Urinary Tract Infections

Urinary Tract Infections^*

Urinary Tract Infection (UTI) is a common infection that usually occurs when bacteria enter the opening of the urethra and multiply in the urinary tract. The urinary tract includes the kidneys, the ureters (tubes that carry urine from the kidneys to the bladder), the bladder, the urethra (tube that carries urine from the bladder) and the prostate in men. Men, women, and children can develop UTIs.

Urinary tract infections usually develop first in the lower urinary tract (urethra, bladder, prostate) and if not treated, may progress to the upper urinary tract (ureters, kidneys). Bladder infection is by far the most common UTI. True kidney infection (pyelonephritis) requires urgent treatment and can lead to reduced kidney function and possibly even sepsis and death in untreated, severe cases.

Risk Factors

Men: urethral obstruction (see strictures) and enlargement of the prostate

Women: urinary infections occur more frequently with intercourse (not a veneral disease) and menopause (due to loss of vaginal estrogen)

Other conditions that increase risk in both men and women include diabetes, kidney stones, neurogenic bladder, obstruction, congenital urinary tract abnormalities, prior genitourinary surgery, and instrumentation such as urethral catheters.

Diagnosis and Treatment

Diagnosis

Diagnosis requires careful history and physical exam; urinalysis and culture (to identify the germ and its sensitivity to antibiotics), possible radiologic procedures such as ultrasound or CT Scan; and possible cystoscopy

Treatment

Treatment may include an antiobiotic based on the bacteria identified and correction of risk factors, especially in patients with recurrent infections (see Chronic UTI)