UTI in women: How to reduce the risk of getting urinary tract infections

This week's article has a bias on women, addressing urinary tract infections which tend to be a recurring reason for gynaecology consults.

Women will be familiar with UTI as the abbreviation for the said infection. The infection tends to occur mostly in the bladder and the urethra (the tube that brings urine out). In some cases, the infection can spread to affect the kidneys as well.

In women, the urethra is shorter than in men. This makes it easier for bacteria to reach the bladder, thus making women more prone to UTIs compared to men. Bacteria can easily ascend from the skin, vagina and anus into the urethra and the bladder.

Several factors increase the risk of getting UTIs including frequent sex, incomplete emptying of the bladder and other disease conditions like diabetes. The risk is also increased during pregnancy and in menopause.

How do you suspect that you may be having a UTI? One sign is a strong urge to pass urine that cannot be delayed (medically referred to as urgency).

As urine flows out, a burning sensation may be felt in the urethra. There may also be some discomfort in the lower abdomen or in the pelvis. The urine may also be cloudy and smelly. Fever, chills, back pain, nausea and vomiting may signify a serious infection that may have spread to the kidneys. This requires prompt and urgent treatment.

Once a UTI is suspected, it is important to have some tests to make a diagnosis prior to initiating treatment. You will be asked to provide a urine sample for a simple test called urinalysis. Further testing may involve trying to identify the specific bacteria causing the infection, and the best antibiotic to use.

If a severe infection involving the kidneys is suspected, you may be asked to have additional blood and imaging tests.

Treatment for UTIs is simple and effective. The type, dose and length of the antibiotic treatment will be advised as appropriate. Symptoms resolve within one to two days. Severe infections involving the kidney may warrant hospital admission and injectable antibiotics.

You can take several strategies to reduce your chances of getting a UTI. Maintain good genital hygiene by carefully washing the area around the vagina and the anus daily. After passing urine or opening bowels, wipe from the front backwards to avoid spreading bacteria around the urethra. Empty your bladder as soon as you feel the urge if at all possible. And also try to empty the bladder before and after sex. Drinking lots of water helps to flush out bacteria from your urinary system. If you suspect an infection, get prompt testing and treatment.

- Dr Alfred Murage is a Consultant Gynaecologist and Fertility Specialist

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