Do you ever experience a burning sensation when urinating? Do you get the urge to urinate more frequently than usual? These could be signs of a urinary tract infection, the second most common type of infection in humans.
The urinary tract is made up of the organs of the body that produce, store and discharge urine. These organs include the kidneys, ureters, bladder and the urethra. This system can be divided into upper urinary tract comprising of the ureters and kidneys and the lower urinary tract being the bladder and the urethra.
The urinary system does several important jobs. It removes liquid waste from the blood in the form of urine. It also regulates, keeping a stable balance of salts and other substances in the blood. The system also produces a hormone that is essential in the formation of red blood cells and also an enzyme that plays a role in blood pressure. The kidneys also regulate blood pressure by adjusting the volume of blood as well as the flow in and out of them.
What causes infection? This very important system of the body, however, gets infected frequently. The lower urinary tract tends to be more prone to infections. The most common cause of urinary tract infections is bacteria within the body. The bacteria from the bowel that is found on the skin near the rectum or vagina may spread and enter the urinary tract through the urethra causing urethritis. The infection may go up to the bladder, infecting the bladder (cystitis). When it reaches the kidneys it causes a more serious infection called pyelonephritis. Germs may be introduced into the urethra by wiping from back to front after bowel movement.
Infections may be introduced also by anything that obstructs or delays the flow of urine, for example kidney stones or holding urine longer. Weakening of the bladder muscles also allows residual urine, which promotes multiplication of the germs. Sexual activities and introduction of foreign bodies into the urethra also encourages infections. Women are more prone to urinary tract infection due to their shorter urethras and the close proximity to the anus.
For men, uncircumcised individuals are at greater risk of urinary tract infection as the foreskin of the penis makes it easier for the germs to get trapped and enter the urinary system. In an elderly man, an enlarged or infected prostate increases the risk of urinary tract infection. Unprotected sex and anal sex also increase the risk of urinary tract infection.
These are the symptoms and signs of urinary tract infection: Urinating more often or waking up from sleep to urinate; urine that smells bad; the urine may be cloudy or tinged with blood; pain or burning when you urinate; very little urine produced and the urge to urinate recurs quickly; and pain or pressure in the lower abdomen. When the infection spreads up to the kidneys (pyelonephritis) this could be more serious and can cause shaking chills with a fever.
This may be associated with side pain or lower back pain that gets worse. Vomiting may also occur.
There are simple steps that help preventing urinary tract infections: Drink plenty of fluids, drinking a lot of water (six to eight glasses of water daily) leads to passing a lot of urine which has the effect of flushing the urinary tract. Always wipe from front to back after a bowel movement to avoid introducing anal bacteria. Avoid holding urine for long periods of time; urinate as soon as you feel the need.
Good hygiene is of great importance in preventing urinary tract infections. Both men and women ought to exercise good hygiene before and after sexual intercourse. Hygiene in men is significantly improved by undergoing circumcision. Medical male circumcision is offered free in government health services and covered by medical aid, so ask your health provider.
If one suspects having urinary tract infection, take lots of fluid especially water and visit the nearest clinic or doctor. The nurse/doctor will take note of your symptoms, examine you and may take a sample of your urine for analysis. Urinary tract infection may be treated with oral antibiotics and with more severe cases hospitalisation may be necessary.
• Dr Emmanuel Tom is a general medical practitioner at Wanaheda Medical Centre in Windhoek (e-mail: etom@wanmedcentre.com).