Urinary Tract Infections

Urinary tract infections (UTI) are a common and cause troublesome urological complaints. UTI’s are very common with more than 50% of women suffering from at least one UTI in their life time. It is less common in men, though it is much more of a difficult problem to treat when men are effected.

Symptoms:

UTI can cause different symptoms depending on the site of infection. When the infection is in the bladder (cystitis) it typically causing pain whilst passing urine. Simple cystitis is bothersome, causing irritating and sometimes debilitating symptoms such as passing urine more often, stinging/offensive urine, pain in the lower abdomen and feeling unwell. More seriously, kidney infections (Pyelonephritis) can cause fevers/shaking and significant loin pain. In men, UTI can occur in the prostate (bacterial prostatitis) and testes (epididymo-orchitis). These sites of infection are much more difficult to treat.

Causes:

UTIs are often seen in patients with underlying risk factors or causes, which can include post-menopausal, a family history of UTI, diabetes, bladder obstruction (e.g. an enlarged prostate), sexual activity, spermicidal contraceptives and kidney or bladder stones.

Treatment:

Uncomplicated cystitis is easily treated with appropriate antibiotics. However recurrent cystitis, kidney infections, prostatitis and epididymo-orchitisneed further investigations and are usually treated by urologists.

Recurrent UTI is a common condition, and requires a methodical consultation and careful use of investigations to detect any underlying causes. Treatment approaches in the acute setting (i.e. an active infection) focuses on identifying and treating the causative bacteria with the appropriate antibiotic. After excluding or identifying specific causes, treatment of recurrent UTIs concentrates on aiming to prevent further episodes. Preventative treatment includes lifestyle advice, which is modified to the patient’s specific circumstances.

Preventative treatment options can be focused around avoiding antibiotics, and include a variety of medications that can be offered depending on the patients specific clinical condition. Alternatively, or in conjunction with this a patient may be offered judicious treatment of longer term, low dose preventative (prophylactic) antibiotics tailored to the causative bacteria for that individual patient.