A urinary track infection (UTI) can occur anywhere between the kidney and the urethra (the tube leading from the bladder to the outside). However, they may have different names; such as kidney infections are called pyleonephritis, bladder infections are termed cystitis, and urethra infections are called bacteriuria.
On an outpatient basis, it is the second most common infection among adults. It is estimated that 7 million visits a year occur in primary care, and about 1 million in the emergency room. These numbers are probably significantly higher, as infections sometimes are symptomless. These infections are cleared naturally from the system and no treatment is necessary, although exceptions exist.
Women have a higher risk of contacting a UTI as their urethra is shorter, and the anus is closer to the outside of the urethra. It is estimated that 95% of the people who have cystitis are women. E. Coli is the most likely infectious agent, as this bacteria lives naturally in our intestines, and in suspectible women, contact with the urethra will cause an infection.
Almost 1 in 2 women will experience a UTI sometime in their lifetime. Women with diabetes have almost a 3 times higher risk of getting a UTI than women without diabetes. The costs of this infection are also high; with approximately 700 million being attributed to direct costs, and almost 1 billion attributed to indirect costs.
The reasons for having an infection differ among age groups. In young women, the infection usually corresponds to sexual activity; whereas with post-menopausal women, it is related to urine stasis (i.e. the bladder does not completely empty with urination, but retains a small amount of urine where bacteria can breed.
Prevention also differs depending on age groups. In sexually active women diaphragms or spermicides may help. While in post-menopausal women may be helped by topic estrogen in the vaginal canal to prevent shrinkage.
Items which DO NOT HELP are the following:
- postcoital voiding,
- timed or frequent voiding,
- wiping patterns,
- douching,
- use of hot tubs, and
- wearing pantyhose
Therefore, there is presumably little utility in advising patients to alter any of the aforementioned habits.
Symptoms of cystitis or bacteriuria include:
- frequency,
- burning,
- straining,
- urgency, and
- pain with voiding.
Symptoms of pylenophritis include:
- fever,
- chills, and
- backpain in the middle, outer back.
Pylenephritis may also have different causes other than bacteria creeping up through the outside through the urethra and bladder. Renal masses or other blood diseases can cause pylenephritis, and should be investigated by one's doctor.
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