Herald Café:
How common are Urinary tract infections (UTIs)?
Dr
Madhumohan R Prabhudesai: Urinary infections are one of the commonest disease
conditions seen in our day-to-day practice.
HC: Which
age group is predisposed to UTIs commonly?
Dr MP: Irrespective
of the age and gender, UTIs can affect anybody, from neonates to the elderly.
HC: What are
the causes of UTI and what are the underlying predisposing factors?
Dr MP: Causative
organisms for UTI may be bacteria, fungi or viruses. The cause for UTI is
variable depending on the age or gender of the patients.
In paediatric age group, UTI may result from obstruction
to urinary flow (due to congenital obstruction of the tract) like phimosis,
reflux disease, valve disease etc. In adults, there are different predisposing
factors like Diabetes mellitus, decreased immunity (ability to fight
infections), renal stones etc.
In Males, obstruction of the urinary tract from
prostatic enlargement, stricture urethra, (narrowing of the urethral lumen),
etc are common causes, while in females, common predisposing factors include
cystitis, urinary incontinence and pregnancy etc.
HC: When
should one suspect UTI? What are the manifestations?
Dr MP: UTI
commonly presents with burning urination, increase in frequency of urination
during the day and at night, pain at the end of urination, hematuria (blood in
urine), fever with chills and generalised weakness without any cause.
HC: What are
the treatment options for UTI?
Dr MP: The
treatment of UTI includes diagnosis of the cause of UTI, treatment of the
cause, and treating the symptoms of UTI. Based on the causative organism,
obtained from urine culture and sensitivity report, UTI needs to be treated
with antibiotics in case of bacterial infections, anti fungals in case of
fungal infections and by providing supportive treatment for viral conditions.
Besides this, controlling the predisposing factors like diabetes, maintaining
hygiene, boosting patient’s immunity and by treatment of underlying conditions
like renal stones, prostatic enlargement, incontinence, etc is of paramount
importance. In children, congenital obstructive problems need definitive
management.
HC: Why do
some people suffer from recurrent UTI?
Dr MP: UTI
can recur due to the presence of predisposing factors like uncontrolled
diabetes, bad hygiene, persistent presence of causative factors and very often
incompletely treated first episode of UTI. Hence it is very important to take
care of the cause of the infection along with management of the symptoms.
HC: Can
drinking water and fluids help in UTI?
Dr MP: Yes,
dehydration itself can act as a predisposing factor for UTI. Having plenty of
fluids not only helps in asymptomatic bacteriuria but also helps in healthy
functioning of the kidneys.
HC: Which
tests can confirm UTI?
Dr MP: Diagnosis
of UTI can be done by routine urine examination and by urine culture and
sensitivity. In addition, routine blood tests like sr creatinine, blood counts,
Hb are also helpful. USG of kidney, ureter, bladder (KUB) is also done
routinely. Few cases may require special tests like IVP intravenous pyelogram,
MCU (micturating cysto-urethrogram), ASU (ascending urethrogram).
Some cases may also require CT scan, MRI and
urodyanamic studies for UTI work up.
HC: Can UTIs
be prevented?
Dr MP: UTI
can be prevented by maintaining good hygiene, having adequate water, treating and
controlling the predisposing factors and not neglecting initial symptoms of UTI.
HC: What can
happen if UTIs occur in young children?
Dr MP: In
children, UTI needs to be investigated thoroughly to prevent damage to the
bladder and kidneys. Any child with fever irrespective of the cause must
undergo urine routine examination to rule out urinary tract infections.
HC: What
happens if UTIs are left untreated?
Dr MP: In
paediatric cases, if UTI is neglected it can cause damage to the bladder and
lead to urinary bladder dysfunction. In extreme cases, it can even result in
kidney failure. In adults, if UTI is not treated on time, it can result in
dreaded complications like sepsis, kidney failure and may also result in loss
of life.
