Urinary Tract Infections

One of the most common problems in urology is urinary tract infections. Managing those infections is one of the most common things a urologist does on a daily basis. The entire scope of a urinary tract infection is beyond what I can cover in a simple webpage, but I will try to cover the basics.

A urinary tract infection is most commonly a bacterial infection with bacterial overgrowth within the bladder, kidneys, ureters, prostate, or urethra.

A bacterial infection can happen at any time and to anyone, but it is most common in women and patients with urological conditions, such as neurogenic bladder or the chronic need for catheterization. Because of the level of instrumentation and foreign body placement within the urinary tract (catheters, stents) urinary tract infections are common.

Symptoms of infection are many and vary from infection to infection. Most often with a bladder infection there is burning , frequency, small voids, and sometimes hematuria. Symptoms of prostatitis may include the same. Kidney and ureteral infections cause flank pain and possibly fever along with the other symptoms. Urethritis causes burning with urination.

Bacterial infections are tested with urine culture and treated accordingly. A urine culture is simply taking the urine sample and putting it on an agar plate to allow bacteria to grow. When the bacteria has matured a laboratory can identify the type of bacteria and determine the sensitivity of the bacteria to different antibiotics.

Common bacteria include E coli, Klebsiella, Proteus, Enterococcus, Pseudomonas, Citrobacter, Staphylococcus and Streptococcus as well as other species of bacteria.

Treatment most often includes an antibiotic prescription. The choice of antibiotic depends on what bacteria is present and its sensitivity or resistance to individual antibiotics.

Common antibiotics include penicillins, cephalosporins, sulfa-based antibiotics, nitrofurantoin, flouroquinolone antibiotics.

Prevention of infections includes hydration and making sure there is adequate drainage of urine from the urinary tract. Careful attention is paid to patients with catheters as CAUTI (catheter associated urinary tract infection) causes many problems for hospitalized patients as well as patients managing their urinary tract with catheters in the outpatient setting.