Urinary tract infections are not only common, but also prone to recurrence, and in severe cases even occur several times a year, bringing endless troubles to patients. Most recurrent urinary tract infections have some specific causes, and careful search for these causes and timely treatment accordingly may reduce the chance of recurrent infections. What are the factors that may lead to recurrent urinary tract infections?
1, acute urinary tract infection attacks when treatment is not standardized
Usually the course of antibiotics for acute cystitis is 3~5 days and for acute pyelonephritis 10~14 days, and the urine routine and (or) urine culture need to be rechecked after 1 week of discontinuation, and only two consecutive negative test results can indicate that the infection is cured. However, some patients often stop the medication on their own after their symptoms improve, and the course of medication is not enough, or they do not go to the hospital for timely review after stopping the medication, resulting in relapse or prolongation of the disease, or even turning into chronic, thus increasing the difficulty of treatment. In addition, the abuse of antibacterial drugs will lead to bacterial resistance, drug-resistant bacterial infection is also likely to lead to poor treatment, so that recurrent urinary tract infections.
2, urinary system structural deformities
Developmental malformations of the urinary system will significantly increase the chance of urinary tract infections. Small kidney or kidney dysplasia, ectopic kidney, horseshoe kidney, duplicate kidney, duplicate renal pelvis, duplicate ureter, obstruction at the junction of the renal pelvis and ureter, ureter after vena cava, ureteral bulge or stenosis, bladder contracture or scar formation bladder diverticulum, renal cyst, renal prolapse, sponge kidney and other changes in the anatomical structure of the urinary tract will lead to poor drainage of urine from the renal pelvis, urine retention in the urinary system, which is conducive to bacterial The growth of urinary tract infections will occur repeatedly over time. Therefore, patients with recurrent urinary tract infections must undergo relevant imaging examinations, such as renal ultrasound, CT, intravenous pyelogram, etc.
3.Combined underlying diseases
1) Diabetes mellitus or urological diseases: Patients with diabetes mellitus or urological tumors have local or systemic factors that can easily cause recurrent urinary tract infections.
(2) Immunocompromised: Patients with diabetes, tumors and radiotherapy, long-term use of immunosuppressants, AIDS, chronic renal insufficiency, the body resistance of such patients is lower than normal, prone to various infections, including urinary tract infections.
3) Urinary stones: When urinary stones are present, urinary tract infections are also prone to recurrent episodes because they are often accompanied by obstruction of the urinary tract. Patients have repeated urine tests indicating leukocyturia and red cell urine, as well as symptoms such as lumbar discomfort.
(4) Catheter or urethral foreign body: Patients with long-term indwelling catheters, ureteral stents, renal pelvis or cystostomy are also prone to recurrent urinary tract infections. Catheters are often an important trigger for urinary tract infections in hospitalized patients, and leaving a catheter in place for more than 1 week can greatly increase the chance of urinary tract infections. Many patients with indwelling catheters have low resistance due to the presence of various underlying diseases, which increases the risk of urinary tract infections.
5) Prostate infection: male patients with prostate inflammation are prone to recurrent urinary tract infections, so male patients with recurrent urinary tract infections should be checked for prostate conditions.
6) Gynecological inflammation: Gynecological inflammation causes a large increase in inflammatory secretions, which directly contaminate the urethral orifice and cause upstream urinary tract infections.
7) Abnormal urinary tract function: Some patients may have normal urinary tract function affected by surgery in some other parts of the body, or because of neurogenic bladder, which is also prone to recurrent urinary tract infections. Neurogenic bladder is a general term for a group of diseases in which neurological lesions cause bladder and/or urethral dysfunction, that is, urinary storage and/or voiding dysfunction, which in turn produces a series of lower urinary tract symptoms and complications.
4, the special nature of the female genitourinary system structure
Women’s urethra is shorter and looser than men’s, and the external sphincter is weak, so there is no physiological protection barrier, which leads to pathogenic microorganisms easily invading through the urethral opening, and upstream infection occurs; on the other hand, women’s urethral opening is very close to the vagina and anus, and there are a lot of bacteria around the vagina and anus themselves, so the urethra is located in an environment where it is easy to be infected, so women are prone to repeated urinary tract infections.
5, female genitourinary system structural abnormalities
Such as congenital incomplete obstruction of the urethral hymenal umbrella, urethral-hymenal fusion, hymenal umbrella, labia minora fusion, etc. can lead to poor drainage of urine, reflux during urination, or bacterial upstream infection, thus repeatedly occurring urinary tract infections. Therefore, patients with recurrent urinary tract infections in women should be promptly checked for the presence of the above conditions and treated in a timely manner.
6. Declining hormone levels in the body
With age, the function of ovarian secretion of estrogen in middle-aged and elderly women is weakened, the level of estrogen in the body decreases significantly, and the ability of cells in the urethra and bladder neck to resist invasion by external pathogenic microorganisms is then weakened. Therefore, middle-aged and elderly women are prone to recurrent urinary tract infections, and the infections are more difficult to cure than in younger women. In addition, due to the decrease of estrogen level in the body, the epithelial tissue of vaginal mucosa becomes thinner and the anti-infection barrier is very poor, so the slightest lack of personal hygiene will cause urinary tract infection.
7. Inappropriate personal hygiene or lifestyle
1) Menstrual hygiene: Menstrual blood is the best culture medium for bacteria. Various bacteria, mycobacteria, protozoa and other pathogenic microorganisms hidden in the vagina get rich nutrition from menstrual blood to grow and multiply rapidly, and the number increases dramatically. If you do not pay attention to menstrual hygiene, you may contaminate the urethra and cause acute urethritis and cystitis.
2) Sexual life: the female urethral opening is only 0.5~1.0 cm away from the vaginal opening below, it is very easy to be contaminated and damaged during sexual life and cause inflammation, in serious cases frequent urination, urgent urination, painful urination and difficulty in urination just after intercourse.
3) Holding urine and drinking less water: Holding urine for a long time may lead to urinary tract infection, mainly because: ① urine stays in the bladder for a long time, a small amount of bacteria invasion, there is more time to reproduce and more time to invade the tissue; ② the bladder is full, the pressure increases, urine will flow backwards up to the ureter or renal pelvis, if there is already bacteria invasion, it will cause pyelonephritis. In addition, drinking less water will reduce urine, resulting in fewer opportunities for urinary flushing and increasing the chance of infection.
8. Effects of pregnancy
When pregnant, the enlarged uterus will compress the bladder and ureter, and endocrine changes will also slow down ureteral diastole and peristalsis, resulting in slow urine flow or the formation of mild effusion, which is conducive to bacterial invasion and reproduction, leading to urinary tract infections. It is recommended to check urine regularly during pregnancy and treat infections as soon as they are detected.