Diagnosis - Treatment of Urinary Tract Infections

UTIs are manifested by one or more of the following symptoms:

1. pain in the lower abdomen (supra pubic pain)
2. pain or a sense of burning during urinating (dysuria)
3. need to urinate frequently (frequent urination),
4. cloudy, dark, bloody, or foul-smelling urine

Fever above 38◦C may coexist in severe cases.

The above symptoms can also be caused by other conditions, such as sexually transmitted infections, vaginitis, use of irritating chemicals (soaps, deodorants), stones (kidney, ureter, bladder), interstitial cystitis, bladder cancer or inflammation of the prostate (prostatitis). For this reason, an appropriate diagnostic approach is required, which will determine the exact cause.

Most UTIs are caused by bacteria (usually E.coli) that originated in the gut.

Most women have at least one episode of UTI in their lifetime, and a number of 20% of them suffer from repeated episodes, especially when they are pregnant, sexually active, or postmenopausal women. Στις γυναίκες η αυξημένη συχνότητα σε ουρολοιμώξεις οφείλεται στο ότι η ουρήθρα είναι κοντή και πολύ κοντά στον πρωκτό με αποτέλεσμα εύκολα τα μικρόβια να φτάνουν στην ουροδόχο κύστη και να προκαλούν λοίμωξη.

UTIs in men are more serious because they are often due to an underlying problem, such as an enlarged prostate or prostatitis.

Mild UTIs sometimes can be treated by drinking plenty of water (8-10 glasses a day) and taking of pain relievers (paracetamol, aspirin). More severe UTIs require antibiotic treatment. The treatment is based on the patient's history, the type of microbe, and the antibiogram. Typically the effectiveness of the treatment is checked by a urine test 7-14 days after the completion of the treatment. Delaying treatment of cystitis can lead to kidney infection (pyelonephritis). In severe cases, this can lead to the spread of germs in the blood (sepsis).

Surgical treatment is rarely indicated for UTIs unless there exists an underlying causative factor that requires surgical treatment.

In cases of repeated episodes of UTI, especially in women, prophylactic administration of low-dose antibiotics for 3-6 months may be required. If UTIs occur after intercourse, it is recommended to take a dose of antibiotics immediately after intercourse. Also, long-term intake of cranberry juice or pills may be helpful, as studies have shown their prophylactic effect. Also, some simple preventive measures are recommended, such as drinking plenty of fluids, not delaying urination, when there is a strong desire, urinating before and after sexual intercourse, wiping from front to back after urinating or defecating, avoiding synthetic underwear, avoiding antiseptics and deodorants in the vagina area and washing it with plain water.