THE PROBLEM WHEN YOU PEE
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Urinary-tract infections (UTIs) are extremely frequent, especially among females but also in men over 50. Non-complicated forms used to be considered minor and temporary ailments, but they've begin to concern the medical community due to the increasing nu
A UTI is usually a bacterial infection in any part of the urinary system – kidneys, bladder, ureters (the narrow tubes linking the kidneys and the bladder), or urethra (the tube that carries urine from the bladder). In women, the urethra is less than two inches long and just above the vagina. In men, it runs the length of the penis.
Bacteria that live in the bowel cause most UTIs. Women are especially prone due to their much shorter urethra and its opening near the sources of bacteria, the anus and vagina. For women the lifetime risk of contracting a UTI is greater than 50 per cent.
Some individuals are more prone to UTIs than others, particularly those with diabetes, immune deficiency, artificial tubes in the urethra or bladder following surgery, and elderly men with enlarged prostates.
Sexual activity increases bacteria in the urine of women, and if the body doesn’t naturally clear them, a UTI can result. Some forms of birth control, such as the diaphragm, increase the risk of UTI because they slow urine flow.
Symptoms in normal adults for a non-complicated UTI (so-called “urine infection” or cystitis) typically include a painful, burning feeling in the bladder or urethra during urination and a frequent and intense urge to urinate. The urine might be cloudy, darker, contain blood or have a strong odour. But there is no fever.
Although few UTIs lead to complications, there is the possibility of a contaminated urinary tract up to the kidneys. This is called pyelonephritis and can seriously damage the kidneys and let bacteria into the bloodstream, a condition known as septicemia, which can be life-threatening.
Sudden fever with chills, upper back and flank pain and vomiting suggest an acute kidney infection, which represents a medical emergency.
Several tests are needed to confirm the diagnosis. Ideally, a urine sample is analysed in the lab. The urine may be cultured to identify the strain of bacteria and determine its sensitivity to different antibiotics.
Numerous antibiotics are effective, but many induce potentially serious side effects. This is why self-prescription should be avoided. Treatment should always be under medical supervision. In case of recurrent UTIs, additional tests should be performed to assess the urinary-tract anatomy.
How to avoid UTIs:
- Drink plenty of water – it dilutes the urine and gets you to the toilet more often.
- Clean up after you urinate and defecate to keep bacteria away from the vagina and urethra.
- Drain the bladder soon after sexual intercourse.
- Avoid feminine cleansing solutions that might irritate the urethra and genital area.
Dr Gerard Lalande is managing director of CEO-Health, which provides medical referrals
for expatriates and customised executive medical check-ups in Thailand. He can be
contacted at [email protected].
