Urinary Tract Infection (UTI) is a common disease of the urinary system, primarily affecting the urethra, bladder, kidneys, and other parts. It can be classified into lower urinary tract infections (such as cystitis) and upper urinary tract infections (such as pyelonephritis). The incidence is significantly higher in women than in men and may be accompanied by serious complications. Understanding its causes, symptoms, and treatment methods can effectively reduce the risk of infection and subsequent health impacts.
UTIs are mostly caused by bacteria invading the urinary system, with Escherichia coli being the most common pathogen. Symptoms are diverse and may include painful urination, frequent urination, hematuria, and in severe cases, even kidney damage. Modern medicine has developed various diagnostic and treatment methods, but correct prevention measures and timely medical consultation remain key.
The treatment and management of UTIs should be personalized based on the site of infection, pathogen type, and patient health status. This article will explore in detail their causes, symptoms, diagnostic procedures, and prevention strategies, helping readers develop a comprehensive understanding of this disease and emphasizing critical indicators for when to seek immediate medical attention.
UTIs are mainly caused by bacteria ascending into the urinary system, with Escherichia coli accounting for over 80% of cases. This bacteria ascends through the urethra to the bladder or kidneys, utilizing the lack of adhesion ability of the urethral mucosa to colonize and proliferate. Women are more prone because their urethra is shorter and closer to the anus, making it easier for bacteria to enter directly, resulting in a 30-fold higher incidence than men.
Specific populations have a higher risk of infection, including pregnant women, diabetics, and those with long-term indwelling catheters. Diabetic patients have increased glucose in urine due to poor blood sugar control, providing a breeding ground for bacteria. Long-term bedridden patients have urine retention, creating an environment conducive to bacterial growth.
Frequent sexual activity may mechanically push bacteria into the urethra, and postmenopausal women experience decreased estrogen levels, leading to reduced mucosal resistance. These are high-risk factors. Additionally, congenital urinary abnormalities such as urethral strictures or reflux can increase the likelihood of recurrent infections.
Lower urinary tract infections (cystitis) typically present with frequent urination (urinating multiple times per hour), urgency, burning pain during urination, and cloudy or bloody urine. Some patients experience lower abdominal distension and pain at the end of urination. These symptoms usually occur suddenly and worsen over a short period.
Upper urinary tract infections (pyelonephritis) are accompanied by systemic symptoms such as high fever (over 39°C), flank pain, nausea, and vomiting. Severe cases may lead to sepsis. Pediatric patients may only show poor appetite or unexplained fever, requiring special vigilance.
About 10-15% of patients may present with atypical symptoms, such as elderly individuals showing only disorientation or altered consciousness, which may be misdiagnosed as other neurological conditions. Asymptomatic bacteriuria patients have positive urine cultures but lack obvious symptoms and usually do not require antibiotics.
The diagnostic process generally involves three stages: first, a medical history inquiry where the doctor asks about symptom duration, pain location, and related history. Second, urine analysis includes microscopic examination of white blood cells, red blood cells, and bacteria, while chemical dipstick tests rapidly detect nitrites and protein indicators.
Urine culture is essential for diagnosis, requiring midstream urine samples cultured for 24-48 hours to identify the pathogen and its antibiotic sensitivity. Complex UTIs require further imaging, such as ultrasound to assess renal structural abnormalities, intravenous pyelography (IVP) to show urinary obstruction, and CT scans for severe cases suspected of perirenal inflammation or abscesses.
Acute uncomplicated lower UTIs are usually treated with a three-day course of antibiotics, such as first-line drugs like norfloxacin or cephalosporins. Complex infections may require two weeks of treatment, with antibiotic choice guided by sensitivity testing. Special populations like pregnant women should use safe antibiotics such as ampicillin.
Symptom relief can be achieved by oral hydration solutions to maintain fluid balance, avoiding caffeine and alcohol which irritate the bladder. Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce fever and pain but should be used cautiously due to gastrointestinal side effects. Local symptom relief includes hot compresses on the lower abdomen, but self-use without clear contraindications is generally safe.
Prevention should emphasize wiping from front to back after urination to avoid contamination from anal bacteria, urinating immediately after sex to flush out potential bacteria, wearing cotton underwear for ventilation and dryness, and avoiding tight clothing that creates a warm, moist environment.
Increasing fluid intake to over 2 liters daily helps dilute urine and promote bacterial flushing. Cranberry juice contains proanthocyanidins that may inhibit bacterial adhesion, but commercial juices often contain high sugar levels which may affect efficacy. Diabetics should strictly control blood sugar levels, as hyperglycemia fosters bacterial growth.
If any of the following symptoms occur, seek medical care immediately: high fever over 38.5°C, severe flank pain, vomiting with inability to eat, hematuria, or altered consciousness. These may indicate upper urinary tract infection or systemic sepsis requiring hospitalization and antibiotic treatment.
Pregnant women, immunocompromised patients, and diabetics should seek medical attention even with mild symptoms due to higher risk of complications. Long-term catheter users should undergo urine testing promptly if they experience difficulty urinating or cloudy urine to prevent renal damage.
Cranberry contains certain components that may help reduce bacteria adhesion to the urethral wall, but relying solely on cranberry juice cannot fully prevent infections. Studies show its protective effect is limited, and good hygiene practices and early medical consultation are still necessary. In case of symptoms, cranberry cannot replace antibiotic treatment.
Why do UTIs tend to recur?Recurrent infections may be related to anatomical abnormalities, poor blood sugar control in diabetics, weakened immunity, or incomplete treatment. Women are more prone due to shorter urethras and bacterial ascent after sexual activity. Doctors may recommend prophylactic medication or further testing to identify underlying causes.
Can I continue sexual activity during treatment?It is advisable to pause sexual activity during infection, as friction can worsen urethral irritation and delay healing. If necessary, both partners should ensure proper cleaning before and after, and treatment should be completed before resuming. After 48 hours without symptoms, sexual activity can usually be resumed, but ongoing observation is recommended.
Why do antibiotic doses vary among individuals?The dosage depends on infection severity, pathogen type, age, and renal function. For example, complex infections like those with diabetes may require longer courses, and different antibiotics may be used to prevent resistance.
Are symptoms of UTIs in postmenopausal women different from those in younger women?Postmenopausal women may experience less burning during urination due to thinning of the urethral mucosa caused by decreased estrogen, but they may have increased urinary incontinence or frequency. Local estrogen supplementation or pH-balanced cleansing products can help strengthen urethral defenses.
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