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Urinary Tract Infections | written by Dr. Elsade Kruger

“Over 50 per cent of women will suffer from a urinary tract infection in their lifetime, and up to a third of these women experience recurrent infections, defined as at least three UTI episodes a year”.

 UK National Health Service

I’m sure that all the ladies reading this page will, at some time in their life, have experienced that burning pain on urination that heralds the onset of cystitis (inflammation of the bladder usually caused by an infection). For some of us, it will be a temporary inconvenience- maybe clearing up by itself if we drink enough water, or clearing in a few days with antibiotics prescribed by a doctor. For others, it may mean recurrent periods of misery, with a UTI causing acute pain and necessitating many rounds of medication, maybe even hospital tests and scans.

What’s the difference between cystitis and a urinary tract infection (UTI)?

Cystitis is inflammation of the bladder that can be caused by infection or a non-infectious condition. UTIs are infections of the urinary tract, including everything from the urethra to the bladder to the kidneys.

UTIs affect people differently at different stages of their life.

  • In babies and toddlers, the symptoms are not straightforward, meaning that the infection could easily be missed. Common symptoms are fever, vomiting and appearing to be generally unwell.  Babies’ urine that tests positive for a UTI must always be sent to a laboratory for analysis in case they have a condition called urethral reflux, in which the infected urine flushes upwards towards the kidneys, thereby potentially causing kidney problems, and even failure, if not picked up early.

  • In teens and adult women, the most typical symptoms of a UTI are burning on urination and the need to urinate frequently and with urgency. Infections may be uncomplicated, or, in some cases, they may develop into kidney infections, in which case the patient will feel severe pain in the region of the kidneys, together with fever, headache and nausea or vomiting.

All bladder infections are treated with antibiotics, and if UTIs occur frequently, your doctor will send a urine sample to be analysed in order to prescribe the correct antibiotic for your specific type of infection.

What causes a UTI?

Most cases are thought to occur when bacteria that live harmlessly in the bowel or on the skin get into the bladder through the urethra (tube that carries urine out of your body).

It’s not always clear how this happens, but it can be caused by:

  1. having sex
  2. wiping your bottom after going to the toilet – particularly if you wipe from back to front
  3. inserting a tampon or urinary catheter (a thin tube inserted into the urethra to drain the bladder);
  4. not changing tampons or sanitary pads frequently enough;
  5. using a diaphragm for contraception.

Other common causes of UTIs are:

  • underlying constipation preventing the patient from emptying the bladder completely;
  • not drinking enough water;
  • keeping urine in for too long;
  • underlying structural abnormalities such as kidney stones or genetic malformations.

You should see your GP if:

  • your symptoms don’t start to improve within a few days
  • you get cystitis frequently
  • you have severe symptoms, such as blood in your urine
  • you’re pregnant and have symptoms of cystitis
  • your child has symptoms of cystitis

So what can you do to prevent cystitis/UTIs?

  • don’t hold back your urine, and always empty your bladder fully
  • stay well hydrated – drinking plenty of fluids may help to stop bacteria multiplying in your bladder 
  • always wipe your bottom from front to back when you go to the toilet
  • change sanitary protection every few hours
  • empty your bladder as soon as possible after having sex

Finally, as we age, the changes we experience after menopause can sometimes lead to more serious conditions affecting the bladder and urethra. One of these is a prolapsed bladder (cystocele). This is when the wall between the bladder and the vagina weakens, and the bladder drops or sags into the vagina.

Symptoms of a cystocele include:

  • Feeling of pelvic heaviness or fullness
  • Bulge in the vagina that you can feel
  • Aching or a feeling of pressure in the lower belly or pelvis
  • Lower back pain
  • Frequent urinary tract infections
  • Need to urinate often or urgently
  • Leakage of urine
  • Incomplete emptying of the bladder
  • Constipation
  • Pain during sex

A patient presenting some or all of the above symptoms, especially if she has frequent UTIs, will be referred to a urologist for further tests such as a cystoscopy, ultrasound or MRI scan.

Treatment depends on the severity of the condition, but it can be treated with a pessary (a ring that is inserted into the vagina to hold up the bladder), or surgery.

Recurrent UTIs can also be treated with meds that acts as urinary antiseptica, to keep the urine “germfree”.

To find out more about cystitis and urinary tract infections, you may find these links helpful:


Mayo Clinic 

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