Urinary tract infection

All information on urinary tract infection

At a glance

A urinary tract infection, or UTI for short, is an infection of the inducing urinary tract caused by pathogens.

It is estimated that 50 million women worldwide have recurrent HWIs. More than $10 billion is spent annually and 150,000 to 200,000 deaths occur due to HWI-related complications.

Depending on the area in which the urinary tract infection is located, one distinguishes lower and upper urinary tract infections:

  • A lower urinary tract infection occurs when the urethra or bladder is affected and urethral inflammation or cystitis has arisen.
  • An upper urinary tract infection forms when the infection spreads to the ureters and kidneys. This often leads to inflammation of the renal pelvis.
For more information

Because of the significantly shorter urethra, urinary tract infections are much more common in women than in men. Urinary tract infections are the most common nosocomial infections. Between the ages of 15 and 39, 15.2 % of the women have at least one urinary tract infection per year, of the 40 to 59-year-olds this is 11.4%, and for women aged 60 to 79 it is still 9.7%. This is because women have a much shorter urethra than men. This makes it easier for pathogenic germs to enter the bladder. In men, cystitis is rare between the ages of 17 and 79. Only 2.2 % suffer per year, from the age of 80 it is 5.3 %. Favorable factors here are permanent catheters, stay in a nursing home or hospital and enlargement of the prostate.

 

Depending on the cause, two forms of urinary tract infection are distinguished:

  • An uncomplicated urinary tract infectionis an infection caused exclusively by pathogens, in which there are no favorable risk factors. Often such urinary tract infections heal on their own. In some cases, therapy with antibacterial drugs (antibiotics) is required.
  • A complicated urinary tract infectionoccurs when there is a basic disease (e.g. diabetes mellitus) or if the urinary tract is additionally disturbed in its function or changed in its structure (e.g. by foreign bodies, urinary stones,enlarged prostate,tumors). If the beneficial factors are not eliminated, there is a risk of chronic urinary tract infection.

 

Symptoms

  • Burning when urinating (Algurie, Dysuria)
  • increased urge to urinate (pollakisuria)
  • attenuated urinary ray
  • Pain in the lower abdomen
  • Difficulty holding the urine
  • In upper urinary tract infections (e.g. inflammation of the renal pelvis) fever, flank pain and knocking pain of the kidney camps may occur
  • Blood in the urine, which leads to an intense red colouring of the urine even to a very small extent
  • However, it is not uncommon for a urinary tract infection to remain asymptomatic. About five to ten out of a hundred women with a urinary tract infection are completely free of complaints.

 

Causes/risk factors

  • Frequent sexual intercourse (honeymoon cystitis)
  • Certain methods of contraception, e.g. vaginal diaphragm
  • Immunodeficiency (e.g. in diabetes mellitus)
  • Disruption of urinary outflow (BPH and others)
  • Medical procedures such as bladder catheters, cystoscopy and rinses
  • Pregnancy
  • Spinal cord injury
  • Incorrect “wiping technique” after bowel movements. When wiped from the back to the front, intestinal bacteria are transported towards the urethra entrance.

 

Urine diagnostics:

  • Urine examination with test strips (detection of nitrite and leukocytes in urine)
  • Urine testing in the laboratory (“urine status”)
  • Microbial breeding of the triggering agents (urine culture)

 

Therapy – General measures

 

Did you know?

  • Difference between urinary tract infection and cystitis
  • Bladder inflammation, like urethritis, is a lower urinary tract infection. It therefore only affects the bladder, while a urinary tract infection can generally also affect the upper urinary tract.

Sources

  • Fink, B: et al.: Harnwegsinfekt, URL: https://flexikon.doccheck.com/de/Harnwegsinfekt, Retrieved 18.6.2019
  • Bracht von, T. (2019): Harnwegsinfekt: Erkennen und richtig behandeln, URL: https://www.onmeda.de/krankheiten/harnwegsinfekt.html, Retrieved 18.6.2019
  • die-nephrologen: Nieren, Nierenerkrankungen und Nierenpatienten, URL: https://www.die-nephrologen.de/fakten.html, Retrieved 18.06.2019
  • Baumann, S. (2018):Experteninterview zum Thema Blasenentzündung, URL: https://www.lifeline.de/blasenentzuendung/experteninterview/, Retrieved 18.6.2019
  • Haag, P. et al. (2014): Gynäkologie und Urologie Für Studium und Praxis 2014/2015. Medizinische Verlags- und Informationsdienste, Breisach
  • WebMD: Urinary Tract Infections (UTIs), URL: https://www.webmd.com/women/guide/your-guide-urinary-tract-infections, Retrieved 18.6.2019
  • Mayo Clinic (2019): Urinary tract infection (UTI), URL: https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447, Retrieved 18.6.2019
  • S. Department of Health and Human Services (2017): Bladder Infection (Urinary Infection Tract—UTI) in Adults, URL: https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-infection-uti-in-adults/definition-facts, Retrieved 18.6.2019
Status of information: Autumn 2019