Urinary tract infection

Infections in the urinary tracts are common, especially in women. Other names for urinary tract infection are UTI, lower urinary tract infection, bladder infection and cystitis. There is also a kind of infection that is known as pyelonephritis, or upper urinary tract infection.

UTI is caused by bacteria invading and infecting the urethra and the bladder. Pyelonephritis, which is a more serious and less common infection, occurs when the infection spreads via the ureter up to one or both kidneys.

How common?
Urinary tract infections are quite common and may affect both women and men. Women are more often affected than men. The infections generally resolve themselves. Women are much more easily affected since the female urethrae is shorter, and since it is easier for bacteria to enter female genitals and urethrae.

The body generally heals the infection by itself, but the time it takes may vary. Around 30% of infected persons get rid of their symptoms after a week without treatment.

Urinary tract infections are among the most common issues in the genitalia in women. An estimated 50% of all women have at least one infection during their lifetime. Around 10% of women over 18 receive at least one treatment for UTI a year. Younger women and postmenopausal women get urinary tract infections more often than women in other age groups. It is not uncommon for women to have more than one UTI or recurring problems within one year.

Causes
Urinary tract infections are induced by bacteria entering the urethra. Infections may be caused by a number of different types of bacteria.

The bacterium E. Coli is the most common cause for UTIs and is thought to cause 80 to 85% of observed cases. The second most common type of bacteria is Staphylococcus saprophyticus, which is estimated to cause 5 to 10% of all cases. Other bacteria causing UTIs are Proteus, Klebsiella, Pseudomonas and Enterobacter. Viruses and fungi can in rare cases cause a UTI.

Two types
There are two types of urinary tract infections:

  • The most common type is called UTI or lower urinary tract infection. The infection is limited to the urethra and the bladder. It is also known as cystitis.
  • A less common and much more serious type of urinary tract infections affect the kidneys and the renal pelvis. This type of infection is generally known as pyelonephritis.

Risk factors
UTI or pyelonephritis can affect everyone, but there are some factors that can increase the risk of infection.

  • Sexual activity, especially with a new partner
  • Spermicidal agents can increase the risk of infection. If you come into contact with spermicidal agents regularly through contraceptive diaphragms and condoms, it might increase the risk of infection
  • Genetic reasons, i.e. if other family members are often affected by UTIs
  • The use of a urinary catheter
  • Some parasites or sexually transmitted infections can increase the risk of getting a UTI
  • When your general condition or your immune system is weakened
  • People who have difficulties emptying their bladder may run a higher risk. If the bladder is not completely emptied, the risk of bacterial growth increases, which may lead to an infection
  • Elderly people often get urinary tract infections. This can be due to a number of reasons such as diseases, a weakened general condition or a weak immune system. Elderly people often experience difficulties in emptying their bladder, which can increase the risk of infection
  • -Postmenopausal women. Due to delicate mucous membranes, variations in the vaginal flora and other changes make it is easier for bacteria to grow and cause an infection
  • Women experiencing incontinence get infected between two and five times more often than other women
  • Urinary tract infections are common among diabetics
  • Pregnant women is another group that is more often affected by UTIs than others

Symptoms
Symptoms of cystitis (also known as a bladder infection or a lower urinary tract infection):

  • Increased urge to urinate
  • Burning and pain while urinating
  • The bladder often feels full and you frequently feel the need to empty it
  • Blood in the urine
  • Some lower abdomen pain. The pain is often located near the bladder
  • Some infected people feel a bit cold

The influence on your general state of health of an infection in the urinary tract can vary, but the disease generally does not cause large problems or acute symptoms. If you experience two or more of the above mentioned symptoms and you do not have other problems in the genital area, it is likely that you have attracted a urinary tract infection.

If you are in doubt about your symptoms you should contact your health centre for consultation and help. If the symptoms are not enough, they can be complemented by a urine test for a correct diagnosis.

Symptoms of pyelonephritis are very similar to those of a urinary tract infection, but the difference is that those of pyelonephritis are more acute. If you suffer from pyelonephritis you often feel very unwell and you experience a strong general feeling of illness. Typical symptoms:

  • You are very sick and tired
  • Nausea and fever
  • Low back pain or pain on the side of the abdomen
  • Other symptoms are similar to those of a bladder infection but are more acute
  • A diagnosis can be made based on observed or perceived symptoms and a urinalysis if necessary.

    Treatment
    UTI rarely causes serious problems. The symptoms are generally mild and the infection heals by itself in most cases. The symptoms can be mitigated with ordinary pain killers.

    The infection can be successfully treated with antibiotics. A treatment is primarily used to deal with more severe cases with acute symptoms, or if you want to be healed quickly. In general, it is advisable to start the treatment a few days after the appearance of the first symptoms. However, there are no specific reasons for suspending the treatment if you want to be healed quickly, and taking medications in the early stages of the disease is absolutely fine.

    There are a few different types of antibiotics that can be used for treating an infection. At present, most commonly used preparations are those containing pivmecillinam, nitrofurantoin, or trimethoprim. Medications containing cephalosporins or fluoroquinolones can also be used.

    Trimethoprim is a short-acting antibiotic that is easy to use. Symptoms can be reduced after 24 hours under favourable conditions. Trimethoprim is both potent and fast, which is why it is often prescribed to women having recurring UTIs. One course can range between 3 to 14 days. The pills are taken orally and the dose usually has to be taken twice a day.

    Recurring symptoms and frequent treatments can increase the risk of antibiotic resistance.

    If you experience relapses of urinary tract infections you should treat the infections with an antibiotic from another group in order to avoid resistance.

    When the treatment no longer works or the symptoms recur within one to two months, you should consult your doctor about further measures.