Urinary Tract Infection

Urinary Tract Infection is a bacterial infection that can affect any part of the renal tract (kidneys, ureters, bladder and urethra). Most frequently, UTI is termed cystitis, as it is localised to the urethra and bladder. Occasionally, it ascends to the kidneys (causing pyelonephritis).

UTI commonly presents with strong urgency to urinate, hesitancy, passing small amounts of urine frequently, a foul odour to the urine, possible blood in the urine, and dysuria with lower abdominal pain/discomfort.

Women are most at risk of getting a UTI, with approximately 50% of them experiencing a UTI at least once in their lifetime. This is because of a much shorter urethra compared to men, and also the proximity of the anus to the urethra. Certain ladies with incomplete emptying of the bladder also have a higher risk of UTI, as the residual urine becomes rapidly infected. Sexual intercourse increases UTI risk (honeymoon cystitis), due to local irritation and trauma; and the use of spermicide add to increased risk. Diseases that impair the immune system (like diabetes mellitus) or certain medications that suppress the immune system (eg. chemotherapy agents) also increase risk; as well as prolonged use of catheters, or the presence of bladder stones.

If a UTI occurs three or more times in a year, it is considered as a recurrent UTI, and is caused by uropathogenic bacteria that make their home in the large intestine. The commonest infective bacteria is the E. coli species, but there are other bacteria that can also cause UTI. The type of bacteria, and more importantly the antibiotic sensitivities, can be deduced from urine microscopy and culture testing. In recurrent cases, there may be a need for further testing, including ultrasound scans and cystoscopy. A course of appropriate antibiotics and preventive measures treat and reduce the risk of recurrence usually will handle most UTI, although longer term suppression antibiotics may be required for RUTI.