WHAT IS IT?
Your urinary tract plays a vital role. It filters wastes from your blood-substances that would poison your cells if they were allowed to build up in your system. Then it flushes these toxins out of your body in the form of urine.
The urinary tract is made up of the kidneys; the ureters, two tubes that carry urine from the kidneys to the bladder; the bladder, the balloonlike organ that stores urine; and the urethra, the tube that passes urine out of the body. Normally the tract is free of bacteria, viruses, or fungi. In fact, the urine that travels through the tract is normally sterile; it contains no germs.The tract can become infected, though, when bacteria-often spread during sex-stick to its mucous linings, then thrive. Two common urinary tract infections are cystitis, a bladder infection, and urethritis, in which the urethra is inflamed.
Americans make 10 million visits a year to doctors for urinary tract infections. Though men and children can get urinary infections, they’re most common in women. About one in five women will have a UTI sometime in her life. Sexually active women are especially at risk because during sex bacteria often make their way from the anal area to the urethra, just above the vagina. Men get urinary tract infections when something blocks the tract, such as a stone in the urethra or an enlarged prostate gland (which wraps around the top of the urethra)-or they may get urethritis through sex.
If you have a urinary tract infection, you may feel burning or stinging pain when you urinate. Your urine may be milky, bloody, or cloudy. You may also feel the urge to urinate all the time, though hardly any urine comes out.
You can do a lot to prevent urinary tract infections by making sure you practice safe sex and proper hygiene. If you already have an infection, you and your doctor can take steps to cure it and prevent it from coming back.
WHAT IS HAPPENING?
The kidneys are the workhorses of the urinary system. They filter waste from the blood, then combine it with excess water and salts to form urine.
During the course of a day, about a quart and a half of urine leaves the kidneys and flows down the ureters to be stored in the bladder. From time to time, the bladder expels this liquid into the urethra to be emptied outside the body.
The flow of urine washes harmful germs out of the urinary tract. In men, the prostate gland at the base of the bladder also secretes substances that kill or deter bacteria in the urinary tract. The urethra contains immune cells and mucus that also fight germs. But sometimes infections still take hold, causing redness, swelling, and pain. Most often, infection appears in the bladder or urethra. In men, that can cause prostatitis, an infection in the prostate gland that can become chronic.
Most often, colon bacteria called Escherichia coli that travel from the rectum to the urethra during sex are to blame. In women, sex often pushes the bacteria up into the bladder too, causing cystitis. Other bacteria that get moved to the urethra during sex, such as chlamydia and mycoplasma, may also cause urinary tract infections.
Though infections in the bladder or urethra are usually not serious, the bacteria can travel upward to the kidneys. A kidney infection is a serious ailment. If it isn’t treated, it can lead to kidney damage and even kidney failure, which can be fatal.
WHAT CAUSES IT?
No one can say exactly why one person gets a urinary tract infection and another doesn’t, but researchers have found certain factors that increase the risk. Some-such as your sex and age-are outside your control. Others, fortunately, are things you can change.
THINGS YOU CAN’T CHANGE
Gender
Women are more likely to get urinary tract infections than men are. Researchers think one reason may be that a woman’s urethral opening is near sources of bacteria, the anus and the vagina. Also, a woman’s urethra is shorter, which makes it easier for bacteria outside the body to reach the bladder. Men, whose prostate glands secrete a protective fluid into the urinary tract, have more protection from bacteria.
Age
Urinary tract infections become more likely as you age, especially for women. One reason may be that the mucous lining of the bladder thins out and normal immune defenses weaken as you get older. Another problem for women after menopause may be the decrease in the female hormone estrogen secreted by their ovaries. Estrogen encourages the growth of good bacteria, or lactobacilli, which fight against infection.
Illness or organ deformities
People with diabetes often don’t have a strong enough immune response to fight bacteria. And when urine is blocked by a deformed organ, bladder tumor, or enlarged prostate, infection is more likely. The reason? Urine can’t wash out the tract.
Using a catheter
When you wear a catheter, a tube inserted into your bladder to empty urine, you are at risk for urinary tract infections because bacteria can easily invade the catheter.
Sexual activity
In women, some urinary tract infections seem linked to sexual activity, perhaps because sex pushes bacteria into the bladder.
THINGS YOU CAN CHANGE
Sex practices
Practicing safe sex and washing the genital area well before sex can help stop the spread of bacteria. Also, use plenty of lubrication during intercourse to reduce irritations that can lead to infection.
Using feminine hygiene sprays and scented douches
These can irritate the vagina and make it easier for bacteria to attach to its mucous linings. Then the bacteria can spread to the urethra.
Using a diaphragm
Diaphragms make infections more likely. Researchers believe that diaphragms may keep the bladder from emptying. Urine left in the bladder can breed bacteria. Another reason may be that the nonoxynol-9 spermicide often used with diaphragms decreases the vagina’s ability to fight infection.
Tight clothing
Tight pants can irritate the urethra. Polyester clothing, especially underwear, may trap moisture and heat, helping bacteria grow.
Drinking too little fluid
Bacteria flourish when urine is condensed. But when it’s dilute, it’s sterile. That’s why drinking fluids is vital. Drink at least eight glasses of water every day. Drinking cranberry juice can also help. It raises the acid level in the urine, reducing bacteria in the urinary tract.
Cleanliness
When you don’t keep your genitals and anus clean, bacteria spreads and causes an infection. Women should wipe from front to back after using the toilet to keep rectal bacteria away from the vagina and urethra.
WHAT YOU CAN DO FOR YOURSELF
You can help prevent urinary tract infections by making smart choices about sex and cleanliness practices. If you already have an infection, you can ease it by drinking water, taking your medicine, and treating the pain with home remedies. Be sure to see your doctor if you have signs of a urinary tract infection.
To prevent urinary tract infections:
Change your sexual and birth control practices
If you are a woman, always use plenty of lubrication, such as K-Y jelly, to avoid stressing the urethra. If you use a diaphragm, make sure it fits properly. And if your diaphragm seems to be causing your urinary tract infection, try one with a different type of rim. If that doesn’t work, ask your doctor about other birth control methods. Wash your diaphragm after each use with warm, soapy water, then rinse and dry it.
Wash the genital area before and after sex and ask your partner to do the same. And urinate right after sex; this helps flush out bacteria that may have entered the urinary tract.
Practice safe sex
To prevent bacteria from spreading, practice safe sex, especially if you have more than one partner. Here are a few tips.
Get to know your sex partner. Talk about whether you’ve both been checked for sexually-transmitted diseases (STDs), and which ones you’ve been tested for.
Don’t have unprotected sex with someone whose sex history you don’t know.
If you have sex with more than one person, use latex condoms even during oral sex. Never reuse a condom. Smearing the condom with a water-based lubricant (such as K-Y jelly or Replens) will help prevent it from tearing. If you have oral sex with a woman, you can split the condom lengthwise and put it between your mouth and her body.
Use the sperm-killer nonoxynol-9 to improve how well condoms protect you from sexually-transmitted infections-unless it irritates your vagina or you get frequent urinary tract infections. It works best when put into the vagina or anus rather than just on the condom.
Look for signs of a sexually-transmitted disease in your sex partner such as sores around the penis or vagina. But remember that people with STDs don’t always have symptoms.
Keep clean
Use plain water to cleanse the genital area once a day and before and after sex. Stick to showers because bacteria can spread in bath water. If you’re a woman, keep the urethra free of bacteria from around the anus by always washing and wiping from front to back. Also, change tampons every four hours during your period to avoid a buildup of bacteria in menstrual blood.
Avoid perfumed products
Avoid scented soaps, powders, deodorants, douches, bubble bath, tampons, and toilet paper.
When you have to go, go
Don’t hold in your urine. That increases the chance of infection.
Flush out the bugs
To keep your urine dilute and flowing throughout the body, drink eight glasses of fluid a day. Water is best. Cranberry juice may help prevent an infection by making the urine more acidic. Acidic urine fights against bacteria that try to cling to the urinary tract lining.
Wear loose clothing
Wear cotton-crotch underwear and loose-fitting clothing. They don’t trap bacteria or irritate the vagina or penis.
Get checked
If you are pregnant or have diabetes or an enlarged prostate, get checked often by your doctor to prevent a urinary tract infection. Take your medicines to keep any illness under control.
To treat urinary tract infections:
Ease the pain
If you have abdominal pain or a backache, apply a heating pad to the area that hurts. Avoid caffeine, alcohol, and spicy or acidic foods. These may irritate the bladder, increasing your pain. Drink lots of water to relieve the burning when you urinate. And take over-the-counter medicines such as aspirin, acetaminophen (Tylenol), or ibuprofen (Advil or Motrin).
Eat yogurt
Antibiotics, which your doctor will prescribe to cure your urinary problem, may cause a vaginal yeast infection. To prevent this problem, eat plain yogurt with live cultures or take acidophilus capsules. If you get signs of a yeast infection, such as itching and thick cheesy discharge, over-the-counter medicines may help.
WHAT YOUR DOCTOR CAN DO FOR YOU
Your doctor will recommend treatment based on your symptoms and the source of your urinary tract infection.
Antibiotics
The treatment for a urinary tract infection is an antibiotic, a drug that fights bacteria. The kind of antibiotic will depend on the type of bacteria you have. Sometimes a doctor will prescribe one drug at first, and then ask you to take another after lab tests show that a second medicine may be better.
Symptoms often go away after one or two days of treatment. But it’s vital to take all your drugs to make sure the infection is cured. Your doctor will check you after you finish your medicine to make sure all the bacteria is gone. If the problem comes back, your doctor may prescribe an antibiotic that you take after you have sex to prevent more infection.
Long-term antibiotics for prostatitis
If you have a urinary tract infection resulting from prostatitis, an infection of the prostate gland that makes urinating painful, you may need long-term treatment (one month) with an antibiotic. These drugs treat the urinary tract infection and the prostatitis. It’s hard for antibiotics to reach prostate tissue, so a cure may take longer.
Pain medication
People who have severe pain with a urinary tract infection may take a prescribed painkiller, phenazopyridine. But be aware that this medicine causes side effects such as stomachaches and headaches, and it turns urine bright orange, which stains clothing.
Surgery
If a tumor or a deformed urinary organ is causing urinary tract infections, a surgeon may remove the tumor or correct the shape of the organ. Your doctor will give you antibiotics to clear up the infection first. Then you’ll have the surgery. You may have to stay in a hospital for a few days.
If you have prostatitis and cysts filled with pus form on the prostate and burst into the urethra, you may need surgery.
If an enlarged prostate bothers you a lot, your doctor may advise drugs that make urinating easier. If this tactic doesn’t work, you may need surgery to remove the excess prostate tissue.