Often called cystitis which means inflammation of the bladder,
urinary tract infections generally involve the bladder and rarely ascend
(go upward) to involve the kidney where it is called pyelonephritis.
Symptoms
- Frequent urination
- Urgency (constant need to urinate)
- Dysuria (pain when urinating)
- Small volumes when urinating
- Hematuria (blood in the urine)
- Fever and/or flank/back pain
Causes and Treatments
The initial treatment for a urinary tract infection is antibiotics for
3-10 days, on average. If you have recurrent infections, treatment will
depend upon the cause of the recurrent infections. There are multiple
causes of UTI, depending on the age of the patient and/or their sex, with
the primary causes listed below:
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- Sexual activity is the most common cause of
recurrent urinary tract infections in the sexually active young
female. Bacteria reside on the perineum (area between the rectum
and vagina) and are introduced into the urethra/bladder during
sexual intercourse. This type of infection is generally treated
with antibiotics after sexual intercourse, and is called post
coital prophylaxis.
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- Urethral diverticula develop in some women
when a gland along the urethra becomes obstructed and swells.
A small bulge can be felt vaginally coming from the urethra. During
urination, this can fill with urine that may not empty. In addition,
patients may have urinary frequency, dysuria (pain with urinating),
and/or dyspareunia (pain with sexual intercourse). This condition
is treated by surgical removal of the diverticula.
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- Menopause may lead to urinary tract infections
because of the lack of estrogen. Local estrogen therapy restores
the ability of the urethra to prevent ascent of bacteria into
the urethra/bladder.
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- Stones, which can become infected and may continually
infect urine in a descending (downward) way. These stones can
be in the kidney, ureter or in the bladder. Stones are treated
either medically or surgically depending on the composition of
the stone and/or its location.
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- Retained Urine occurs if there is either an
obstruction to urine flow or poor bladder contractility (weak
bladder), leading to a retention of urine that can lead to a UTI.
In men, obstruction may be due to urethral strictures or BPH (Benign
Prostatic Hyperplasia). While rare, obstruction in women can be
due to pelvic prolapse (dropped bladder or uterus) or urethral
strictures. Poor bladder contractility may be due to Diabetes
or neurologic conditions such as spinal cord injuries, stroke
and/or Parkinson's Disease. In either case, patients may have
symptoms of frequency (especially at night), straining to urinate,
decreased force, and/or prolonged urination. Currently, the only
treatment for retained urine due to poor bladder contractility
is catheterization. These soft rubber catheters can either be
used temporarily or permanently.
With patients that have retained urine because of obstruction,
treatment is aimed at relieving the obstruction. Patients that have
urethral strictures can have these dilated or incised. If the obstruction
is due to BPH, patients may have TURP (trans-urethral
resection of the prostate), TUNA (trans-urethral
needle ablation of prostate), or open surgical procedures. |
For a referral to a Beth Israel urologist in Manhattan or Brooklyn for urinary tract infection treatment, call our Physician Referral Service at 1-877-484-3466.
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