Urinary tract infection: After-sex ritual and other practices that cut your risk

Urinary tract infection (UTI) is one of the most dreaded infections and most women suffering from it shy away from opening up due to the embarrassing nature of the presentation and the affected area.

In fact, most of them suffer in silence at the initial stages until the problem persists and they are forced to seek medical attention.

But this needs not to be the case. Good treatment outcomes for UTI begin with having a better understanding.

How likely will a woman get UTI?

UTI is among the most common types of infection in Kenya. Nearly half of all women will suffer from a urinary tract infection at some point in their lives.

UTI is more prevalent in women compared to men due to the fact that the urethra is shorter for women than men and it is also closer to the back passage (anus) than in men thus allowing bacteria quick access from the urethra to the bladder and causing an infection.

How does a UTI occur?

The urinary tract system encompasses the urethra, bladder, ureters and kidneys. An infection occurs when bacteria enter this system and multiply.

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What are the common symptoms?

The symptoms include a burning sensation during urination, constant urge to pass urine, frequent urination, pain in the lower abdomen, nausea and fever. In severe cases, the urine may be bloody or have a foul smell.

Though viruses and fungi can cause an infection, in 80 percent of the cases of UTIs, the main cause is a bacterium found in the intestine; Escherichia coli, commonly known as E.Coli.

How are UTIs managed?

Most UTIs are bladder infections and are not serious if treated right away. However, if left untreated, a bladder infection may travel to the kidneys and cause complications.

When the infection is just in the bladder and urethra, it is called a lower UTI but if it travels up to affect one or both kidneys, then it becomes an upper UTI. This can be more dangerous than lower UTIs, as the kidneys can be damaged by the infection.

A urine culture is used to determine the cause of the infection. UTIs are normally treated with antibiotics for a short period of time.

Depending on the severity of the symptoms, treatment ranges from two days to three weeks.

What complications can occur?

When treated promptly and properly, lower UTIs rarely lead to complications. But if left untreated, they can cause serious health problems including kidney damage, low birth weight or premature delivery especially if it occurs during pregnancy, repeated infection and potential sepsis especially if the infection travels up the urinary tract to the kidneys.

What factors can predispose one to UTIs?

Risk factors for UTI include diabetes, pregnancy, recent sexual activity, history of UTI, kidney stone, and prostate cancer. The infections are common in pregnancy due to the increase of the pregnancy hormone, progesterone, which slows down the clearing mechanism of the bladder as well as the physical changes caused by the pregnant uterus on the urinary system.

Children are also susceptible to UTIs because their genitals easily come into contact with soiled nappies. E. Coli can be caused by contamination from the back passage when passing stool, therefore people who have problems with bowel control are prone to UTIs.

Can UTI be spread through sexual intercourse?

UTI is not sexually transmitted; however anal sex can cause it, especially in gay partners. In most cases, UTI infections are caused by bacteria located in the urinary tract, not in the birth canal.

Some sexually transmitted infections (STIs) may present with symptoms similar to UTI, especially in recurrences, it might be prudent to check for STIs as potential causes and treat them appropriately.

Any UTI prevention methods?

There is no reliable way to prevent urinary tract infections, but there are several preventive measures that can be taken to help minimise the chances of getting one.

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Practice good hygiene, drink plenty of water to flush out the bladder and urethra and cranberry juice which changes the PH of urine and prevents E. coli from sticking to the wall of the bladder, among others, drink plenty of fluids, urinating after sexual intercourse and avoid holding in urine for long hours.

Dr Okemo is a consultant Obstetrician Gynaecologist at Aga Khan University Hospital.