UTIs are considered to be the most common bacterial infection and are more common in females. Nearly 30% of women will have had a symptomatic UTI by 24 years of age and almost half of all women will experience a UTI during their lifetime.
Women are at a higher risk of infection due to shorter urethra (passage of urine from urinary bladder to outside) which makes it easier for bacteria to ascend in from outside environment. Other risk factors for UTI are diabetes, dehydration, poor personal hygiene, spinal cord injuries, prolonged hospitalisation, long term indwelling catheters, AIDS, chronic illness etc.
Patients experience pain and burning while passing urine, urgency, frequency, lower abdominal discomfort and blood in urine. In severe cases there might be fever, chills, retention of urine and flank pain. A basic urine microscopy detects urine infection and a urine culture is helpful in isolation the causative organism with its drug sensitivity. Basically a urine culture guides the doctor about which antibiotic will work against the microorganism responsible for the infection. It is very important to collect the urine sample before starting any medication. Sometimes an ultrasound or CT scan is required to ascertain the diagnosis.
Relapse or persistence of infection is not uncommon and should be investigated for specific causes like obstruction in urine( stricture urethra and prostatomegaly in males, meatal stenosis in females), Reflux of urine to the kidneys while urination, diverticulum of the bladder ( outpouching of bladder leading to retention of urine) , urogenital fistulas etc. When identified such disorders require further evaluation and specific treatment.
Adequate oral fluid intake is the most important factor in preventing UTI. An adult working in moderate climatic condition should be drinking around 2.5 to 3 litres of fluids per day. Personal and washroom hygiene should be maintained as majority of infections are acquired from outside environment. Cranberry juice/extract and more recently probiotics have shown supportive role in preventing recurrent UTIs but these cannot be used as single therapies for treatment.