Urinary Tract Infections in Women
Urinary tract infections are a serious health problem affecting millions of women each year. Infections of the urinary tract are the second most common type of infection in the body. Women are especially prone to UTIs for reasons that are not yet well understood. One woman in five develops a UTI during her lifetime. UTIs in men are not as common as in women but can be very serious when they do occur.
An infection occurs when tiny organisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. The urethra is the tube that carries urine from the bladder to outside the body. Most infections arise from one type of bacteria, Escherichia coli (E. coli), which normally lives in the colon. In many cases, bacteria first travel to the urethra. When bacteria multiply, an infection can occur. An infection limited to the urethra is called urethritis. If bacteria move to the bladder and multiply, a bladder infection, called cystitis, results. If the infection is not treated promptly, bacteria may then travel further up the ureters to multiply and infect the kidneys. A kidney infection is called pyelonephritis.
Some people are more prone to getting a UTI than others. Nearly 20 percent of women who have a UTI will have another, and 30 percent of those will have yet another. Of the last group, 80 percent will have recurrences. Pregnant women seem no more prone to UTIs than other women. According to some reports, about 2 to 4 percent of pregnant women develop a urinary infection. Scientists think that hormonal changes and shifts in the position of the urinary tract during pregnancy make it easier for bacteria to travel up the ureters to the kidneys. For this reason, many doctors recommend periodic testing of urine during pregnancy.
- Frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination.
- It is not unusual to feel bad all over—tired, shaky, washed out—and to feel pain even when not urinating.
- Pressure above the pubic bone
- Desperate urge to urinate with only a small amount of urine is passed.
- Milky or cloudy urine, even reddish if blood is present.
- Normally, a UTI does not cause fever if it is in the bladder or urethra. A fever may mean that the infection has reached the kidneys.
- If a UTI has progressed into a kidneys infection, you may feel pain in the back or side below the ribs or experience nausea, or vomiting.
Most UTIs are treated with antibacterial drugs. The choice of drug and length of treatment depend on the patient’s history and the urine tests that identify the offending bacteria. The sensitivity test is especially useful in helping the doctor select the most effective drug. Often, a UTI can be cured with 1 or 2 days of treatment if the infection is not complicated by an obstruction or other disorder. Severely ill patients with kidney infections may be hospitalized until they can take fluids and needed drugs on their own.
Women who have had three UTIs are likely to continue having them. Four out of five such women get another within 18 months of the last UTI. Many women have them even more often. These women might benefit from a longer course of antibiotics or targeted dosing schedules when symptoms appear.