Urinary Tract Infection

How will you know if you have true cystitis and not just some irritation of the bladder causing symptoms? The only real way to know is for a urologist to take a thorough history, examine you and, most importantly, do an analysis of the urine.

Urinary tract infection (UTI) is a common infection that usually occurs when bacteria enter the opening of the urethra and multiply in the urinary tract. The urinary tract includes the kidneys, the tubes that carry urine from the kidneys to the bladder (ureters), bladder, and the tube that carries urine from the bladder (urethra). The special connection of the ureters at the bladder help prevent urine from backing up into the kidneys, and the flow of urine through the urethra helps to eliminate bacteria. Men, women, and children develop UTIs.

Urinary tract infections usually develop first in the lower urinary tract (urethra, bladder) and, if not treated, progress to the upper urinary tract (ureters, kidneys). Bladder infection (cystitis) is by far the most common UTI. Infection of the urethra is called urethritis. Kidney infection (pyelonephritis) requires urgent treatment and can lead to reduced kidney function and possibly even death in untreated, severe cases.

Approximately 8 to 10 million people in the United States develop a UTI each year. Women develop the condition much more often than men, for reasons that are not fully known, although the much shorter female urethra is suspected. The condition is rare in boys and young men.

Urinary Tract Infection / Cystitis

Cystitis is a general term that includes any inflammation or infection of the bladder. Cystitis is generally caused by a bacterial infection, but it can also be caused by yeast or viruses. A unique type of cystitis known as interstitial cystitis is not caused by an infection, but it is more like an inflammation that involves the bladder lining and muscle.

For a detailed discussion of the diagnosis and management of interstitial cystitis, click here for the American Urological Association’s clinical guidelines.

Symptoms may be varied and range from severe and intensely painful to simply annoying. These include burning with urination, bladder pressure and pain, blood in the urine, and increased frequency and urgency of urination. Some patients even experience leakage of urine, also known as incontinence. Some patient likewise may experience the inability to urinate, known as urinary retention.

Treatment depends on the cause. Bacterial and yeast cystitis is treated with appropriate medicines. Viral cystitis, although rare, is generally self-limiting and requires no treatment except symptomatic. Interstitial cystitis treatment depends on the severity and duration of the symptoms and it can be very complex.

Prevention can be difficult, but obviously, patients should drink plenty of fluids and maintain good urinary tract hygiene.