Urinary Tract Infections: Causes, Symptoms & Treatment

16/12/2022

Normally, urine flows out of the kidneys at extremely low pressure. If the flow of urine is obstructed, urine backs up behind the point of blockage, eventually reaching the small tubes of the kidney and its collecting area (renal pelvis), swelling (distending) the kidney and increasing the pressure on its internal structures. Such kidney distention is called hydronephrosis. The elevated pressure due to the obstruction may ultimately damage the kidney and can result in loss of its function.

When the flow of urine is obstructed, stones (calculi) are more likely to form. An infection may develop when the flow of urine is obstructed because bacteria that enter the urinary tract are not flushed out. If both kidneys are obstructed, kidney failure may result.

Long-standing distention of the renal pelvis and ureter can also inhibit the rhythmic muscular contractions that normally move urine down the ureter from the kidney to the bladder (peristalsis). Scar tissue may then replace the normal muscular tissue in the walls of the ureter, resulting in permanent damage.

Partial and complete obstruction tend to cause similar problems, but most problems, and particularly kidney damage, are more severe when obstruction is complete.

16/12/2022

Urinary tract obstruction is a blockage that inhibits the flow of urine through its normal path (the urinary tract), including the kidneys, ureters, bladder, and urethra.
Blockage can be complete or partial.
Blockage can lead to kidney damage, kidney stones, and infection.
Symptoms can include pain in the side, decreased or increased urine flow, and urinating at night.
Symptoms are more common if the blockage is sudden and complete.
Testing can include insertion of a urethral catheter, insertion of a viewing tube into the urethra, and imaging tests.
Treatment can include measures to open up a blocked path and to treat the cause of the blockage.
A blockage (obstruction) anywhere along the urinary tract—from the kidneys, where urine is produced, to the urethra, through which urine leaves the body—can increase pressure inside the urinary tract and slow the flow of urine. An obstruction may occur suddenly or develop slowly over days, weeks, or even months. An obstruction may completely or only partially block part of the urinary tract. Sometimes only one kidney is affected, but obstruction may affect both kidneys.
The prevalence of urinary tract obstruction ranges from five in 10,000 to five in 1,000 depending on the cause. In children, obstruction is due mainly to birth defects affecting the urinary tract. Men, particularly those older than 60, are also more likely to be affected because, as men age, the prostate gland tends to increase in size (a condition called benign prostatic hyperplasia) and block the flow of urine.
Hydronephrosis: A Distended Kidney
In hydronephrosis, the kidney is distended because the flow of urine is obstructed. Urine backs up behind the obstruction and remains in the kidney’s small tubes and central collecting area (renal pelvis).

16/12/2022

Ureteral obstruction might have no signs or symptoms. Signs and symptoms depend on where the obstruction occurs, whether it's partial or complete, how quickly it develops, and whether it affects one or both kidneys.

Signs and symptoms might include:

Pain
Changes in how much urine you produce (urine output)
Difficulty urinating
Blood in the urine
Urinary tract infections
High blood pressure (hypertension)

02/12/2022

Why do antibiotics sometimes not work for UTIs?

While antibiotics are tough on infections, it’s actually quite easy for bacteria to become resistant to them. The more resistant bacteria are, the less effective future antibiotics will be. In fact, antibiotic resistance is a serious global health concern. Over 35,000 people die every year from antibiotic-resistant infections in the US alone.

There are a few ways you can become antibiotic-resistant. First, if you stop taking your antibiotics UTI treatment before you’re supposed to. This is a common problem since most people start to feel better after 3 days of treatment and toss the remaining pills. Taking the same antibiotics over and over again can also lead to resistance. This is a major concern for people who struggle with recurrent UTIs.

But antibiotics can cause other issues, too. They can disrupt the gut and vaginal flora, allowing bad bacteria to take over. Taking a daily probiotic, like Utiva’s Probiotic Power supplement, can improve gut flora and urinary tract health while reversing any damage caused by antibiotics.

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02/12/2022

Urethritis Treatment
Antibiotics can successfully cure urethritis caused by bacteria. Many different antibiotics can treat urethritis. Some of the most commonly prescribed include:

Adoxa, doxycycline (Vibramycin), Monodox, Oracea
Azithromycin (Zmax), Zithromax
Ceftriaxone (Rocephin)
Urethritis due to trichomonas infection (called trichomoniasis) is usually treated with an antibiotic called metronidazole (Flagyl). Tinidazole (Tindamax) is another antibiotic that can treat trichomoniasis. Your s*xual partner should also be treated to prevent reinfection. It’s important to get retested after three months to make sure the infection is completely cleared. This includes even if your partner was treated.

Urethritis due to herpes simplex virus can be treated with:

Acyclovir (Zovirax)
Famciclovir (Famvir)
Valacyclovir (Valtrex)
Often, the exact organism causing urethritis cannot be identified. In these situations, a doctor may prescribe one or more antibiotics that are likely to cure infection that may be present

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02/12/2022

If you are having painful urination, your doctor may assume an infection is present. They may treat it with antibiotics right away while waiting for test results.

Tests can help confirm the diagnosis of urethritis and its cause. Tests for urethritis can include:

Physical examination, including the ge****ls, abdomen, and re**um
Urine tests for gonorrhea, chlamydia, or other bacteria
Examination of any discharge under a microscope
Blood tests are often not necessary for the diagnosis of urethritis. But blood tests may be done in certain situations.

02/12/2022

Urethritis Causes
Most episodes of urethritis are caused by infection by bacteria that enter the urethra from the skin around the urethra's opening. Bacteria that commonly cause urethritis include:

Gonococcus, which is s*xually transmitted and causes gonorrhea.
Chlamydia trachomatis, which is s*xually transmitted and causes chlamydia.
Bacteria in and around stool.
The herpes simplex virus (HSV-1 and HSV-2) can also cause urethritis. Trichomonas is another cause of urethritis. It is a single-celled organism that is s*xually transmitted.

Sexually transmitted infections like gonorrhea and chlamydia are usually confined to the urethra. But they may extend into women's reproductive organs, causing pelvic inflammatory disease (PID).

In men, gonorrhea and chlamydia sometimes cause epididymitis, an infection of the epididymis, a tube on the outside of the te**es. Both PID and epididymitis can lead to infertility.

24/11/2022

What happens if I have a multidrug-resistant urinary tract infection?
hospital treatment for an antibiotic resistant UTI
Some strains of bacteria are now resistant to all of the most commonly used antibiotics. When UTIs recur or don’t go away with treatment, urine samples are usually tested at a microbiology lab. If resistant organisms are discovered they are often found to be ESBL E. coli or ESBL Klebsiella. If you have a UTI with either of these resistant bacteria, you will probably be treated in hospital by an infectious disease doctor and their team. They will often prescribe a specific antibiotic via an intravenous (IV) drip (or combination of antibiotics) known to be active against ESBL- producing bacteria. This might be carbapenem antibiotic. These are considered ‘last resort’ antibiotics which are kept especially for those highly resistant bacterial infections.

If you have an antibiotic-resistant UTI, you’re not alone. There are many different support groups online where people suffering with resistant UTIs can help one another.

Preventing UTIs using natural products
Many of those who suffer with recurring or resistant UTIs are keen to reduce the risk or occurrence. They try using natural products to help with their symptoms. These include D-Mannose, cranberry products (like triple strength tablets or juice), Kefir /probiotics, manuka honey and so on.

Anecdotally, many report finding some of these useful in the prevention of UTIs; however, there is very little published evidence to support the effectiveness of these natural products, and more research is needed.

24/11/2022

How are antibiotic-resistant urinary tract infections usually treated?
packets of antibiotics
For most common UTIs, there is usually a ‘first-line’ antibiotic that is often used as standard, although these vary across the UK. If you have had a UTI, the chances are you are familiar with these drugs. So GPs will usually follow guidance to treat a UTI immediately with first line therapy according to local guidelines. If this doesn’t eliminate the infection, a urine culture is often sent to the lab to test what the bacteria actually is and what antibiotic is likely to kill it. Other antibiotics such as fosfomycin and pivmecillinam might be used where first line antibiotics have not worked. Fosfomycin is an oral broad-spectrum antibiotic that acts against many multidrug-resistant pathogens in the urinary tract.

What is colonisation and biofilm?
When people have had several UTIs, and several courses of antibiotics for a UTI, antibiotics may initially appear to work and symptoms often resolve for a while. However, the more resistant organisms are known to sometimes attach themselves to the bladder wall as well as forming colonies of resistant bacteria within other parts of the body such as the kidney.

These colonies of resistant bacteria can multiply in number over time, and become immune to the effect of the antibiotics. The bacteria become harder to eradicate, even when taking powerful antibiotics, as they form a biofilm. This is where the colonies of resistant bacteria form a protective layer around themselves, making it even more difficult for antibiotics to reach and kill them.

An antibiotic resistant UTI can then become a chronic condition and can often cause frequently recurring outbreaks of infection, with an increased risk of serious kidney infection (pyelonephritis) and even sepsis.

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