Urinary Tract Infection and Bladder Infections

Urinary Tract Infection
Bladder Infection

Urinary tract or bladder infections (UTI) develop in the lower urinary tract area which includes the urinary bladder itself. Bladder infections are often caused by bacteria, rickettsiae, mycoplasma, and sometimes by a virus. Most common are the gram-negative bacteria, specifically E. coli. The signs of infection are frequent urination, painful urination, burning or stinging; a feeling of urgency or a rush to pass urine, a feeling of the bladder is still full shortly after passing urine. Finding bacteria, red cells and white cells in the urine, and frequently passing small amounts of urine at a time are all signs of a possible UTI. Blood may or may not be present in the urine, and it is usually due to irritation of the mucous lining. Most important there could be some other form of pathology which can cause bleeding in the urine as well. Therefore once a urinary tract infection is diagnosed and treated with antibiotics, the urine should be rechecked for the presence of blood. If the urine is negative for blood, it was probably from the infection. However, if it is positive there could be another cause. The blood may be seen visually or only by microscope. Blood may arise from the irritation or it could be another ominous sign including a kidney stone. There may be some spasm of muscles around and in the bladder from the blood. Blood often causes bladder irritation and bladder spasm. There may be some additional severe pain in the lower urinary tract. The urine may appear cloudy, bloody, and darker in color like apple cider or clear to the naked eye. Particulate matter will be seen during a microscopic exam of the urine, and it usually is necessary. Microscopic evaluation of urine is often necessary for proper diagnosis after a routine urinalysis. Even cells of all parts of the urinary tract might be seen to give vital information. Sometimes an insistent patient may say, “I know I have an infection, so give me my antibiotics. I’ve had this ten times this year.” But why is she having ten infections?

Urinary tract infections are more common in women than men. Women have a short urethra, and it is therefore easy for bacteria to get inside. Urinary tract infections occur more frequently with diabetes, immune suppression, and pregnancy. The most common cause of UTI in women is sexual activity. Sexual activity often spreads bacteria into the vaginal area and entrance of the ureter. Sexual arousal manifests a secretion of mucous in women which is high in fructose. This sugar, usually used as an energy source for sperm, now is giving the bacteria food to grow. Once bacteria and sugar are inside the wet and warm bladder, a UTI can quickly ensue. During intercourse, bacteria from surrounding areas are physically rubbed into the opening of the urethra. Women who have had multiple births may have a bladder and/or urethra that have fallen, and are more prone to bladder infections. These women may need to talk to their gynecologist to see if they require bladder surgery. Without surgery, this type of problem will consistently recur. Older men can get bladder infections, sometime due to an enlarged prostate. Males can get a rare infection from sexual intimacy. A culture of the urine can then be done to see which bacterium is causing the infection and to determine the bacterial resistance for correct antibiotic treatment.

Bladder infections are usually treated with antibiotics. Antispasmodics can be given as well for comfort until the antibiotics take effect in a few days. It helps relieve the pain and spasms of the bladder with urination and that usually turns the urine a bright orange color. Other pills for bladder spasm may be taken. If bladder infections are frequent in women or occur in young men, further tests need to be done to determine why the infections are occurring. There could be reflux of urine up the ureter. This reflux could be the cause of the infection and can be a cause of sepsis and even rare death. A hot tub can introduce bacteria especially if you cough in the water and the rectus abdominal muscle causes the water to be sucked into the bladder.

When the bladder infection spreads upward to the kidneys, there can be pain in the sides of the mid-back along with fever, chills, nausea and vomiting. If the fever is above 101.5° and associated with vomiting, you may need to be admitted to the hospital for IV antibiotic therapy. At this stage this is not a normal problem but a kidney infection called pyelonephritis. This could occur with a worsening UTI. People with poor immune status and older patients may even get bacteria in the blood from a bladder or kidney infection. This infection can result as very high fever with sepsis, shock, kidney damage and even rare death.

Treatment of kidney infections is done with an antibiotic shot and pills or admission to the hospital for I.V. antibiotics. It could result in kidney damage. If a kidney infection occurs during pregnancy, admission to the hospital is often necessary. Infection should be treated quickly and effectively to lessen the chances of damage to the kidneys, scaring, further infection, stone formation and anatomical defects possibly causing many problems.

In short these can be simple or quite ominous in effect. The faster current and precise medical care is performed the better. Follow up that all infections are totally clear and nothing is lurking behind the simple appearance of the problem is essential.

John Drew Laurusonis M.D.
Doctors Medical Center