Frequently Asked Questions about Urinary Tract Infection, and it is answered by Dr Lisa Hawes of Chesapeake Urology Associates.
What is a urinary tract infection, a urinary tract infection?
Overall, it means that you have bacteria somewhere in the kidneys, urethras or bladder. But for the most part, we use that colloquial colloquially to mean a bladder infection. So for the most part, when you hear I have a UTI or a urinary tract infection or bladder infection, they all mean the same, which means that you have bacteria growing in the bladder
Why are women more likely to get a UTI than men?
Women get UTI a lot more frequently, mostly because of anatomy. The female urethra is several centimeters long, perhaps three centimeters, whereas the male urethra is much longer. The other thing is that the urethra sits right next to the vagina and closer to the rectum than in men. And so in general, it’s much more conducive to getting infections in its location. The other thing is that women go through a lot of hormonal changes over time with both puberty and then menopause and that often changes the bacterial flora in the vagina, increasing the risk of infections.
What is the difference is between a simple UTI and a complicated UTI?
A simple UTI in general means that you have the basic symptoms of frequency urgency burning when you urinate. And that simply means that there are bacteria in the bladder, a complicated UTI means that the symptoms have become a little more advanced. Perhaps you have blood in the urine, fevers and chills, low back pain. And that’s when we start to worry about the bacteria actually getting up into the kidneys and causing what we call pyelonephritis or infection in the kidneys. And when you get to that point, it becomes a much more serious issue.
Is it Important to diagnose UTI at initial stages or is it curable in the advanced stages?
It absolutely is that way. Definitely want to try and catch an infection early. The problem is in younger women, they tend to get a lot of symptoms and a lot of irritation and jump right on it in older women and I mean women in their 70s and 80s that have gone through menopause, a lot of times the symptoms are much more subtle. We don’t tend to get the same frequency urgency burning that we did in our 20s.
And a lot of times the symptoms are as subtle as mental status changes, meaning confusion, forgetfulness, things that other people around you start to notice but you don’t really notice on your own. And so for the elderly, it’s really important for family members to be a little bit hyper-vigilant when they know that their mother or father isn’t quite acting normally.
Do children get UTI?
Anybody can get a UTI. Children get UTIs, young children, even one, two and three years old get bladder infections. It’s really critical. If you have a young child under the age of five who has more than one bladder infection, that you go to a pediatric urologist to be seen because there is a condition called Bassekou urethral reflux, where those infections can get up to the kidneys much more easily and cause long term damage to the kidneys. So any child under the age of five who has more than one bladder infection needs a work up, male or female. But the other thing is that even if I were 10 or 13, I would and you have infections, I would go ahead and have that worked up to duties of a certain age group more than others.
Is it perhaps common more than it is of a different age group?
Infections become more common once one becomes sexually active. So for women, a lot of times this happens in their early 20s when they go off to college and become more sexually active. There’s such a thing as many people heard of honeymoon cystitis. So after you get married, a lot of women get infections and then after menopause, a lot of women get infections. And that has to do with the change in the age of the vagina, with the change in hormones.
So there are infections all the way through life and some people are more prone to getting bladder infections. But those are the most common ages, right? When you become sexually active right after marriage.
How is UTI treated?
Most commonly, it’s a weekend. It’s a night, it’s a holiday, and your doctor’s office is closed. So a lot of people go to the minute clinic, the local clinic near them. And what happens when you go in there as you urinate in a cup and they do what’s called a dipstick test where they check for blood and white cells? It’s a very crude, simple test. They see you might have blood or white cells in the urine.
They give you an antibiotic and send you out the door, and that’s the end of it. The problem with that is that those tests are a little bit crude and they don’t necessarily mean that you have an infection. So I strongly recommend that you go somewhere where they will send the urine out for culture. And what that means is they actually send the urine to a lab and the lab grows the urine on a food plate for two days to see if any bacteria grow.
And if the bacteria grow, then they put different antibiotics on it and come back the next day to see that the bacteria are gone. And then they know what antibiotic works against those bacteria. And that’s a much better test. I don’t care if they send you out with an antibiotic, but you don’t know if you really had an infection and B, if you were put on the right antibiotic and then two weeks later you feel bad again. And we don’t know because we don’t really know what you had to begin with.
So I really recommend that when you go to a minute clinic, your primary care doctor, the urologist, they send a culture at the same time that they start to with antibiotics.
Do you have any advice on ways to utilize can be avoided?
There’s infinite information and recommendations on the Internet about how to prevent UTI. Some of those are accurate, some of them aren’t. But the most common and best recommendations are to drink plenty of fluid during the day and then not to hold your bladder. So when you feel like you need to go, don’t wait five or six hours, but go ahead and urinate every three to four hours in the day. Cranberry pills definitely can help cranberry pills or juice or fine, and they help find the receptors on the bacteria so the bacteria can’t find to you.
So a lot of people use cranberry pills or dominos. Which is a sugar that does the same thing, urinating within half an hour after having sex helps clear any bacteria that get in the bladder and that’s a great idea. But the other thing that most people don’t know about is controlling constipation. If you’re constipated, it increases your risk of getting infections. So making sure you’re having bowel movements regularly, either by taking fiber supplements or drinking water, fruit juice medications. That’s a very important way to help prevent infection.
Are there any other types of bladder infections that a patient can get besides that you want to touch on today?
The most important thing that I believe is happening is that we are treating a lot of bladder irritation like bladder infection. So people get the feeling of infection, meaning frequency, urgency, pressure burning when they urinate and they say, oh, those are the symptoms of infection they get on Google. Dr. Google says, yeah, you must have a bladder infection. You go to the minute clinic and they treat you. But the truth of the matter is there are other things that can give you the same symptoms but are not mediated by bacteria.
Constipation can do the stress can do it, hormone changes, foods, etc. There’s a long list. So the most important thing is to find out if you really have a bacterial infection. Now, there are other concerns. Some people think maybe there are viral infections that we can’t culture that are bothering the bladder. And that’s an open-ended question. We don’t have the answer to that at this time, but we’re working on it.
Do you have any just general bladder health tips for folks today?
The biggest thing I would say are that drinking lots of water helps keep the bladder healthy. Urinating regularly, not waiting five or six hours, but trying to go every three to four hours is better for the bladder. Teachers and nurses are known to be bladder holders and that can be an issue. And then the other thing is trying to cut down on foods that make the urine more acidic. A lot of women have frequency and urgency of urination because they’re drink a lot of coffee or soda and those things will make it go more often and probably aren’t the best for the bladder.
I encourage anybody who has more than to bladder infections a year to see their primary care doctor and if if needed, see a urologist, because you don’t have to suffer with these bladder infections, they impinge upon your enjoyment of life. You’re afraid to go on vacation, you’re afraid to have sex, and they can be treated and things can be done to help prevent them. So don’t just tolerate the infections and accept them, but go ahead and seek help.
Text Credits: Urological Care Foundation