Urinary Tract Infection

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Urinary tract infection is caused by bacteria entering the urethra and bladder. Cystitis is the most common form of urinary tract infection. Then you may need to urinate often and it may burn. The trouble usually subsides after a few days.

You can try to prevent the trouble if you get bladder catarrh often. Sometimes you may need treatment. This could be, for example, if you are pregnant and have cystitis, or if you have pelvic inflammation.

Children who get a urinary tract infection usually get treated with antibiotics. Urinary tract infection in young children can be difficult to detect. Unlike adults, children should not wait to seek care.

Cystitis or renal pelvic inflammation

When bacteria enter the urinary tract you can get a urinary tract infection. Most often, the infection stops in the urethra and bladder and is then called cystitis. Sometimes the bacteria spread to the kidneys and the pelvis. Then it is called renal pelvic inflammation.

Bladder catarrh often goes by itself

Women get lighter bladder catheters because the urethra is shorter on women than on men. More than half of all women get it at some point in their lives. Cystitis in women often gets better after a few days and often goes away by itself within a week.

Sometimes you need treatment

You may need treatment for cystitis in some cases. This may apply, for example, when:

  • You are pregnant and you get cystitis. Then you need to be treated with antibiotics, among other things, to make bacteria easier to reach up to the kidneys during pregnancy. You may also submit a urine sample on which it is cultured to see if the infection is caused by GBS. If so, you will need to be treated with antibiotics intravenously during childbirth so that the baby is not infected.
  • You may have problems with the prostate. If you are a man and have bladder catarrh, you usually need treatment with antibiotics, because the problems can be due to the prostate gland, and then bacteria can reach the kidneys.
  • Children who get cystitis usually get treated with antibiotics.

Renal pelvic inflammation must always be treated 

Bacteria can sometimes reach the kidneys and pelvis. Then it is called renal pelvic inflammation, or pyelonephritis. It must always be treated with antibiotics. Otherwise, there is a risk that the kidneys will be damaged, or the bacteria will spread to the blood. Then the bacteria can cause blood poisoning, so-called sepsis which can be life-threatening.

Symptoms of urinary tract infection

Symptoms of urinary tract infection can be one or more of the following:

  • You need to pee often.
  • You may feel it burning when you are kissing and even just afterward.
  • You may have pain in the lower abdomen above the bladder.
  • You may feel a little frozen. 
  • You can sometimes see that there is some blood in the urine.
  • Elderly people can sometimes become confused about infections, even in urinary tract infections.

It is unusual to have a fever in the bladder catheter.

Signs that you may have kidney pelvic inflammation may be one of the following problems:

  • You usually feel really ill.
  • You usually have a  fever and may feel ill. 
  • You often have side aches in your abdomen or lower back. 
  • You can sometimes also get the same symptoms as in bladder catarrh, ie burning and need to urinate often. 
  • You who are older can have a high fever without other symptoms. 

Renal pelvic inflammation must always be treated.

When and where should I seek care?

You who are a woman and are 15 years or older are not pregnant, do not have visible blood in the urine and suspect that you have cystitis can wait for up to a week before seeking treatment. However, if you have major problems or have not started to get better after three days, you should contact a health care center.

Contact a  health care provider  if you have any of the following:

  • You have visible blood in the urine.
  • You are a man and suspect you have bladder catarrh.
  • You are a girl under 15 and suspect that you have bladder catarrh.
  • You suspect sexual contamination, for example, have urethral flow or sheath.
  • You are pregnant or have recently given birth and suspect you have cystitis.

If it is a weekend and you are fever-free, you can wait until it becomes everyday. You can contact many receptions by logging in.

If it’s in a hurry

If you have one or more of the following problems, please contact a health care center or an on-call reception immediately :

  • You suspect you have kidney pelvic inflammation.
  • This applies to a child under the age of two who you suspect has bladder catarrh or pelvic inflammation. 

If it is closed at the health center or on-call reception, seek care at an emergency room.

You can seek care at any reception you want throughout the country.

What can I do for myself?

You can treat yourself for up to a week if the symptoms are not troublesome, if you are female, not pregnant and otherwise healthy, but feel confident that you have had cystitis. Often, the trouble goes away by itself.

Here’s what you can do to relieve the problems of bladder catheter:

  • You can drink plenty of water.
  • You can take painkillers.

How can I prevent urinary tract infections?

There are several things you can try to reduce the risk of getting a urinary tract infection.

Pee out the last

If you have an easy urinary tract infection, it may be because there is some urine left in the bladder after you have been kissed. You can then get into the habit of getting up for a short while and then sit down again and try to pee the last one. 

Estrogen treatment after menopause

After menopause, women usually get thinner and brittle mucous membranes. It can be counteracted by using estrogen that you bring into the vagina in the form of, for example, pills or cream. For some women, it reduces the risk of urinary tract infections. 

Investigations

There are several studies and investigations that can be done to find out what your complaints are.

Leave urine sample

You often have to pass a urine sample. This is mainly done to find out if the problems are due to bacteria in the urine. Sometimes a urine culture is also done to find out which bacterium is involved and whether it is resistant to antibiotics. For example, if you have recently been abroad, the risk is greater than the infection is caused by resistant bacteria.

The urine sample should come from the so-called middle ray line. This means that you first start peeing and insert the can into the beam while you are peeing. Ideally, you should not have paused for four hours when you leave the test.

The sample can be left directly at the health center, or you can take the sample at home. You can pick up samples from the health care center or buy it at a pharmacy. Leave the can to the health care center as soon as possible. If you cannot leave it immediately, it should be placed in the refrigerator.

Urinary tract and urinary incontinence 

The urine sample is usually examined with the urinary tract, sometimes even with bacterial culture. When the specimen is examined with a urine stick, the stick is first dipped in the urine. The urethra can sometimes give information directly if there is bacteria in the urine but does not show what kind of bacteria it is. In other cases, there may be bacteria even though the stick does not show it. The urethra also shows if there are very white blood cells in the urine which may be a sign of urinary tract infection. 

When a urine culture is to be done, the urine sample is sent to a laboratory. Then it takes one to three days for the answer to arrive. The cultivation gives information about what kind of bacteria it is and how many bacteria it is. It also shows if the antibiotics that are usually used will help or if the bacterium is resistant, resistant, to them. 

CRP tests may indicate renal pelvic inflammation 

If your doctor suspects that you have kidney pelvic inflammation, you may have a blood test for a so-called  CRP test, also called a quick lowering because it is quick to get an answer to the test. In renal pelvic inflammation, CRP rises rapidly. In the case of a bladder catheter, however, CRP is not elevated or only slightly elevated.

Sometimes you may be gynecologically examined 

Sometimes, as a woman, you may need to be gynecologically examined if the diagnosis is uncertain. This is especially true if the symptoms could be due to a  sexually transmitted disease, such as chlamydia. You may also submit other samples in connection with it. 

If you are older, sometimes a gynecological examination is also done to see if there is any gynecological disease or change that causes recurring infections. 

Investigations of recurrent cystitis 

Some women have recurring bladder catarrhs. Then more tests are sometimes done to see if there is an underlying cause that can be treated. Sometimes an examination is done to see if there is any urine left in the bladder after you have kissed. This examination is now easily done with an ultrasound device that is available at many health centers. 

Sometimes the kidneys may need to be x-rayed, and sometimes the bladder may need to be examined through the urethra, so-called cystoscopy. 

Surveys when you are pregnant

If you have had a urinary tract infection many times before in your life and are pregnant, you usually have to pass a urine sample. If you have bacteria in the urine you will receive antibiotics and after the treatment, you will be given a new urine test to check that the bacteria have disappeared. 

Surveys for you as a man 

If you are, you always do a urine culture. Sometimes you also have to submit for chlamydia. If you are middle-aged or older, the prostate is also examined.

Treatment of urinary tract infection

There are various treatments you can get when you have a urinary tract infection.

Different kinds of antibiotics

Depending on whether you have cystitis or renal pelvic inflammation, you may be treated with different types of antibiotics. If you have passed urine samples, you will receive medicines that are adapted to the bacteria that cause the infection. 

Bladder catarrh in pregnant women 

Pregnant women with cystitis have an increased risk of renal pelvic inflammation and must, therefore, receive antibiotic treatment. Pivmecillinam can be safely taken throughout pregnancy. Trimethoprim should not be taken during the first twelve weeks of pregnancy and nitrofurantoin should not be taken in conjunction with childbirth because there is then a small risk that the baby’s blood may be temporarily affected. 

When breastfeeding 

If you breast-feed, you can take pivmecillinam and trimethoprim without the risk of the baby being affected. However, nitrofurantoin should not be taken as long as the child is under one month. 

Bladder catarrh in women who are not pregnant 

If you are not pregnant but have major problems with bladder catarrh, you may need treatment with antibiotics. It is common to treat for three to five days with medicines containing, for example, pivmecillinam or nitrofurantoin. Another alternative is trimethoprim. 

Preventive treatment if you get urinary tract infection often

You may need treatment with antibiotics for preventive purposes if you are a woman and often get a urinary tract infection. Then for a few months, you can take a small dose of antibiotics every night to reduce the risk of getting an infection.

If you get a slight urinary tract infection in connection with intercourse, you can take an antibiotic tablet for preventative purposes. The effect persists for 24 hours.

Bladder catarrh in men 

If you are a man and have a bladder catarrh, you will receive different types of medicines depending on whether you have a fever or not. If you do not have a fever, you will be treated with nitrofurantoin or pivmecillinam for seven days. If you have a fever, you get ciprofloxacin, a so-called quinolone. This is because the prostate gland is often then infected, and quinolones also act in the glandular tissue. If you have a urinary tract infection with a fever, you will receive treatment for two weeks. Sometimes you may need to be hospitalized and receive antibiotics intravenously.

Treatment of renal pelvic inflammation 

If you have renal pelvic inflammation and are not pregnant, you will receive treatment between seven and ten days with ciprofloxacin or a combination of trimethoprim and sulfa.

If you are pregnant and get kidney pelvic inflammation, you should be treated with antibiotic drops in the hospital. 

Bacteria in the urine without symptoms 

Both women and men over the age of 50, but sometimes also younger women, can have bacteria in the urine without any symptoms. It is more common the older you get. If you have no symptoms of urinary tract infection, you should not be treated with antibiotics.

An important exception is if you are pregnant, as the risk of pelvic inflammation increases without antibiotic treatment. This is one of the reasons why you are allowed to pass urine samples at the midwifery clinic, MVC.

Influence and participate in your care

In order for you to be involved in your care and treatment, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand. For example, you should receive information about treatment options.

When you get urinary tract infection several times

Many people get urinary tract infection several times. It is most common in women of their 20s. But it is also common in women and men who are older. It can depend on different things.

You don’t empty the bladder

If the bladder is not completely emptied when you urinate, the bacteria will have a greater chance of getting attached and spreading in the urinary tract. Therefore, try to empty the bladder completely every time you kiss. 

You use some p-drugs

Women can more easily get bladder catarrh when using diarrhea or condoms with spermicides. 

You have used antibiotics

All antibiotic treatment affects the natural bacterial flora in the vagina and the skin around the vagina. Bacteria from the intestine can then multiply there and then enter the bladder. This is why some women easily get cystitis after receiving an antibiotic course. 

You’re older 

The older we get, the easier we get urinary tract infections. One reason is that it becomes more and more common for urine to remain in the bladder after you have been kissed. It can often be due to prostate enlargement if you are a man. It may depend on appearance if you are a woman. It is common for the mucous membranes of the urethra to become thinner in you who are female and older.

Older people can often be more delicate than younger, and can often be severely ill with infections, such as urinary tract infection.

You who are older and have renal pelvic inflammation can get high fever without any other symptoms. 

Elderly people can sometimes become confused about infections, even in urinary tract infections.

complications

Renal pelvic inflammation can sometimes lead to complications, especially in young children and the elderly. Small children are at risk of kidney damage.

Rarely do the bacteria spread to the blood. Then there can be blood poisoning, also called sepsis. It is more common in the elderly. Then you need to be hospitalized and get antibiotics in the drip.

What happens in the body?

What happens in the body?

The urine is formed in the kidneys to carry away substances that the body does not need. It flows from the kidneys down through the ureters and collects in the bladder, to eventually continue out through the urethra. 

The transition between the ureter and the bladder acts as a valve that prevents the urine from flowing back into the kidneys. 

In the wall of the bladder, there are muscles that you cannot control with the will. When the bladder is stretched to a certain limit, the muscles contract and compress the bladder so that the pressure increases – you become pissed off. 

Around the mouth of the urethra at the bottom of the bladder are muscles that can be controlled with the will. When you relax these muscles, the urethra opens and the urine flows out. 

Read more about how the kidneys and urinary tract work.

The body defends itself against bacteria

In the case of a urinary tract infection, bacteria enter the bladder through the urethra. The man’s long urethra provides better protection against the bacteria’s upward movement than the woman’s short. Therefore, cystitis is more common in women than in men. 

Inside the bladder, the bacteria multiply rapidly. The body can then rely on its infection defense and it becomes an inflammation. It is this inflammation that causes the typical symptoms of cystitis, also called cystitis. 

Sometimes the bacteria continue up through the ureter to either one or both kidneys and cause an infection there. The reason may be that the valve at the mouth of the ureter in the bladder does not work. It may also be due to enlarged prostate gland.

The bacteria then penetrate the kidney tissue and it becomes an inflammation that causes fever, general illness and often kidney pain. It is called renal pelvic inflammation, or pyelonephritis.

Different bacteria can cause urinary tract infection 

There are several types of bacteria that can cause urinary tract infection. The most common are colobus bacteria, which are usually present in the intestine. The next most common is a particular type of staphylococcal bacteria that often causes cystitis in younger women in late summer and autumn. Sometimes the bacteria are resistant, so-called resistant, to certain types of antibiotics.

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