Urinary Infections (Cystitis)

Urinary infections are caused by the growth of bacteria in the bladder. Usually the bladder is germ-free. Sometimes, however, bacteria travel up the urethra (the canal through which urine is eliminated) and reach the bladder, causing cystitis (a urinary infection). Women have shorter urethras than men, so they are more at risk of infection. In fact, 1 woman out of 5 will suffer from at least 1 episode of cystitis in her lifetime.

People with cystitis usually experience some of the following symptoms:

• pain or burning sensation while urinating;
• pain in the lower abdomen;
• a frequent need to urinate;
• cloudy or malodorous urine;
• traces of blood in urine;
• low back pain;
• fever or shivering.

On occasion, cystitis can go completely unnoticed. In such circumstances, only urine analysis can detect the problem.

Prevention

• After a bowel movement, be careful not to contaminate your urethra with bacteria found in the stools (wipe away, not toward your urethra).
• Wear clean cotton underwear and change them daily. Avoid all synthetic (nylon, polyester) underwear; they prevent airflow and promote bacterial growth by keeping the area moist and warm;
• Urinate after sexual intercourse.
• Do not refrain the urge to urinate.
• Drink cranberry juice regularly. It prevents bacterial growth.

Treatment

Bacteria cause cystitis, so antibiotics are the only drugs that can treat it. In addition to antibiotic therapy, you should also:

• take warm baths or use a heating pad to relieve pain;
• avoid coffee, alcohol, and spicy foods that can irritate the bladder;
• drink plenty of water (6-8 cups/day) to fill and empty the bladder more often.

There is also a drug called “Phenazo” that can be prescribed to relieve the pain often associated with cystitis. This agent is used only for the first few days, while the patient waits for the antibiotic to kick in and it is available only with a prescription.

How long should antibiotic therapy last?

Depending on which antibiotic is used, the treatment can last 3, 7, or 10 days. Three-day courses are mostly used to treat first-time or mild infections. This shorter course is not recommended for men, pregnant women, or women who frequently have cystitis. A urine analysis is sometimes performed after drug therapy is completed to make sure that the infection is really gone.

Pyelonephritis

Pyelonephritis is a kidney infection. In its acute form, it often follows cystitis when the bacteria present in the bladder ascend the ureters to reach the kidneys. The slowing down of the urinary flow, caused by the presence of a urinary stone or malformation, also promotes the multiplication of bacteria in the bladder and their ascent to the kidneys. Chronic pyelonephritis, which is more rare and develops slowly, may lead to kidney atrophy and kidney failure.