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Illnesses We Treat
Urinary Tract Infection (UTI)
What is a Urinary Tract Infection
A urinary tract infection (UTI) is an extraordinarily common health problem, especially for women. Each year, eight to 10 million visits to doctors are a result of urinary
tract infections. There are two types of UTI's; lower tract infections and upper tract infections. Lower tract infections involve bacteria in the bladder and urethra,
while upper tract infections involve bacteria in the kidneys and ureters.
Causes of UTI's
A bladder infection (cystitis) usually occurs when bacteria travel up the urethra, enter the bladder, and begin to multiply. Women develop far more episodes of
cystitis because the urethra is shorter, allowing bacteria faster access to the bladder. Any abnormality of the urinary tract which obstructs the flow of urine sets the
stage for a UTI.
One common source of infections are tubes, or catheters, placed in the bladder. Bacteria, which normally live on the skin or in the environment, can essentially "crawl
up" the catheter and infect the bladder. People who cannot void or who are critically ill sometimes need catheters permanently, and are at high risk. People with
diabetes are also at an increased risk because of changes in the immune system. Men with enlarged prostates whose bladders do not fully empty are also at risk for
bladder infections.
Symptoms of UTI's
Symptoms of a lower tract UTI include a frequent urge to urinate and a burning sensation and/or pain upon urination. Suffers often complain that even though they
have a sense of urgency to urinate, only a small amount of urine is passed. The urine may look cloudy and may have blood in it. Many times, women feel pressure in
the lower abdomen above their pubic bone and men may feel a sense of fullness in their rectum. Intercourse can also be painful. Some signs and symptoms of an
upper tract UTI include lower tract symptoms accompanied by high fever, nausea, vomiting, fatigue, chills, back pain, and bloating.
How UTI's can be diagnosed
If you suspect that you have a UTI, you should consult your physician immediately. Your physician will take a detailed medical history and ask you to provide a urine
sample upon which a urinalysis test will be performed. If the urinalysis test reveals an infection, then a culture will be performed on the urine to identify the organisms
causing the infection. In addition to a urinalysis, you may also undergo a sonogram of your bladder and kidneys and/or a cystoscopy. These tests may or may not be
ordered by your physician. During a cystoscopy, a urologist looks inside the bladder with a lighted telescope. It is recommended only in certain circumstances.
Treatment options for UTI's
Bladder infections are usually treated with oral antibiotics. Based upon the results of the urinalysis and cultures used to diagnose your UTI, your physician will choose
the most appropriate antibiotic to treat the specific bacteria causing your infection. UTI's can often be treated and cured in 2-3 days if complications are not present.
However, it is usually recommended that patients take their antibiotics for a week to ten days. It is important to take your prescribed medications for the length of
time that your physician recommends, even though your symptoms have gone away. Even though the symptoms may disappear, the infection may still be present in
the bladder.
An upper tract UTI is far more serious, and is accompanied by any of the following symptoms: high fever, nausea, vomiting, fatigue, chills, back pain and bloating.
Although an upper tract UTI may be treated with oral antibiotics as an outpatient, it is often necessary to admit patients to the hospital, where they are given
antibiotic drugs intravenously. Depending upon the seriousness of the infection, multiple antibiotics may be necessary and rarely, treatment in an intensive care unit is
required.
What you can do to prevent future UTI's
UTI's are not only common, but they recur often. Nearly 20 percent of women who have a UTI will have another UTI in the future, and 30 percent of those women
will have yet another UTI. Of those people, 80 percent will have more UTI's. Because susceptibility to recurrences is so great, it is important to take steps to prevent
future UTI's.
Some things you can do to prevent future recurrences include:
- Drink plenty of fluids
- Don't resist the urge to urinate. Empty your bladder fully,
especially after intercourse
- Wear cotton underwear and avoid panty hose or tight fitting pants
- Avoid bubble baths or perfumed soap
- Wipe from front to back after a bowel movement or intercourse
- Treat vaginal infections as soon as you suspect them
If you have had more than three or four infections a year, it is probably appropriate for you to see a urologist and undergo a full diagnostic workup. This is necessary to
make sure that you do not have a correctable abnormality of the urinary tract, such as a kidney stone, blockage of the urinary tract, or a bladder which does not
empty fully. Only a urologist can properly evaluate you if your infections have become more than an occasional annoyance.
For further information or to schedule an appointment, contact:
Thomas Grimaldi, M.D.
Nicole Beth Fleischmann, M.D.
5 East 98th Street, Box 1272
New York, NY 10029
Tel: (212) 241-4812
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