Understanding Urinary Tract Infections

Sep 3, 2024

Urinary Tract Infections (UTIs)

Introduction

  • Focus on the urinary tract: kidneys, ureters, bladder, urethra.
  • Normal urine flow: Kidneys -> Bladder -> Urethra -> Out of body.

Pathophysiology

  • Infections can be caused by viruses, fungi, or bacteria.
  • Common infections: pyelonephritis (kidneys), cystitis (bladder).
  • E. coli is a common causative agent.

Urinary Tract Anatomy

  • Urovesical valve prevents backflow.
  • Backflow and blockages cause UTIs.
  • Urine should ideally flow downward and remain sterile.

Risk Factors for UTIs

  1. Gender: More common in females due to shorter urethra and proximity to rectum.
  2. Medications: Antibiotics can disrupt normal flora.
  3. Immunosuppression: Conditions like diabetes increase risk.
  4. Urinary Catheters: Provide pathway for bacteria to enter.
  5. Obstructions: Kidney stones, enlarged prostate, etc.
  6. Hygiene: Improper cleaning, particularly wiping back to front in females.

Signs and Symptoms

  • Painful urination (dysuria).
  • Urgency and frequency.
  • Dark or foul-smelling urine.
  • Back pain, fever, and flank pain.
  • Older adults may show confusion or incontinence.

Diagnostics

  • Urinalysis: Clean-catch, mid-stream sample required.
  • Presence of blood, WBCs, bacteria indicates infection.
  • Urine culture identifies specific bacteria and appropriate antibiotics.
  • Imaging (ultrasound/CT) for abnormalities or obstructions.

Treatment

  • Antibiotics: Sulfonamides, fluoroquinolones.
    • Be aware of allergies and potential side effects.
  • Analgesics: Pyridium (phenazopyridine) turns urine orange.
  • Additional meds: Tylenol for fever, Zofran for nausea.

Patient Education

  • Complete full course of antibiotics.
  • Promote fluid intake: ~3 liters per day.
  • Avoid cranberry juice if cystitis is present.
  • Urinate every 3-4 hours and after intercourse.
  • Maintain hygiene: wipe front to back, avoid prolonged wet swimsuits.
  • Avoid alcohol and coffee.

Summary

  • Understanding UTIs, their causes, symptoms, and treatments are crucial for managing and preventing this common infection. Proper hygiene and timely medical intervention can prevent complications and recurrence.