Urinary tract infection (UTI)

Urinary tract infection is a common affliction that can happen to both men and women. It can range from a minor health problem to a life-threatening one.

Patients may feel unwell, feverish, and experience pain in the back (kidney area) or lower abdomen (bladder area). Some patients will experience pain along the urinary passage when passing urine.

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Urinary tract infection is treated with antibiotics. If the infection is mild, a 5 day course of oral antibiotics is sufficient treatment. If the infection is severe, hospitalisation and intravenous antibiotics may be necessary.

After the treatment has commenced, it is important to investigate if there is a problem with the urinary tract. An ultrasound or CT scan may be necessary, as well as flexible cystoscopy to check the bladder.

Possible causes of urinary tract infection include: urinary stones, blockage of the urinary tract, diabetes mellitus, prostate enlargement in men and postmenopausal changes in women.

Bacteria originating from the rectum may contaminate the area around the urethra and vagina. UTIs in women are usually caused by these bacteria entering the bladder through the urethra.

Common causes of recurrent UTIs in women

• Sexual activity – UTIs may occur soon after sexual intercourse, as the bacteria are more likely to enter the bladder during sexual intercourse.
• Menopause – Women who have reached menopause are also at higher risk of urinary tract infections because of disruption of the normal bacterial population living in the vagina.

Examples of other causes of recurrent UTIs

• Diabetes mellitus
• Inability to empty the bladder
• Kidney stones
• Sometimes, women may get recurrent UTIs without having an underlying condition.

Assessment for recurrent UTIs

Women who have recurrent UTIs should be assessed thoroughly, to find out if there is any underlying condition contributing to the UTIs. Investigations may include:

• Urine tests
• Ultrasound of the kidneys and bladder
• CT scan of the urinary tract
• Flexible cystoscopy (a test where a thin flexible endoscope is inserted through the urethra into the bladder)

Management of recurrent UTIs

Firstly, any active UTI has to be fully treated with the appropriate antibiotics. After successful treatment, preventive measures may be recommended, such as:

• Cranberry supplements
• Probiotics (supplements containing healthy bacteria)
• Preventive antibiotics