Urinary Infection

Urinary tract infections (UTIs) occur when a pathogenic microorganism (usually a bacterium) reaches the urethra and affects the urinary pathways. These germs typically move from the rectum or enter the body through the skin.

There are four types of urinary infection depending on the affected organ:

• Cystitis: occurs in the bladder.
• Pyelonephritis: develops in the kidney.
• Prostatitis: localized in the prostate, a gland of the male sex organ involved in semen production.
• Urethritis: develops in the urethra, which is the duct through which urine is expelled from the bladder to the outside.

To choose the most appropriate treatment, it is necessary to determine the type of condition:

• Primary infection: is an isolated infection.
• Unresolved infection: typically does not resolve because an inappropriate antibiotic has been used.
• Recurrent infection: repeats due to bacterial persistence or reinfection, which is most common.

Due to their anatomy (shorter urethra and proximity to the rectum), urinary infections are more common in women than in men. However, the female sex has a higher tendency for cystitis, which presents with mild symptoms and few complications.

Although less frequent in men, they have a higher risk of complications, requiring longer treatments. Notably, prostatitis generates more severe symptoms and has the potential to become chronic.

In most cases, it is a condition that, when treated promptly, resolves in 24 to 48 hours. However, when it affects the kidneys, it may last up to a week.

Symptoms

The most common symptoms of urinary infections are:

• Blood in urine (hematuria).
• Cloudy urine.
• Pain or burning sensation when urinating (dysuria).
• Urgent need to urinate.
• Urinary incontinence.
• In some cases, fever.
• In the case of pyelonephritis, high lower back pain.

Causes

Urinary infections are usually caused by bacteria. In most cases, the culprit is Escherichia coli, which is present in feces. Other common causes include Proteus, Enterobacter, Klebsiella, Citrobacter, Pseudomonas, Streptococcus faecalis, Serratia, and more commonly, Staphylococcus saprophyticus.

Risk Factors

The factors that increase the risk of contracting a UTI are:

• Women: especially sexually active women and pregnant women.
• Children and the elderly.
• Changes in vaginal flora: due to hormonal changes, such as menopause, or the use of spermicides.
• Enlarged prostate.
• Poor hygiene.
• Family or personal history of urinary infections.
• Diabetes.
• Immunocompromised individuals.
• Infectious kidney stones.
• Kidney obstruction.
• Vesicoureteral reflux: urine backflows from the bladder to the kidneys.
• Uncircumcised infants under one year old.

Complications

When a urinary infection is not treated or does not respond adequately to treatments, the following complications may arise:

• Chronic infection.
• Scarring nephropathy: scars form, irreversibly damaging the renal parenchyma (the cortex and medulla, which are the functional parts of the kidney).
• Renal failure: the kidneys stop functioning or function poorly.

Prevention

Some tips to prevent urinary infections include:

• Drink plenty of liquids to stay hydrated.
• Urinate after sexual intercourse.
• Take showers instead of baths.
• Avoid vaginal douches.
• Wipe from front to back after defecating, especially for women.

Which doctor treats urinary infections?

Urinary tract infections are diagnosed and treated in family medicine, pediatrics, geriatrics, internal medicine, urology, and nephrology consultations.