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Many of you will have experienced a urinary tract infection (UTI) or know someone who has. UTIs are fairly common infections and the majority are not serious but do still need prompt treatment. Below is a breakdown of what causes UTIs, why it is important to recognise them early and the treatment options we offer at Sloane Street Surgery.

What is a Urinary Tract Infection (UTI) and what causes it?

UTIs can occur in any part of your urinary tract, which includes the kidneys, ureters, bladder, and urethra. The infections are often caused by bacteria from the gut, the most common one being E. coli.

Men, women and children can all get UTIs. However, the majority of infections occur in females due to the short length of the urethra compared to males. Half of the female population will get at least one UTI in their lifetime and twenty percent of these women will have recurrent infections so it is an important condition to know about and be able to recognise the symptoms.

What are the symptoms to look out for?

The number and severity of UTI symptoms varies from person to person. Sometimes it can be hard to distinguish the symptoms from other conditions such as thrush or sexually transmitted infections so it important to discuss what you are experiencing with one of us.

Some of the symptoms to look out for are pain on passing urine, passing urine frequently, urinary incontinence, blood in the urine, pain in the lower abdomen, urgency to pass urine and unpleasant smelling urine.

If bacteria travel further up the urinary tract, past the bladder, then one can get an infection of the upper urinary tract (the kidneys). In this case the above symptoms maybe more severe and one may also experience back pain and fevers.

How do doctors diagnose a UTI?

As soon as you think you may have symptoms it is of upmost importance to come and see us. The earlier the doctor can examine you and obtain and test a urine sample, the less likely the infection is to progress in severity and the less discomfort you will experience.

We will need a mid-stream urine sample from you which we will test in clinic with a dipstick. This is to check for a number of parameters such as microscopic blood and white blood cells, which indicate infection. We will then send off the sample to the lab for the urine to be cultured. The earlier we do this, the earlier we find out what microorganism caused the infection and what antibiotics will work against it.

What are the treatment options for UTIs?

Antibiotics are the mainstay of treatment. The doctor will have a look at your medical record and your symptoms and decide which antibiotic is best for you. It is important to finish the course of antibiotics because if this is not done, some bacteria can remain in the urinary tract and cause a repeated infection and can become resistant to the antibiotic, causing issues in the future.

The doctor will also go through other supportive measures you can do to help recovery such as hydration, dietary changes and avoiding types of clothing that can worsen symptoms.

There is some evidence that cranberry juice helps prevent the bacteria sticking to the bladder walls. However, there is no evidence to show it can be used as a treatment for UTIs but may help prevent a UTI from developing. Cranberry juice may not be suitable for everyone so please do discuss this with us.

How can I prevent getting a UTI?

Prevention is key, especially for those who experience recurrent UTIs. We can explore triggers such as sexual activity or specific hygiene practices, and suggest strategies to reduce your risk, such as proper hydration, timely bladder emptying, and, for some women, the use of topical oestrogen.

What if I keep getting UTIs?

Recurrent UTIs are common and can be very troublesome. For men who have more than one UTI, it is vital to have a discussion with us about why this is happening. It is likely we will refer you for a scan and potentially arrange an appointment with a specialist urologist for a in depth assessment including a prostate check.

For women, it may not be necessary to see a urologist straight away as there any many measures we can consider with you, such as prophylactic antibiotics. These are taken in different regimes and the doctor will tailor it to your pattern of infections.

Methenamine hippurate is a tablet that the doctor may suggest. It is increasingly being used to prevent recurrent UTIs. It is not an antibiotic but more like an antiseptic which sterilises the urine. With rising rates of antibiotic resistance this is can be effective and safe alternative to prevent UTIs.

D Mannose is another supplement that the doctor may discuss with you. It is a naturally occurring sugar that is found in many fruits. There is evidence to show that it can block E. coli, the most common UTI-causing bacteria from growing in the urinary tract. It is not suitable for all patients so it’s important to check in with a doctor before taking it.

If none of the above work, we will discuss with you a referral to a specialist. One option they can offer is intravesical treatment directly in the bladder. It is given by inserting a small amount of liquid into the bladder over 6 months, with the aim of restoring the bladder lining.

What is the new UTI vaccine?

Uromune is a newly developed oral vaccine. It is a pineapple-flavoured spray that is taken under the tongue daily for 3 months. It contains 4 strains of inactivated bacteria that cause the most common UTIs. It works by allowing the immune system to learn how to fight the bacteria whilst inactivated. The clinical studies so far show that this vaccine can reduce infections by 70% in patients who have tried all other alternative treatments. It can be given to men and women but it is not suitable for everyone and is expensive.  Please do come in to discuss if this is a good option for you.

If you have any questions about UTIs or about the treatment options, please book an appointment through our website here or give us a call on 0207 245 9333.

 

Article produced by Sloane Street Surgery, a private GP practice in London that provides world-class private healthcare for patients in Chelsea, Knightsbridge, Belgravia, West London, Hampshire, and beyond.

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