WHAT IS THE URINARY TRACT?

 

Urinary Tract includes 4 main sections:

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• 2 kidneys - where the blood gets filtered and urine is produced

• 2 Ureters - tubes that carry urine from the kidneys to the bladder

• Bladder where the urine is stored before it comes out

• Urethra - is a small tube that carries the urine out.

The urethra is where the bacteria enters the urinary tract and start colonizing (growing). If you look at the figure to the the urethra in females is almost 5-6 times shorter than in males, therefore, it is way easier and faster for the bacteria to enter the bladder. Urinary Tract infection in females is the most common infection and has very definite symptoms. 

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WHAT ARE THE COMMON SYMPTOMS OF THE URINARY TRACT INFECTION?

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• Urgency to urinate: it seems like you always want to urinate, but the amount of the urinary output is barely noticeable. 

• Burning sensation on urination: It is very sharp and burning sensation while urinating, sometimes it even feels like there is a cut.

• Blood-tinged urine: You may notice some bright red blood on the tissue or urine.

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If the infection not treated, the bacteria travels up past the bladder via the ureters to the kidneys. Kidney infections are less common, they can cause the same symptoms plus fever, flank tenderness/pain, nausea/vomiting. The medical term for kidney infection is pyelonephritis. 

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WHAT ARE THE CAUSES OF URINARY TRACT INFECTIONS?

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Urinary Tract is sterile but there is bacteria that lives close to the urethra in both females and males. Young, sexually active females are at high risk for UTIs due to the frequent sexual activity. There is higher risk for UTI in females that use spermicides or bubble baths as there is less friction to pass through the urethra. Diabetic females have high risk for UTI as well due to a few reasons: high blood glucose, poor circulation, and lesser ability to empty the bladder. However, some females might just be more likely to get UTIs due to the genetic predispositions. 

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CAN MY URINARY TRACT INFECTIONS SYMPTOMS BE SOMETHING ELSE?

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The answer is yes. Burning on urination can be caused by other conditions, for example, vaginal yeast, or inflammation of the urethra (urethritis). It is important to discuss your complaint with a health care provider before assuming you have a bladder infection. 

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URINARY TRACT INFECTIONS DIAGNOSIS

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In most cases health care providers can diagnose UTI  based on patient symptoms. The test for UTI is not always needed. If you are a female and have no vaginal irritation or discharge, complains on burning on urination, increase in frequency and urgency - it is very likely you have a UTI.  In some cases, urinalysis and/or urine culture are needed to help diagnose a UTI. I usually suggest my patients to purchase over-the-counter AZO test strips to run urinalysis at home. The test kit is about $12.00 in CVS, Walgreens, or Walmart that has 3 strips in. If the test strip shows increase in leucocytes (white blood cells) - that means there is an overproduction of white blood cells in order to fight an infection.

Urine culture is the test that is performed in a laboratories.  The culture takes about 48 hours to see the final result of bacteria growth. The result will specify what bacteria is in your urine and what antibiotic is sensitive and/or resistant. 

Most of the time patients that require urine culture are those with: 

• persistent symptoms after 24-48 hours of antibiotic start date.

• suspected kidney infection

• have frequent bladder infection

• pregnant females

• recent UTI 

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WHAT IS THE BEST ANTIBIOTIC FOR A UTI?

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If you are a young healthy female, the usual treatment include a course of an antibiotic. The typical options would be Macrobid (or generic name is Nitrofurontoin), Bactrim (or generic name is Trimethoprim/Sulfamethoxazole), or Monurol (Fosfomycin). 

You can also take over-the-counter Pyridium (phenazopyridine ) that numbs the bladder and urethra and helps reduce the burning pain on urination. You should only take Pyridium for 2 days max.  Pyridium (phenazopyridine) is not an antibiotic and does not treat UTI. It can change your urine color to dark orange which will go away once you complete it. Some doctors recommend drinking more fluids to flush bacteria out, or take cranberry juice. Though, it is ok to follow those recommendations, they are not evidence-based recommendations and there are no studies performed to prove the effectiveness of those strategies. 

Other commonly used antibiotics for UTI are Ciprofloxacin, Levofloxacin, Amoxicillin, Cefdinir. It is important to inform your health care provider about your past medical history, allergies, and history of previous urinary tract infections.

If you develop a second UTI within 12 weeks period we would strongly recommend Urine Culture to find the most effective antibiotic for your bacteria. We work with LabCorp, Quest, or if you are our local patient we can collect your urine at our office. 

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HOW TO PREVENT URINARY TRACT INFECTIONS?

 

It is not always possible to prevent UTI. However, you can take a few steps to reduce your risk of urinary tract infections. Here they are:

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• Drinking plenty of fluids makes you urinate more frequently allowing bacteria to flow out of urethra

• Wipe front to back will prevent bacteria from around the rectum spreading and accumulating too close to the urethra

• Emptying your bladder as soon after the sexual intercourse

• Avoid feminine products, spray, douches, lotions, etc

• Avoid bubble baths

• Change birth control method. Some spermicide, condoms, diaphragms can contribute to bacteria growth.

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At eCareNow virtual urgent care, we treat uncomplicated UTIs in females. We will discuss with you the history of your symptoms and will determine the treatment plan. We send your prescription electronically to the pharmacy of your choice and will follow-up with you if needed. 

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If you are a female and have the symptoms of UTI, please click on the button below to book an appointment with us. 

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The article above serves for informative purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment.