Femal Urinary Tract Infections Chattanooga TN
How do I know if I have a urinary tract infection?
In most patients, urinary tract infections will cause specific symptoms that may include:
- Urinating more often than usual (urinary frequency)
- Sudden urge to urinate that is difficult to control (urinary urgency)
- Pain or burning when urinating (dysuria)
- Urine that is colored pink or red from blood (hematuria)
- Pain in your pelvis
- Abdominal or back pain if infection involves your kidneys
It is important to note that there are many conditions other than urinary tract infections that may cause these symptoms. In some groups of patients, particularly those with neurologic conditions, these symptoms may not be felt with an infection. Additional laboratory testing may be useful in diagnosing a urinary tract infection. However, this is not always necessary as patients who have had confirmed infections in the past are often fairly accurate in interpreting their symptoms correctly.
What can cause a urinary tract infection?
There are risk factors that may make some people more prone to getting a urinary tract infection (UTI). These risk factors may change over time making you more or less likely to experience infections at various times in your life.
Women tend to experience more UTI than men, which may be due to the shorter length of their urine tube (urethra). Furthermore, women who have undergone menopause may experience changes in the lining of the vagina that occur from decreased levels of estrogen. These changes may increase the risk of infection and may affect the types of bacteria that live in the vagina.
Women who are sexually active may experience increased risk of UTI, though this is not because UTI are a sexually transmitted infection. Also, certain forms of birth control such as diaphragms or condoms with spermicide may contribute to the risk of infection. Finally, some types of birth control may affect levels of estrogen and thus have an effect on the vaginal lining that make you more likely to experience UTI.
Abnormalities of the urinary tract can often lead to recurrent UTI. These range from abnormalities that begin at birth to complications from previous surgeries. Patients may have a blockage that prevents emptying the bladder or even stones or foreign bodies in the bladder that increase the risk of infection.
Some patients may have neurologic abnormalities that make it difficult to empty the bladder, perhaps even requiring placement of a tube (catheter) into the bladder to empty it. This can increase the risk of UTI, especially for patients who use a catheter. It is important to know that the presence of bacteria in the urine does not always mean that you have an infection.
A decreased immune system resulting from diseases such as diabetes or treatments such as chemotherapy may increase the risk of urinary tract infections. The use of antibiotics may also increase the risk of subsequent infections, which may be resistant to some antibiotics.
How are urinary tract infections diagnosed?
Often it is not necessary to visit the office to be diagnosed with a urinary tract infection (UTI). Particularly for women who have had previous confirmed infections, the presence of symptoms typical of infection is enough to reliably diagnose a UTI. This may not be true in some patients who may have other disorders that can mimic UTI or who experience repeated episodes of symptoms that do not improve with antibiotic therapy.
In other instances, you may not be sure if your symptoms are caused by a UTI or another problem. It can be helpful to have a laboratory analysis of the urine (urinalysis) to look for signs of infection such as red blood cells, white blood cells, bacteria or yeast.
A urine culture is a lab test in which the urine is kept for one or several days in an environment that makes bacteria likely to grow. The bacteria can then be specifically identified and recommendations can be made as to which antibiotics may successfully treat the bacteria. If few bacteria grow, it can be an indication that an infection was not present or that it has been successfully treated. Given the length of time it can take for culture results to return, it may be advisable to begin an antibiotic while waiting for the results. The choice of antibiotic can be changed if the culture reveals that the infection is not sensitive to the original antibiotic.
When do I need more extensive testing?
When patients present with recurrent episodes of infections or seem not to be improving with proper treatment, it may be necessary to perform more extensive testing. This can help to identify an underlying cause for the infection or reveal another cause of the symptoms entirely.
Often radiology images of the urinary tract are obtained to identify underlying structural problems that may predispose to infection. This may include x-rays of the abdomen, ultrasounds of the kidneys and bladder, or computerized tomography (CT).
Particularly in patients with prior surgery or injury to the urinary tract, it may be helpful to look into the urine tube (urethra) and bladder with a small lighted scope (cystoscope) to look for abnormalities that can lead to UTI. This may be a done in the office or under sedation in the operating room, depending on your preference.
How are urinary tract infections usually treated?
For most urinary tract infections that are not complicated by another disease, structural abnormality or condition, a short course of antibiotics is usually sufficient. You should remember that longer courses of antibiotics are not usually required or even recommended and may predispose you to other problems such as a vaginal yeast infection. For many antibiotics, 3 days is often a sufficient course.
Some patients may have more complicated infections. This includes patients with structural abnormalities such as urinary tract stones, catheters, or blockages of the urinary tract. Patients with decreased immune response such as patients on chemotherapy, taking medications after organ transplant or with diabetes may also be considered to have complicated infections. These patients may require longer duration of treatment. Patients with infections of the kidney will also usually receive longer courses of antibiotics. A repeat urine culture may be useful to confirm clearance of the infection in these patients.
What if I get recurring urinary tract infections?
Patients with recurrent urinary tract infections (UTI) will often feel as though they have just finished their last treatment when the next infection comes along. This can be incredibly frustrating and cause a major disruption given the severe bother of the symptoms each time.
The evaluation for recurrent urinary tract infections should first confirm that the symptoms are actually related to a urinary tract infection. These patients may need urine cultures prior to treatment with antibiotics to confirm that infections are causing their symptoms. Urine cultures can also be useful in ensuring that the infections are treated with appropriate antibiotics. Finally, repeat cultures will establish whether the infection is fully cleared by therapy.
Patients should be assessed for underlying abnormalities such as urinary tract blockages, urinary tract stones, or other factors that can contribute to recurrent infections. Many times, a thorough history and physical can suffice to rule out many of these possibilities. However, in some patients, images of the urinary tract or a scope in the urethra and bladder may be necessary.
At UT Urology, we can help in the evaluation and treatment of complicated urinary tract infections. We have the expertise necessary to look for any underlying causes of recurrent UTI and have the experience to repair those abnormalities when they are found. We have the only urologists in the region who have completed fellowship training focusing on the female urinary tract and the reconstruction of those irregularities that can lead to recurrent urinary tract infections. Contact us today for your evaluation and take the first step to regaining control and returning to a more healthy life.