Urinary Tract Infections

A urinary tract infection (UTI), which is sometimes called cystitis, happens when bacteria in the bladder or kidney multiples in the urine and enters the urinary tract. UTI’s are not necessarily sexually transmitted, but being sexually active can increase the likelihood of developing a UTI due to the transfer of bacteria during sex between the vagina, rectum and urethra.

UTI’s are relatively common among both men and women, but women tend to develop UTI’s far more easily than men due to the structure of female anatomy. The distance between a woman’s bladder and the urethral opening is relatively short with the opening in close proximity to the vagina and rectum, making quick transfer of bacteria possible. Brown University reports that an estimated 50 percent to 80 percent of women will develop UTI’s sometime during their life and that 20 percent to 50 percent of these women will have recurrent UTI’s.

Common symptoms of a UTI include urine that appears cloudy, presence of blood in the urine, foul-smelling urine, urine with a strong odor first thing in the morning, frequent or urgent need to urinate, pain or burning with urination, needing to urinate with very little fluid coming out, night sweats, shaking or chills, pressure in the lower pelvis and low-grade fever. Men with UTI’s may experience a feeling of fullness in the rectum.

A UTI can occur anywhere along the urinary tract. As a general rule, the higher up into the urinary tract that the infection is, the worse the infection will be. The most common type of UTI is iscystitis, or infection or inflammation of the bladder which causes frequent and painful urination. An infection of the urethra is called urethritis, which causes burning urination. In men, urethritis can cause penile discharge as well. Pyelonephritis occurs when a bladder infection spreads to the kidneys, causing upper back pain, shaking, chills, nausea and vomiting. UTI’s in men can lead to toprostatitis, or enlargement of the prostate gland.

The elderly population is at a greater risk of developing a UTI than other age groups. This is partly because of susceptibility to all infections due to suppression of the immune system that is a result of aging and some age-related health conditions such as diabetes, an enlarged prostate or kidney stones. Elderly men and women experience a weakening of the bladder muscles which leads to more urine being retained in the bladder, poor bladder emptying and bladder incontinence, which can all lead to the development of a UTI. Use of a urinary catheter, bowel incontinence, immobility and surgery of any area around the bladder can create a greater risk of having a UTI as well.

When an elderly person has a UTI, they do not always exhibit the common symptoms, such as fever or painful urination, of the infection mentioned earlier in this article. According to the National Institutes of Health, UTI’s in the elderly are often mistaken as the early stages of dementia or Alzheimer’s because symptoms include confusion or a delirium-like state, agitation, poor motor skills, dizziness, hallucinations or falling.

The risk of developing a UTI is higher for people with incontinence who use disposable adult briefs, such as Depends, because these products are in close contact with the skin and can reintroduce bacteria into the bladder. Recommendations to reduce UTI’s among this population is to change the briefs frequently, encourage front-to-back wiping, keep the genital area clean and set reminders or timers for those with who are memory-impaired to encourage use of the bathroom instead of the adult briefs.

UTI’s can cause tissue damage in the urethra, bladder and/or kidneys. Left untreated, a UTI can lead to acute or chronic kidney infections, damage to the kidneys, kidney failure or sepsis, which is a potentially life-threatening infection of the bloodstream. Medical professionals prescribe antibiotics for the treatment of UTI’s in both men and women. These antibiotics include sulfamethoxazole-trimethoprim, amoxicillin, nitrofurantoin, ampicillin, ciprofloxacin and levofloxacin. UTI symptoms usually clear up within a few days of treatment, but antibiotics should be taken for as long as prescribed to completely kill the bacterial infection. In cases with extreme pain while urinating, analgesics, or pain medications, may be prescribed as well. Some bladder medications can discolor the urine, turning it bright orange or red.

Ways to reduce UTI’s among all age groups are to drink 2 to 4 quarts of fluid each day, avoid consumption of caffeine and alcohol which can irritate the bladder, wear loose pants, wear cotton underwear, change underwear at least once a day, sleep without underwear and urinate frequently, emptying the bladder each time. For people without a personal or family history of kidney stones, drinking cranberry juice can help reduce UTI infection rates. (Note: Cranberry juice can cause the formation of kidney stones in some people.) Women should not use douches, should always wipe front to back after using the bathroom and should change tampons and pads frequently during menstruation to lessen chances of developing a UTI.

For sexually active individuals, the use of condoms with sex toys and when changing from anal to vaginal penetration can reduce the transfer of bacteria between the penis, vagina and rectum which in turn can either reduce or eliminate the development of a UTI. Washing the hands before and after sex, especially after any contact with the anus, and urinating before and after sex can reduce the chances of contracting a UTI as well.

People experiencing symptoms of a UTI should seek medical advice as soon as possible. For elderly individuals, any change in behavior should be reported to a health care professional for evaluation as this may be a silent sign of a UTI.


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