Painful Urinary Tract Infections: Everything You Need To Know

Urinary tract infections (UTIs) are infections that affect a part of the urinary tract. UTIs are some of the most common bacterial infections and affect 150 million people each year worldwide. They occur more often in women than in men, at a ratio of 8:1. Approximately 50-60 percent of women have reported at least one UTI in their lifetime. Urinary tract infections occur most frequently between the ages of 16 and 35 years of age and recurrences are common.

Categorisation Of Urinary Tract Infections

UTIs are categorised as either uncomplicated or complicated.

Uncomplicated UTIs generally affect people who are otherwise healthy and have no structural or neurological urinary tract abnormalities. They are differentiated into two categories. If it affects the lower urinary tract it is known as a bladder infection (cystitis) and if it affects the upper urinary tract it is known as a kidney infection (pyelonephritis).

Complicated UTIs is when an infection occurs with an abnormal urinary tract such as urinary obstruction, urinary retention, renal failure, pregnancy, presence of foreign body such as catheter etc. In the United States, 70-80 percent of complicated UTIs are attributed to indwelling catheters.

Symptoms Of Urinary Tract Infections

People with lower urinary tract infection may suffer from

• Dysuria, burning with urination
• Frequent urination in the absence of vaginal discharge
• Painful urination
• Pain above the pubic bone or in the lower back

People with an upper urinary tract infection may suffer from the symptoms of lower UTIs along with

• Flank pain
• Fever
• Nausea
• Vomiting

Causes Of Urinary Tract Infections

80-85 percent of community-acquired UTIs are caused by Escherichia coli (E. coli). Recurrent UTIs are defined as three UTIs within a 12 month period or two UTIs within a 6 month period. Recurrent UTIs are mainly caused by the reinfection by the same pathogen. Having frequent sexual intercourse is one of the main risk factors for recurrent UTIs. Sexual activity is the cause of 75-90 percent of bladder infection and the risk of infection is related to the frequency of sexual intercourse.

The bacteria that causes UTIs typically enters the bladder via the urethra, infection may also occur via the blood or lymph.

Preventing Urinary Tract Infections

• Drinking plenty of fluids, around 2 to 3 litres every day.
• Use alternative contraception method that does not include spermicide as it may kill off Lactobacilli, which is a beneficial bacteria in the vagina. Killing off Lactobacilli makes it easier for E. coli to move in.
• Urinate immediately after sexual intercourse.
• For recurrent UTIs, both taking a short course of antibiotics for each infection or a prolonged course of daily antibiotics are effective. Taking antibiotics used to treat UTIs is the most reliable way of dealing with recurrences.
• Research suggests that drinking cranberry juice may decrease the number of UTIs for people with recurrent UTIs.

Recurrent Urinary Tract Infections

25-30 percent of the women who have had a UTI reported that the infection returned within six months. According to infectious diseases specialist, Dr Kalpana Gupta “Recurrent UTIs aren't due to poor hygiene or something else that women have brought on themselves. Some women are just prone to UTIs.”

Risk factors for UTIs vary with age. Before menopause, the most common risk factors are sexual intercourse and the use of spermicide. After menopause, the numbers of Lactobacilli decline naturally. Genetics also play a role as having a relative who has frequent UTIs is a risk factor.

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