GYN CHRONICLES
Urinary Tract Infection
Dr. Maureen Owiti
In this wonderful season of social
distancing I have been witnessing
interesting things at the clinic.
Wendy (not her real name) came in
one Friday and exclaimed “Doc I have
candidiasis!” Having gotten used to the
usual self-diagnosis, I very patiently
asked “OK! What makes you think you
have candidiasis?” Wendy thinks for a
moment and starts “Well I have been
having a burning sensation especially
when I urinate and it is worse at the end.”
“Are you sure you have a fungal infection
because I was expecting you to tell me
that you have a discharge or something.”
The funny thing about this conversation is
how similar it is with many women. It is
amazing how many women feel they have
a fungal infection when in actual fact they
probably have a urinary tract infection
(UTI) and vice versa. Thank you doctor
google!
So we continue our consultation with
Wendy and it emerges that apart from
the burning sensation she has complained
about she also has the urge to visit the
toilet frequently and occasionally can’t
hold her urine and even messes herself.
She even has to wake up at night to
urinate. Does any of this sound familiar?
Well if you have any of these symptoms
or have ever had any of them then you
probably have or have had a UTI. More
than 50% of all women will experience a
UTI at least once in their lifetime. This
is a very huge number and UTI’s actually
account for majority of out-patient
consultations in hospital settings. About
8-10% of pregnant women suffer a UTI
in the course of their pregnancy.
Apart from Wendy’s symptoms which are
the typical symptoms of a lower urinary
tract infection, there may also be blood
in the urine or one may notice the urine
is not clear and appears cloudy. Some
people just feel a bit of pelvic pressure.
Lower urinary tract infections comprise
of urethritis (more common in men and
normally recognized due to a painful
discharge) and cystitis.
Honeymoon cystitis is what Wendy
had. You are probably wondering did
Wendy get married recently. The answer
Urinary tract infections are like stagnant
pools. When you don’t drink sufficient quantities
of water the urine gets concentrated
and the flow of urine slows down. Because
of this, bacteria have time to grow. Drinking
plenty of water will make the urine flow like
a fast moving river hence prevent accumulation
of bacteria and subsequently a UTI.
is no, the stay at home policy provided a
honeymoon environment if you get my
drift. I love the term and it came about as
it is quite common for newly-wed women
to get a urinary tract infection, cystitis
to be precise (infection of the urinary
bladder) as sexual activity is a risk factor
for developing a UTI.
Other risk factors include pregnancy,
previous UTI, use of spermicides, and
diabetes. In post-menopausal women the
reduced estrogen predisposes them to
UTIs. Abnormalities in the bladder such
as urethroceles or bladder diverticulae
and neurological conditions such as
Parkinson’s disease or Alzheimer’s disease
also make post-menopausal women more
prone to a UTI.
Fortunately, UTIs are very easy to
diagnose and treat. A simple urine test
with culture and sensitivity should be
able to pick up the offending pathogen.
It is usually our beloved Escherichia coli
or E. coli for short. Other bacteria that
commonly cause a UTI are Klebsiella
pneumonia, Staphylococcus saprophyticus,
Enterococcus faecalis, proteus species and
yeast. Other tests to find out the severity
of the disease such as a full blood count
and to rule out other predisposing factors
like diabetes can also be done.
In as much as culture and sensitivity does
not always tell us the responsible bacteria
(only about 50% of the time will we get a
positive culture and even less if the patient
has had any previous antibiotic treatment)
we are still encouraged to perform the
tests to find out the disease pattern in the
community. With a positive culture we
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