The urethra is the canal that moves urine from the bladder to the outside of the body. When this canal becomes infected, inflammation occurs due to the accumulation of white blood cells in the area. When this occurs, it is called urethritis. Besides the urethra, the urinary tract consists of the bladder, ureters, and kidneys. Inflammation can move up the urethra, causing cystitis in the bladder, or nephritis in the kidneys. Collectively, these inflammations are called urinary tract infections or UTIs.
Urinary tract infections are much more common in women than in men, probably due to anatomy. Infections are especially more common in older women, due to bladder problems.
Causes and symptoms
Uncomplicated urethritis usually results from infection by the bacteria Escherichia coli, commonly found in the bowel. Complicated urethritis can occur when other problems exist, such as kidney stones, malformations of the urinary tract, spinal cord injury, or a compromised immune system. People with diabetes tend to have more urinary tract infections, as well as hospitalized patients. Urinary tract infections can also be sexually transmitted. Some people seem to be susceptible to urinary tract infections, having them recurrently.
Frequently, a urinary tract infection has no symptoms. Common symptoms though, include pain and a burning sensation when urinating, frequent urination, or passing blood in the urine. Signs that the infection may be worsening include fever and chills, nausea, vomiting, and lower back pain.
The diagnosis for a urinary tract infection is made by assessing the symptoms, feeling (palpating) the abdomen
Typical treatment for urinary tract infections is a course of antibiotics. In women who have recurrent urethritis, the diagnosis and treatment is often resolved over the phone. Additional drugs are sometimes given to relieve discomfort.
For those individuals who seem to be more susceptible to urinary tract infections, drinking lots of fluids at the first sign of an infection can ward it off by diluting the bacteria present and flushing the system. Adding a teaspoon of baking soda to a glass of water and drinking it can change the pH of the urine, causing it to burn less. Also, cranberry juice contains a compound that can prevent bacteria from sticking to and thus growing in the urinary tract. Antimicrobial herbs, such as uva ursi (Arctostaphylos uva-ursi) and pipsissewa (Chimaphila umbellata), may be helpful. Other herbs, such as marsh mallow (Althaea officinalis), slippery elm (Ulmus fulva), comfrey (Symphytum officinale), plantain (Plantago major), and cornsilk, can soothe the urinary tract. Lactobacillus acidophilus and L. bifidus supplementation reintroduces normal flora into the urinary tract. Acupuncture and home-opathy can also be effective therapies for urethritis.
Given the appropriate antibiotic, urinary tract infections usually go away quickly. If not treated soon enough, however, urethritis can move up the urinary tract, infecting the bladder and possibly the kidneys, resulting in kidney damage. If the infection moves into the blood, additional complications can arise. Those who have previously had a urinary tract infection are more susceptible to additional urinary tract infections. Because of this, patients need to be aware of the symptoms so that a physician can be notified if the infection becomes recurrent.
There are some steps that can be taken to keep the urinary tract healthy and prevent infection.
- drink plenty of fluids;
- do not hold urine once the urge to urinate has occurred;
- after a bowel movement, wipe from front to rear to keep bowel bacteria at a distance;
- wear cotton underwear
- rinse soap off well in the shower
- urinate after sexual intercourse
- for post-menopausal women, estrogen replacement therapy can help prevent urinary tract infection
Harrison's Principles of Internal Medicine. Ed. Anthony S. Fauci, et al. New York: McGraw-Hill, 1997.
The Merck Manual of Diagnosis and Therapy. 16th ed. Ed. Robert Berkow. Rahway, NJ: Merck Research Laboratories, 1992.
"Drink Away Urinary Tract Infections." Prevention Magazine, Jan. 1998, 135.
Cindy L. A. Jones, PhD