF COMMON CAUSES OF BLOOD IN URINE BY AGE:

0-20 YEARS: UTI, Birth Defects causing obstruction

20-40 Years: UTI, Kidney stones, Bladder Tumor

40-60 Years: Bladder Tumor, Stone, UTI

> 60 Years (Male): BPH, Bladder Tumor, UTI

> 60 Years (Female): Bladder Tumor, UTI

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