When cure is better than mere prevention

In men, urine infections may lead to permanent kidney damage due to stone, stricture or urethral narrowing and even life-threatening complications.

Talha, a 24-year old young man, started feeling that the urine was relatively more hot,  accompanied by a few other symptoms such as fever, chills and others.  Known as Urinary Tract infection (UTI), this problem is more prevalent in females than males. The reason is that urethra (end part of the urinary system) is much shorter in females, which allows the bacteria and other critters to have direct and easy access to other parts of the urinary system than in males. The Urinary Tract infection (UTI) is a combination of infections that may occur in any part of the urinary tract, starting from kidneys, bladder, ureter to the very end, urethra.

SYMPTOMS

• Feeling pain or burning when urinating
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• High fever with shivering and chills
• Nausea and vomiting
• Low-grade fever
• Back pain, especially on the sides
• Lower abdomen discomfort (tummy part)
• Increase in the normal frequency of need to urinate
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• Increase in the frequency of washroom visits for voiding during the night
• Immediate and sudden urge to urinate
• Visible change in colour (usually dark or cloudy)
• Change in the smell of urine
• Presence of pus or blood in urine
• Incontinence or wetting may also occur in older patients
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RISK FACTORS

In females, UTIs occur more due to hygiene practices, cleanliness and sexual practices of both self and partners. In males, however, there are a few differences in causes and subsequent treatment.

For instance, those patients with enlarged prostate glands or having a family history of men having prostate issues are likely to suffer from UTIs due to blocking or obstructing usual flow of urine. Similarly, patients having kidney stones or those more prone to having one are likely to have UTIs. In both cases, the reason for UTIs is the pooling of urine in the urinary tract, especially in the urinary bladder.

Other people at risk of developing UTIs may include those who have a weakened immune system (immunosuppressed) (e.g. in case of diabetes) or those are using  immunosuppressant medicines. The body’s defence mechanism, against the bacteria causing UTIs, is also compromised when compared to a normal individual.

Those people who have recently visited a hospital for other reasons are also susceptible to UTIs. Patients who are paralyzed, bed-ridden, have neurological problems or psychiatric illnesses, currently have a urinary catheter (tube used to empty the bladder and collect urine in a bag) or previously catheterized for any surgery, urinary procedure, medical examination or any other reason are all more likely to develop urine infections.

It is necessary to cure, treat and prevent UTIs from occurring repeatedly, especially in men. This is because there are chances of developing permanent kidney damage in case of UTIs due to stone, stricture or urethral narrowing in males and even a life-threatening complication of sepsis may occur, if not treated.

PREVENTION

• Hydration – Increase water or fluid intake will help you to urinate frequently and flushes the urinary tract, before the bacteria can actually cause any infection. Not only will the water dilute the urine, but it will also eliminate the unwanted accumulation of urine. Water also helps in discarding other waste material from the body, while retaining required electrolytes and minerals. An adult should drink at least 8 glasses of water daily.
• Drink Cranberry Juice – Readily available locally in juices, sachet and granules, cranberry juice is suggested to be very helpful to prevent UTIs and increase urine output.
• Food intake – If your infection is secondary to any stones then avoid the precursors of stone development. Strictly follow the diet plan being advised by your physician and this will ultimately curtail the chance of UTI development in the long run.
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• Hygiene and Cleanliness – Maintaining proper hygiene and cleanliness of genital region goes a long way in reducing occurrence of a UTI. It is also recommended to urinate as soon as possible after having sexual intercourse and drink water as well.
• Frequent Urination – As soon as one feels an urge to urinate, one should do so. This will flush out bacteria, thereby making it difficult for it to quickly reach the cells of the tract and in the long run hinders the chances of UTIs from occurring.
• Special cases – For bed-ridden, paralyzed and patients with neurological disorders who may be advised to use diapers and / or are catheterized, prompt change of diapers and regular change of catheters is required.

CURE AND TREATMENT

Like most other infections, antibiotics are the mainstay of the treatment along with symptomatic treatment like fever or pain management. Medical science, however, is trying to switch from antibiotics to home-remedies and over-the-counter-drugs for treating simple UTIs. Furthermore, doctor is also likely to advise the precautions and prevention protocols with special emphasis on hydration and cleanliness.

Before recommending any antibiotic treatment, the physician is likely to advise a Urine Detail Report (Urine DR) test alone or along with a Urine Culture Sensitivity (Urine C/S) if the symptoms are too severe, in case of repeated infections or the infection is not subsiding with the previously prescribed antibiotics.

Any UTI, on an average, may last up to one week. Many a time it may even resolve on its own without any treatment, but one must always consult the doctor as it may lead to unwanted repercussions later on.

Dr Khwaja Ali Shahid

The writer is a physician and hosts the YouTube channel ‘DocTree Gardening’. He tweets @Ali_Shahid82 and can be reached at [email protected]