INTRODUCTION–
It is an infection of urinary system which involves- Upper tract-kidneys and ureters, as well as lower tract- bladder and urethra (any part of tract can be involved). Mostly it involves the bladder and the urethra which is more painful in comparison to upper tract infection but it is graver when kidney and ureter are involved.
As we all know that ‘’Prevention is better than cure ‘’ it suits best in any case of UTI as it is an easily preventable disease by adopting different measures and general awareness.
Women are more prone to UTI then men due to several reasons.
CLASSIFICATION (BASED ON PART INVOLVED)-
1)KIDNEYS-
‘Pyelonephritis’ is the stage where UTI involves up to kidney and it can be acute or chronic which affects kidney permanently if not treated in time, symptoms presented are as follows-
1)Pain in back and flank (side).
2)High grade fever.
3)Chills and shaking.
4)Nausea and vomiting.
2)BLADDER-
‘Cystitis’ is the medical diagnosis in case of UTI when bladder is affected, symptoms presented are-
1) Pelvic pressure.
2)Painful and frequent urination.
3) lower abdominal discomfort.
4) Hematuria ( blood in urine)
3)URETHRA-
In this case it is defined as ‘urethritis’ which shows symptoms like-
1)Burning micturition.
2) Urethral discharges.
Apart from these part centric symptoms there are general sign and symptoms of UTI are also found in all the patients who suffers from it, they are as follows-
1)Frequent urination in small quantity as well as strong persistent desire to urinate all the time.
2)Urination accompany with burning sensation and sometimes pain.
3)Changes in urine are present- cloudy, smell become stronger, red, bright pink or brownish red in colour in case of haematuria.
4)Pain in pelvic region, but it is more marked in women than males which is surrounded around mid-pelvis and around the pubic bone.
ETIOLOGY–
Main causative agent is Escherichia coli (E. coli) whereas some other bacteria is also responsible sometimes. It is a bacterial disease which is caused by invasion of bacteria in tract and multiplying there when get contacted with them, it is not always the case as tract has their own immune system but sometimes it get infected somehow.
RISK FACTORS–
Women are more prone to them than men in general, also they suffer from multiple infections in their lifetime.
Risk factors in case of women are as follows-
1)Anatomical disadvantage- They have shorter urethra which exposes tract to infection more easily as it shortens the path to travel to bladder for invasive bacteria.
2) Family planning measures-In cases of mechanical birth control measures such as diaphragms (barrier method), it increases the chances of infection in comparison of spermicidal agents such as gel, foam, etc.
3) Sexual life- Females with active sexual life is more prone to infection also changing partners increases the chances than those who are not sexually active
4) Tract anatomical abnormality- In such babies it causes urine retention which increases the UTI chances too.
5)Menopause.- As estrogen concentration declines it results in changes in tract which increases the chances of infection.
6)Blockages- physical type such as stones ( kidney stones), prostate enlargement in males also causes urine retention and also increases chances of UTI.
7)Immune deficiency and systemic disorder- In both the conditions ,it impairs the body defence against pathogens which can also add as an important risk factor for UTI.
8)Catheter- In several medical conditions where urine incontinence is present, such as neurological problems, paralysis, hospitalized persons, etc. catheter is used which posses the side effect in form of UTI in such patients.
9)Post op urological surgery-A recent urinary procedure. Urinary surgery or an exam of your urinary tract that involves medical instruments can both increase your risk of developing a urinary tract infection.
DIAGNOSIS–
After clinical case taking different tests and procedure is involved in diagnosis, they are as follows-
1)LAB URINE TEST- To test for detection of bacteria (specific type is determined by urine culture which helps in selection of most effective antibiotic too), red blood cells, white blood cells present in the sample.
2)CT/MRI/ULTRASOUND- In case of recurrency to rule out any anatomical deformity, stone, blockage, etc.Creating images of your urinary tract
3)CYSTOSCOPY- To examine bladder as well as urethra in case of recurrent case of UTI.
COMPLICATIONS–
Any case of UTI needs proper diagnosis and management ,if not it can lead to several complications although lower tract infection rarely leads to any complications, it includes-
1)Infections shows recurrency- patient came with a history of UTI at least two times in a span of six months, etc.
2)Damage to kidney- Permanently it can be caused due to complications of untreated UTI when it reaches to kidney and causes pyelonephritis.
3)Affects pregnancy- it increases the chance of low birth weight of baby or premature birth, etc.
4) In men due to recurrent urethritis, it can lead to urethral strictures in many cases (also seen in cases of gonococcal urethritis)
5) General septic condition (life threating complication)- It is most grave situation where infection travels up to kidney and needs immediate medical treatment.
TREATMENT–
First line of treatment is antibiotics which is prescribed based on culture report which specify which bacteria is causative agent and which antibiotic is most effective and also based on overall health of the patient.
In simple uncomplicated UTI after few days of starting treatment by prescribed antibiotics patient starts improving but it is very important to complete the course of medicine in order to prevent antibiotic resistance and also it lessen the chance of recurrence.
Secondly, in cases of recurrent UTI –
Line of treatment involves-
1)Course of antibiotic prescription-Longer duration but in lower dose initially up to six months but it depends on cases as it can be longer if it is an old case.
2)Be in regular touch with your physician so that any episode of UTI must not remain undiagnosed and untreated in order to prevent complication in long run.
3)Precautionary administration of single dose of antibiotic after intercourse in cases where sex is exciting cause for UTI.
4)In post menopausal women – hormonal therapy (estrogen) also helps in preventing UTI.
Lastly in cases of severe UTI where upper urinary tract are also involved and patient in state of fever and pain continuously then it require hospitalization and intravenous administration of antibiotics and other symptomatic treatment as per the case.
PREVENTIVE FACTORS–
General public awareness plays a vital role in prevention and adopting preventive measures by the public as it is one of the most common diseases and which can be easily preventable in many ways, few important ways are as follows-
1)Most important is to regulate daily water intake and other liquids in day to day life- it helps to flush out toxins as well as harmful bacteria through urine by dilution process.
2) If the birth control method is causing recurrent UTI in any case, then it must be replaced by some other family planning measures as prescribed by the consulting physician.
3)Sexual hygiene (also urination after intercourse) is must to prevent in many cases.
4) Toilet hygiene- washing of parts after urinating or after bowel movement properly to prevent spread from anal area to urethral or vaginal opening especially in case of women. Also, Do not use harsh toiletry in private area to irritate the area or alter their PH in any way.
HAPPY LEARNING
Contributor- Dr. Apurva Varangi
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