Nov 16,2007 00:00
Kenneth L. Noller, MD
Urinary tract infections (UTIs) are a common problem that affects many women. They can be painful and cause serious illness, especially if the infection spreads to the kidneys.
UTIs usually occur when bacteria that live on the skin near the rectum or in the vagina enter the urinary tract. The urinary tract consists of four parts: the kidneys which produce urine; the ureters which take urine from the kidneys to the bladder; the bladder, where urine is stored; and the urethra, which takes urine out of the body. Sexual contact or wiping back to front can transport bacteria to the urethra. The bacteria can then spread to the bladder, ureters, and kidneys.
A UTI may also develop if urine backs up into the bladder instead of flowing out. This may occur because of a blockage (stone) in the kidneys, bladder, or ureters, a narrowed tube or kink in the urinary tract, diverticula—small pockets that bulge out of the bladder wall or the urethra and hold urine, or problems with the pelvic muscles or nerves.
If you have a UTI, you may feel a strong urge to urinate that cannot be delayed, an urge to urinate very frequently, or a sharp pain or burning in the urethra as you urinate. Your urine may look cloudy, have a strong odor, or be tinged with blood. Additionally, if you have back pain, chills, fever, nausea, or vomiting, the infection may have spread to your kidneys. Kidney infections must be treated right away. Contact your doctor if you experience any of these symptoms.
UTIs can be quickly diagnosed with a urine test. Your doctor will prescribe an antibiotic to clear up the infection. Most symptoms go away in 1–2 days, but it is important to finish all of the prescribed medication to lower the risk of the infection coming back. Recurrent infections may signal other problems with the urinary tract, and your doctor may need to perform more tests to make sure there is not a more serious problem.
You are more likely to have a UTI if you are pregnant, have had UTIs before, are postmenopausal, have diabetes, use a diaphragm or spermicide for contraception, have intercourse frequently, or have a new partner. If you develop a UTI while you are pregnant, be sure to tell your doctor immediately.
These tips may help some women prevent UTIs:
¨ Always wipe front to back after bowel movements and urination
¨ Avoid douching, using powder and deodorant sprays
¨ Drink plenty of fluids (including water to flush bacteria from your system)
¨ Empty your bladder as soon as you get the urge, about every 2–3 hours
¨ Try to empty your bladder before and after sex
¨ Wear cotton underwear
For more information, the Patient Education Pamphlet “Urinary Tract Infections” is available in English and Spanish at www.acog.org/publications/patient_education.