Your Questions Answered: Urinary Tract Infections
2nd March 2021
Urinary Tract Infections (UTI) are caused by the presence of bacteria in the urinary tract. Around 10 to 20% of women will experience a UTI at some stage of their life with young women at the greatest risk.
Up to 1.6 million women aged over 18 suffer from UTIs every year. They do occur in men but are much rarer in men and often associated with other underlying conditions.
Mr Jeremy Ockrim, a leading consultant urologist, has a wealth of knowledge and experience treating patients with UTIs.
What causes UTIs?
They are common and between 10 and 12% of women will have some degree of urine infections. Men can get UTIs but it is much less common and nearly always related to an underlying dysfunction of the lower urinary tract, bladder or prostate.
The majority of infections are caused by bugs – bacteria called coliforms and the most well-known of these are E. coli or Staphylococci – that originate naturally in the back passage and the vagina but ascend the urethra (waterpipe) to enter the bladder.
There are two peaks during life when infection is more common; when young women are sexually active and after the menopause when there is a change in hormone levels
What are the symptoms?
The classical symptoms are feeling uncomfortable and pain – sometimes a burning sensation – when you pee, and the need to go to the toilet regularly. Running backwards and forwards from the toilet is a clear sign of a urine infection.
UTIs are more common as women and men get older. At the extremes of age, patients can often have non-specific symptoms such as fever or confusion, rather than the typical bladder-specific symptoms in younger adults. We test for UTIs even though there may be no bladder symptoms.
Is blood in the urine a symptom?
It can be but commonly infections do not cause it and if blood appears in urine you need to be fully assessed. Although there are many reasons why it occurs, it is a red flag and needs to be checked by an expert.
The British Association of Urological Surgeons reports that one in five adults with visible blood in the urine are later discovered to have bladder cancer.
Why is it more common in women?
The female anatomy. Women have a shorter urethra than men that opens directly through the front wall of the vagina, meaning that bacteria can travel to the bladder more easily.After the menopause, hormone levels, particularly protective oestrogen, drop in women and this results in a higher risk of infection.
How is it diagnosed?
Getting a diagnosis quickly is important. UTIs can be diagnosed by Dipstick testing a urine sample to reveal inflammatory cells that are the product of bacteria breaking down proteins. The challenge is that it tells you that you have an infection, but not what infection.
Further examination of the sample is needed – a urine culture – in which the bacteria are grown (cultured) and tested for appropriate antibiotic treatment.
What treatments are available?
Everyone asks what antibiotic is the best and the answer is the correct antibiotic. Everyone wants a strong antibiotic but there is no such thing. We test antibiotics by putting drops on the sample to see if it kills the bacteria. The one that works is the correct antibiotic.
The aim is to give short, effective courses of antibiotics that are specific to that infection so it can be eradicated. Longer courses risk breeding antibiotic resistant strains.
A good patient-physician relationship is also fundamental to providing and receiving excellent care. I feel that it is imperative to create an environment that preserves a patient’s dignity whilst developing a common understanding and a building of trust so sensitive topics can be approached with thoughtfulness and compassion.
When you should see a doctor?
As soon as you have symptoms. See your GP first and in most cases, it will be a one-off infection that your doctor can treat with antibiotics. But if you have recurring infections – that’s defined as two within three months – then you clearly need further assessment. You should be referred to a specialist
Can a UTI be a sign of something more serious?
For the vast majority of patients, especially young patients, it is just a urine infection but if there is blood in the sample or the infections persist then a patient should be sent to see a specialist.
Our Urology department employs the latest techniques to offer the best diagnosis, intervention and aftercare for all urology problems.
Our Consultants have the latest diagnostic equipment and five operating theaters at their disposal for patients, who can enjoy the unique, family atmosphere of the hospital in luxurious surroundings.