INTRODUCTION TO THE URINARY SYSTEM
This image above shows the kidneys, ureters, and bladder. The adrenal glands (part of the endocrine system) sit on top of the kidneys and release renin which affects blood pressure, and sodium and water retention. The bean-shaped kidneys are about the size of a closed fist. They lie against the back of the abdominal wall, outside the peritoneal cavity, just above the waistline in the lumbar area.
Urinary Tract Infections (UTI)
urinary tract infection (UTI) most commonly occur in females; about 50% of all females get a UTI during their lifetime. Many UTIs are not serious but if infection reaches the kidneys, serious illness, and even death, can occur.
Bladder infections are the most common type of UTI. Some individuals may have few or no symptoms; however, the usual symptoms include dysuria (pain or burning during urination), low abdominal pain, and/or urine that is cloudy or smells bad or unusual.
Urinary Tract Infections (UTI) Symptoms:
Urinary Tract Infections (UTI) symptoms in men
Symptoms of an upper tract urinary infection in men are similar to those in women. Symptoms of a lower tract urinary infection in men sometimes includes rectal pain in addition to the common symptoms shared by both men and women.
Urinary Tract Infections (UTI) symptoms in women
How Do Urinary Tract Infections (UTI) Begin?
The vast majority of UTIs start when pathogens (usually bacteria like E. coli ) reach the urethra and then travel up (retrograde) the urethra to the bladder. Urine is usually sterile until it reaches the distal urethra. Women have short urethras compared to men and most clinicians think the shorter urethra is the major reason women have more UTIs than men.
What Increases Your Risk of Getting UTIs?
Risk factors for UTIs were presented previously, but besides being a woman who is sexually active or someone who is elderly or immunocompromised, there are other risk factors:
- Not drinking enough fluids (slows the wash of pathogens out of the body)
- Taking frequent baths (soaking in fluid that may promote retrograde infections)
- Waiting to urinate (promotes retrograde bacterial movement)
- Kidney stones (causes slowing or partial blockage of urine flow)
Diagnosing of UTIs
For the diagnosis of the UTIs, Urinalysis is usually the first diagnostic test done after a patient presents their medical history and has a physical exam. The test provides information about the presence of bacteria, white and red blood cells, and chemical abnormalities. It can indicate that other studies such as urine culture and bacterial drug sensitivity tests should be done. Simple tests like the urine dipstick test or even home tests of urine can be done but they are not 100% accurate. It is best to have your doctor evaluate your symptoms and test results.
Treatment of UTIs
In treating UTIs, Although severe kidney infections are often treated in the hospital with IV antibiotics, most UTIs (and many mild-to-moderate kidney infections) are treated with oral antibiotics. However, many clinicians are sending urine samples to identify the infecting organisms and determine their antimicrobial resistance. It is not unusual for a doctor to call a patient and switch antibiotics because of antibiotic resistance. In addition, the doctor will usually recommend that the patient take in plenty of fluids (water) and encourage frequent urination to flush bacteria out of the urinary tract.
Treating Recurrent UTIs
Recurrent UTIs are not unusual; you should ask your primary care physician (PCP) for a referral to a urologist if you have three or more UTIs per year to see if there may be an underlying urinary tract problem that may be the cause. Your PCP may also suggest taking long-term (months) low-dose antibiotics, recommend taking an oral antibiotic after sex, or taking an oral antibiotic as needed when UTI symptoms appear.
Prevention methods for UTIs have been presented in several preceding slides; here is a short summary of common and easy ways to prevent UTIs:
- Drink a lot of water daily
- Don’t “put off” going to the restroom (don’t delay urination)
- Wipe from front to back
- Don’t use feminine hygiene sprays
- Take showers instead of baths