Friday, 30 June 2023, 11:10
Urinary tract infections (UTIs) are the second most frequent infection to affect the general population, the first being respiratory infections. They are especially prevalent at this time of year, when we spend hours submerged in the water at the beach or pool. "The chances of suffering from cystitis, for example, are multiplied in the case of women, as practically half of us will have at least one urinary infection in our lifetime, and one in four women will encounter recurring infections", warned Dr María Fernanda Lorenzo, head of the Urology service at the University Hospital of Salamanca and an internationally renowned expert in the treatment of such diseases. Men over 50 also develop UTIs (some 10%), but in their case they are usually related to prostate problems. "They are much less common, but more concerning," stated the Spanish Association of Urology (AEU).
However, for both women and men, the origin of these infections is usually bacterial, the exceptions being fungal or viral. "In summer, factors such as the changes in water and air temperature when bathing, increased sweating, the sand and wet swimsuits really favour the growth of micro-organisms and bacteria that affect both the lower abdomen and the genital area", explained pharmaceutical company, Lanier Pharma.
But they are not the only causes. A family history on the maternal side, leading a sexually active life (coitus facilitates bacteria entering as far as the bladder), the use of spermicides or poor intimate hygiene (through excessive as well as a lack of washing) can trigger urinary tract infections.
"They are also frequent during pregnancy, childbirth and the menopause while, in the case of young men, they are almost always related to sexual activity," stated Dr Francisco José Brenes, a member of the working group on Nephrology (kidney research) and Urinary Tract for the Spanish Society of Primary Care Physicians (Semergen).
They vary depending on where the infection is located. "And there are two types: those of the lower tract (cystitis, urethritis...), which affect the bladder and urethra and are usually mild; and those of the upper tract or pyelonephritis, which occur when the germs reach the kidney, or prostate in the case of men, and can become very complicated.
At this time of year, for example, cystitis is very common, which presents a very characteristic clinical picture: pain or itching when urinating, greatly increased urge to pee (pollakiuria), hardly passing urine when going to the bathroom and sometimes passing blood (hematuria). And always without fever", [source: University Clinic of Navarra].
"Until a few years ago it was thought that the urinary tract and urine were sterile, but it has been proven to not be the case. It is possible to have bacteria present without symptoms. We should only get worried and go to the doctor when this colonisation of germs has consequences for our health (stinging sensation or general discomfort when urinating, a continuous need to go to the bathroom...). If we add fever, chills and lower back pain to these symptoms, that already means that the bacteria have reached the kidney – or also the prostate in the case of men – and then we are talking serious business," warned Dr Lorenzo.
To diagnose a UTI, both in adults and children, it is necessary to do a urine culture.
"At first, an instant and rapid diagnosis test is usually done with a urine test strip. This can give us some clues, but without the confirmation of a culture there can be no definitive diagnosis", stated these specialists.
Once a UTI is confirmed, treatment is usually antibiotic in nature, but in cases of recurring urinary tract infections – more than two episodes within six months or more than three in a year.
"The most effective solution is vaccines", said Dr Lorenzo. In this way it is possible to lessen and, in some cases, definitively end infections as cumbersome as cystitis.
Studies carried out confirm that 75% of the immunised female patients significantly reduced the number of infections recorded in the following year and a half after administering the vaccine. "Vaccines are a very good alternative to antibiotics, since many bacteria end up becoming resistant to the drug."
1. Drink plenty of water, up to 2 litres a day: "Fluid intake helps to clean your urinary tract by making you urinate more, thus avoiding the appearance of bacteria that trigger urinary infections," advised Lanier Pharma. 2. Don't wear very tight or synthetic underwear: Letting our intimate areas perspire freely also helps prevent infections. It is important to wear loose clothing and breathable fabrics, such as cotton. 3. Keep the vaginal area as dry as possible after bathing at the beach or pool: Wearing a wet swimsuit for many hours is the perfect environment for the bacteria that cause this type of infection. Try changing into dry clothes after bathing in water. 4. Use pH neutral products to wash your private parts: Perfumed soaps can cause irritation in this sensitive area, thus increasing the risk of bacteria appearing. 5. Go to the bathroom before and after having sex: It is important to urinate once sex has ended, reducing the possibility for bacteria to remain in the vicinity of the urethra.