URINARY TRACT INFECTIONS (UTI)

HOW DOES THE URINARY SYSTEM WORK?

The urinary system is a very important system in the body as it removes waste and excess water from the body.  The urinary tract is comprised of the kidneys, ureters, urethra, and bladder.  It is essential that these organs work together for a healthy functioning urinary tract (1). The kidneys are two bean-shaped organs that are located below the rib cage, one on each side of the spine. The kidneys act as filters for the blood, removing waste from the bloodstream to create urine. Healthy kidneys are also important for healthy bodily function because they perform essential functions like the stability of electrolytes, producing hormones for the regulation of blood pressure, production of red blood cells and bone strength (1).  The ureters are thin, muscular tubes that drain the urine from the kidneys to the bladder. The bladder acts as a storage tank for urine and is eventually emptied through the urethra (2).

WHAT ARE URINARY TRACT INFECTIONS?

Infection of any part of the urinary system is known as urinary tract infection or UTI. This is caused by bacteria entering the urinary tract, resulting in pain, swelling, and inflammation of the urinary tract. The bacteria can travel to the ureters and the kidneys causing more serious infections. Most UTIs are caused by a bacteria known as E.coli, which lives in the intestines, but can less commonly be caused by a bacteria known as Proteus mirabilis (3,4).  Urinary tract infections are divided into upper UTIs and lower UTIs, depending on which part of the urinary system is affected.

Lower Urinary Tract Infection

Lower urinary tract infections are infections of the urethra and the bladder (5).  Urethritis is the inflammation of the urethra, typically caused by sexually transmitted agents such as Gonococcus, Chlamydia trachomatis, and Mycoplasma genitalium (6,7,8).  On the other hand, cystitis is an infection and inflammation of the bladder. However, cystitis is not only caused by UTIs.  Less common causes of cystitis include bladder stones, bladder cancer, and carcinoma in situ (9).

Upper Urinary Tract Infection

Upper urinary tract infections are infections of the ureters and the kidneys and are usually more serious than lower UTIs (10).  Ureteritis is the inflammation of the ureters usually caused by bacteria. Ureteritis is usually an extension of cystitis or pyelonephritis and presents with similar symptoms of painful and frequent urination, flank pain and fever (11).  Pyelonephritis is the infection of the kidney by bacteria found in the intestines (5).  Pyelonephritis requires medical attention as it may be life-threatening if the bacteria spread to the blood.

RISK FACTORS FOR URINARY TRACT INFECTIONS

• Spermicide use (12,13,14,15)
• New sex partner within the past year (13,16)
• Previous UTI (16,17)
• Female anatomy, specifically a shorter urethra can make it easier for bacteria to move from the urethra to the bladder (18)
• Genetic history of UTI (19,20)
• Post-menopause (21,22)
• Increased age (23,24)
• Pregnancy (25,26,27)
• Diabetes (28,29)
• Kidney transplant (30,31,32)
• Nephrolithiasis (Kidney Stones) (33)
• Immunocompromised status (34)
• Prolonged use of urinary catheter (35,36)
• Functional or anatomic abnormality in the urinary tract (35)
• Obstructive uropathy (when urine cannot drain through a ureter and it is back up into the kidney, causing the kidney to swell) (12)

SYMPTOMS OF URINARY TRACT INFECTIONS

Lower Urinary Tract Infections

• Painful and frequent urination
• Urethral itching
• Discharge (37)
• Lower abdominal pain
• Blood in urine
• Mild fever (5,9)
• Rectal or pelvic pain

Upper Urinary Tract Infections

• Flank (upper back and side) pain
• Fever
• Nausea
• Vomiting (38)

URINARY TRACT INFECTIONS FACTS AND STATISTICS

Urinary tract infections are the third most common infection, following respiratory and gastrointestinal infections (12). In 2007 estimates showed that there were 150 million cases of urinary tract infections worldwide (38,39). UTIs account for more than 12% of infections reported by acute care hospitals (40). In 2011, the Health-Care Associated Infection estimates there were 93,000 UTIs occurring in acute care hospitals in the United States (41).

Urinary tract infections affect both sexes and all age groups but are generally more common in women than in men. Almost half of all women will experience a urinary tract infection at least once in their life (42). In the United States, up to 70% of urinary tract infections acquired in hospitals (acute and long-term stays) are due to catheterization (36).

MEDICAL TREATMENT OF URINARY TRACT INFECTIONS

Typically, antibiotics, such as Cephalexin or Fosfomycin, are the first line of treatment for urinary tract infections (5).  Antibiotics are prescribed based on how long one has had the infection and what type of bacteria is present.  For more severe UTIs, intravenous antibiotics given in the hospital may be needed.

NATURAL WAYS OF SUPPORTING A HEALTHY URINARY TRACT

Practices to Support a Healthy Urinary Tract:

• Clean the genital areas before and after sexual intercourse
• Proper genital hygiene
• Avoid multiple sexual partners
• Avoid spermicidal contraceptives, diaphragms and vaginal douching
• Avoid bubble bath liquids, bath oils, vaginal creams and lotions, deodorant sprays or soaps
• After a bowel movement, it is encouraged to wipe front to back

Natural Supplements That Support a Healthy Urinary Tract:

• Cranberries (43,44)
• D-Mannose (45,46)
• Uva Ursi (47,48)
• Grapefruit Seed Extract (49,50)
• Caprylic Acid (51)

REFERENCES

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