More than 40% of women and 12% of men in their lifetime will have one or more urinary tract infections (UTIs). This makes it a little less common than the common cold or other respiratory infections.
Ever woken up to experience one or more of the following?
- Burning or pain upon urination
- Urinating more often during the day
- Feeling like you are not able to urinate completely or needing to exert some pressure to get everything in your bladder out
- Feeling the need to go immediately or not being able to hold urine before reaching a bathroom
- Lower abdominal or side pain
- Bad smelling, cloudy or bloody urine
- Fever and chills?
If you answered yes to any of these, you might have had a Urinary Tract Infection (UTI).
Unfortunately, unlike the common cold, many women know very little about symptoms of UTIs and feel embarrassed to seek appropriate medical care. Similar to other hushed women’s health issues, people present these conditions to doctors only when infections become serious and treatment complicated. Today, we are lifting the hush-hush ban and nipping UTIs in the bud
Pelvic anatomy—what it looks like down there?
Knowledge is indeed power. I found this to be true the first time I learned about the female anatomy and got to examine several during my Ob/Gyn clinical rotation in medical school. I encourage you to be involved in your health care, and ask during your annual Ob/Gyn visit to be aided in examining this area with a mirror. It helps you to better understand your anatomy and to notice any changes that might occur. From the top-down, you have 4 important structures:
1) Clitoris – very sensitive and gives sensual pleasure when stimulated
2) Urethra opening – this is a small hole from which your ‘pee’ flows and the site through which bacteria gets to your system causing UTIs. The urethra is a tube that connects the opening to the bladder.
3) Vagina – menstrual blood exits from here; it is used as the birth canal and for sexual intercourse. It is also the place for inserting contraceptive devices such as IUDs, female condom, diaphragm, etc
4) Rectum/anus – exit site for stool.
The position of each structure creates an ideal setting for UTIs to occur. The anus is not too far from the vagina or the urethral opening. As such, it is very easy for bacteria to travel from the area around the anus to the urethral and up into the bladder especially during sexual intercourse or if you tend to wipe from ‘back-to-front’. Also, women have a shorter urethra than men. Because of this, it is very easy for bacteria to get into the bladder because they have a very short distance to travel. A bladder infection, also known as cystitis, develops as a result of this. If it travels up all the way to the kidneys, it is called pyelonephritis. Urethritis is when it just stays in the urethra.
Other factors that increase your risk for UTIs
(as you can see from the list below, everyday routines can cause UTIs)
- Increased sexual activity
- Kidney stones or other things that block outflow of urine
- Use of diaphragm for birth control
- Diabetes
- Long indwelling foley catheters (tube placed into the urethra at the hospital to help you ‘pee’ after surgery or if you have problems urinating)
People with suppressed immune systems due to AIDS, chemotherapy and immunosuppressant medications
Of interest: uncircumcised males or those with enlarged prostates tend to be at a higher risk for developing UTIs.
It is true that most UTIs resolve on their own without any treatment but some do result in serious complications such as miscarriages in pregnant women, damage to kidneys, urinary incontinence (leaking of urine) and extreme pain during sexual intercourse.
If you have any of the symptoms mentioned earlier, do consider contacting your doctor or going to a clinic. The best time is between 24 and 48 hours after you first notice signs. It is even more important to go within the first 24 hours if you experience intense vomiting, are pregnant, have diabetes or are immune suppressed as you might have pyelonephritis. Your doctor will run a couple of tests including a urinalysis which looks at all the cells and bacteria in your urine. If a bladder or kidney infection is suspected, they might do an ultrasound imaging study.
Treatment options and prevention
UTI treatment in a healthy woman with basic infection consists of a 3-day course of antibiotics that should be prescribed by your doctor. Women with diabetes, or who are at increased risk for kidney infection tend to have a 7-day course instead. Generally, the more organs involved or the more complicated an infection you have, the longer the duration of antibiotic treatment. In a few cases, surgery might be indicated if there is extensive kidney damage or to remove kidney stones.
You can help reduce your chances of getting UTIs by:
- Drinking plenty of fluids, preferably water to help wash out the bladder. Cranberry juice has also been shown to decrease UTIs. However, drink in moderation considering its sugar content.
- Urinate frequently to empty the bladder to prevent stagnant environment for bacterial growth. Some women with recurrent infections find timed voiding helpful (that is, trying to urinate every 4 hours whether you feel like it or not)
- Try to urinate immediately after sexual intercourse to wash out the urethra
- Wipe from front to back after going to the bathroom for either urinating or passing a stool
- Take more showers instead of tub baths
- Stay away from certain scented feminine hygiene sprays and douches; they cause irritation to your urethra and increase UTIs
- Practice good hygiene in general and eat well to boost your immune system (e.g.. take adequate Vitamin C found in natural whole fruits or 100% fruit juices)
- Try eating yoghurts that contain live cultures—studies have found them to be excellent for maintaining the right pH and bacterial balance in the vagina
- If sexually active, encourage your partner to also practice good genital hygiene
Seek other options for birth control besides diaphragms or spermicides if you have a history of recurrent UTIs
The Truth
One in every five women you know will have a UTI infection. About half of these women will have recurrent infections during their lifetime with an increased rate during pregnancy. So, is having a urinary tract infection a big deal? I do not think so. Just remember, you are not alone. After all, this stuff is as common as the common cold, but it needs to be rid of to prevent future complications.