Urinary Tract Infections (UTIs)
Urinary Tract Infections (UTIs) are quite common in the day to day urological practice.
These can affect people of all ages and both genders. Certain population groups are more prone to infections than others – young children, elderly women, patients with catheters, diabetics, immunocompromised individuals.
These infections can affect all parts of the urinary tract and can present with different symptoms depending on their location. Equally they can be completely asymptomatic.
The bacteria causing UTIs are usually of the so-called Gram (-) type and they have special affinity to the cells of the urinary tract.
Young sexually active adolescents more commonly are affected with sexually transmitted organisms such as Chlamydia, Trichomonas, Gardnerella or Gonorrhoea. Infections with some of these organisms can go completely unnoticed by the individual but they can cause narrowings of the urinary passages or block the Fallopian tubes in females, leading to infertility or ectopic pregnancies later in life.
Apart from diagnosing and treating a UTI, it is also extremely important to identify if there are any correctable causes that triggered the infection in the first place. These can be anatomical abnormalities in the urinary tract; presence of stones; rule out malignancy; foreign bodies – mesh, sutures, clips etc; abnormal communication between the urinary tract and bowel.
The presence of bacteria in urine is not always a sign of infection and does not always need to be treated. This is called asymptomatic bacteriuria (ABU). On the other hand, if ABU exists in pregnant women it should always be treated. All pregnant women should be screened for ABU and this should be treated. This has shown to reduce the risk of symptomatic UTIs in pregnancy and also reduces the risk of preterm deliveries.