Recurrent Urinary Tract Infections

Introduction

The urinary tract is a system of organs and tubes that help in the formation, storage and excretion of urine. It consists of the kidneys that filter the blood to form urine, tubes that carry the urine from the kidneys to the bladder called the ureters, the bladder that stores urine and a tube called the urethra that expels urine from the body. Infections of the urinary tract are common and usually affect women more often. Most infections are easily treated but some repeatedly return following treatment. These are referred to as recurrent urinary tract infections.

Causes

Urinary tract infections are usually caused by E. coli bacteria that are normally present in the intestine. Fecal matter containing these bacteria may contaminate the urethral passage causing an infection which then spreads to the bladder where the bacteria multiply. Infection of the urethra is called urethritis and infection of the bladder is called cystitis. If the urinary tract infection reaches the kidneys, a condition called pyelonephritis, it can cause serious illness.

Women have an increased likelihood of urinary tract infections as they have a shorter urethral passage which opens in close proximity to the anus.

Recurrent urinary tract infections are often associated with increased sexual frequency. Other factors include:

• Taking certain oral antibiotics
• Damage to the nerves controlling the muscles of the bladder wall
• Using a vaginal diaphragm for contraception
• Using spermicides
• Vaginal douching
• Hormonal changes with menopause
• An enlarged prostate in men

Signs and Symptoms

If you have a urinary tract infection you may experience:

• A burning sensation while urinating
• Blood in the urine
• Frequent need to urinate
• Pain in the lower abdomen in the region of the bladder
• Pain in the back which is transmitted from the kidneys

Kidney infections may be associated with fever, chills, nausea and vomiting.

Diagnosis

Your doctor will review your medical history of past urinary tract infections and any other conditions. A urine sample is obtained and cultured. Imaging studies may be obtained to view your kidneys and the rest of the urinary tract. A cystoscopy may be performed in which a thin viewing tube with a light and a lens is used to inspect your urethra and bladder for abnormalities.

Recurrent urinary tract infections if left untreated can lead to complications such as:

• Kidney damage
• Septicemia, infection in the blood
• Sepsis, a life-threatening inflammatory condition

Treatment

Urinary tract infections are usually treated by a course of antibiotics. After the infection has cleared, a long course of low-dose antibiotics may be recommended to help prevent recurrence. You may need to take certain antibiotics whenever you have intercourse.

Medications may be prescribed to reduce symptoms such as pain and burning.

Your doctor will recommend continued follow-up with home urine tests for early detection of infection.

Women in menopause who have recurrent urinary tract infections may benefit from hormone therapy.

Drinking plenty of water daily is advised.

Cranberry juice is a natural remedy for recurrent urinary tract infections and can be incorporated into your daily fluid intake.

Other recommendations to keep your urinary tract healthy and prevent recurrence of infection include:

• Wearing cotton underwear
• Wiping from the front to the back after urination
• Using lubrication during sex if necessary
• Urinating after intercourse and at regular intervals
• Regular washing of the foreskin in men

Summary

Recurrent urinary tract infections can prevent you from leading a normal life. Those suffering from this condition should assess themselves regularly for signs of infection and seek out early treatment. This helps reduce the risk of complications. Certain treatments, lifestyle changes and good habits go a long way in preventing a recurrence.