Urinary Tract Infections
The urinary tract is the system that makes urine and carries it out of the body. When germs get into this system, they can cause a urinary tract infection (UTI) in the kidneys, ureters, bladder or urethra. Infection can occur in either the upper urinary tract (kidneys) or lower urinary tract (bladder). As a rule, upper urinary tract infections are more serious. More common in adults than children, urinary tract infections are second only to respiratory infections as the most common type of infection. About 40 percent of women have a urinary tract infection at some point in their lives.
A urinary tract infection occurs when bacteria begin to grow in the urine. The infection usually begins at the opening of the urethra where the urine leaves the body and travels into the urinary tract. Infections are often caused by Escherichia coli (E. coli) bacteria that live in the bowel.
Lower urinary tract infection (cystitis):
- Painful, burning or more frequent urination
- The sensation of not being able to hold in urine
- Feeling that you have to urinate but only a few drops of urine come out
- Cloudy, bad-smelling or bloody urine
- Lower abdominal pain
- Mild fever (less than 101°F) and chills
Upper urinary tract infection (pyelonephritis):
- Fever (higher than 101°F)
- Shaking, chills
- Nausea and vomiting
- Pain in the back and side, at waist level
A urologist will perform a detailed history and physical exam, including a variety of tests:
- Urinalysis: A urine sample is taken on a treated chemical stick and examined under a microscope for the presence of bacteria.
- Urine Culture: The physician may also send your urine to a lab to determine specifically what bacteria are causing the infection. It can take a few days for the bacteria to grow and to be identified.
Patients with recurring UTIs may require image testing to detect underlying problems in the urinary tract:
- Cystoscopy: A tiny camera is inserted through the urethra into the bladder.
- CT scan: A detailed, three-dimensional picture of the urinary tract.
- Ultrasound: Imaging to evaluate kidney and bladder problems.
- Intravenous pyelogram (IVP): A series of X-rays using a contrast dye to highlight abnormalities in the urinary tract.
Antibiotics are used to treat urinary tract infections. The length of treatment depends on the type and severity of infection. Postmenopausal women may want to ask their doctors about using vaginal estrogen to prevent recurrent UTIs.
In more severe cases, hospitalization and IV antibiotics may be necessary. Issues requiring a hospital stay may include the following:
- Unresponsiveness to outpatient antibiotics.
- Underlying diseases or medications compromising the immune system.
- Inability to keep food down because of nausea or vomiting.
- Kidney stones
To learn more about Urinary Tract Infections in women visit WebMD's Urinary Tract Infections in Teens and Adults page.
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