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Preface and Contents

Urinary Tract Infection

Symptoms and Causes

The urinary system is normally composed of two kidneys, two ureters, a single urinary bladder and a single urethra. Urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract. UTI is the second most common type of infection in the body.

What are the symptoms of a urinary tract infection?

The symptoms of urinary tract infections may vary with severity of infection, age and location of infection in the tract.

Most Common Symptoms of urinary tract infection

  • Burning or pain during urination.
  • Frequency of urination and persistent urge to urinate.
  • Fever and malaise.
  • Foul odor and cloudy urine.

Symptoms due to infection of the urinary bladder (Cystitis)

  • Lower abdomen discomfort.
  • Frequent, painful urination with small amounts of urine.
  • Usually low-grade fever without flank pain.
  • Blood in urine.

Symptoms due to infection of upper urinary tract (Pyelonephritis)

  • Upper back and flank pain.
  • High grade fever with chills.
  • Nausea, vomiting, weakness, fatigue and general ill-feeling.
  • Mental changes or confusion in elderly people.

This is the most serious symptom of urinary tract infection as it implies systemic involvement. Inadequate and delayed treatment can be life threatening.

Burning and frequent urination are common signs of urinary tract infection.

What are the causes of recurrent urinary tract infection?

Important causes of frequent or recurrent urinary tract infections are:

1. Urinary tract obstruction:Various underlying causes which canlead to obstruction of urinary tract.

2. Female gender: Because of shorter urethra, women are more susceptible than men to UTI.

3. Intercourse:Women who are sexually active tend to have more urinary tract infections than women who aren’t sexually active.

4. Urinary stones: Kidney, ureter or bladder stone can block the flow of urine and increases risk for UTI.

5. Urinary catheterization:People with indwelling catheters have an increased risk of UTI.

6. Congenital urinary tract anomalies:Children with congenital urinary tract anomalies such as vesicoureteral reflux (condition in which urine moves backward from the bladder up the ureters) and posterior urethral valve have an increased risk of UTI.

7. Benign prostatic hyperplasia:Men over 60 years are prone to UTI because of an enlarged prostate (benign prostatic hyperplasia - BPH).

8. Suppressed immune systems: Patients with diabetes, HIV or cancer are at higher risk for UTI.

9. Other causes: Narrowing of the urethra or ureters, tuberculosis of the genito-urinary tract, neurogenic bladder or bladder diverticulum.

Can recurrent urinary tract infection cause damage to the kidney?

Recurrent lower urinary tract infection usually does not cause damage to kidneys in adults.

UTI in adults can cause damage to the kidneys if predisposing factors such as stone, blockage or narrowing of flow of urine and tuberculosis of the genito-urinary tract are not corrected.

However, in young children, delayed or improper treatment of recurrent urinary tract infection can cause irreversible damage to the growing kidney especially in those with vesicoureteral reflux. This damage may lead to reduction of kidney function and high blood pressure later in life. So the problem of urinary tract infection is more serious in children compared to adults.

Obstruction of urinary tract is an important cause of recurrent UTI.