The urinary tract is made up of the kidneys, the ureters, the bladder and the urethra. Each plays an important role in helping your body to eliminate waste products in the form of urine. Urinary tract infections are inflammations usually caused by bacteria (or germs) attacking the kidneys, ureters, bladder or urethra. Under normal circumstances the urinary tract is sterile and free of bacteria.
Urinary tract infections are caused by bacteria. They enter the urinary system through the urethra and can move upward to the bladder and kidneys. The most common organism that causes a UTI is Escherichia coli bacteria (E.Coli). It is normally found in the lower colon but sometimes can find its way into the urinary tract.
Risk factors for UTIs include previous UTI, sexual activity (particularly with new sexual partners), use of spermicides, menopause, pregnancy, reduced mobility (i.e., after surgery or bed rest), urinary incontinence, kidney stones, and prostate enlargement.
Other risk factors include age (older adults are at higher risk) and gender. Female patients are at higher risk compared to males because of shorter urethra length and proximity of the urethra to the anus, increasing the risk that bacteria will enter the urinary tract.
Also a new class of drugs for the treatment of type 2 diabetes has been associated to increased cases of UTIs in patients. Sodium-glucose cotransporter 2 (SGLT2) inhibitors or “flozins” are oral hypoglycemics that work by increasing the amount of glucose spilled into the urine.
Urinary tract infections (UTIs) generally cause symptoms related to bladder irritation:
- Burning sensation during urination
- Blood in the urine
- Fever (sometimes)
- Abdominal pain (sometimes)
- New or worsened incontinence (sometimes)
Older adults, particularly those with dementia, can also develop delirium — a new aggravation of the mental state — as a result of a urinary tract infection. In fact, sometimes new or worsened confusion can be the only outward sign of a UTI or other infection. It’s a good idea to suppose UTI whenever an older person is having uncomfortable urination or new incontinence. In these cases, make sure the person is seen within 24 hours by his or her doctor or by an urgent care facility.
Doctors first decide if the infection is just in the bladder or has spread to the kidneys and how severe it is. For a simple bladder infection, patients take antibiotics for 3 days (women) or 7 – 14 days (men). For a bladder infection with complications — such as pregnancy or diabetes, OR a mild kidney infection – patients will usually take antibiotics for 7 – 14 days.
Some people have urinary tract infections that do not go away with treatment or keep coming back. These are called chronic UTIs. If you have a chronic UTI, you may need stronger antibiotics or take medicine for a longer time. Surgery is needed if the infection is caused by a problem with the structure of the urinary tract.