Urinary tract infections (or urinary tract infections) account for a large proportion of the disease spectrum in urology clinics. Here is a summary of some common questions that patients often ask in the hope that they will be helpful.
1.What are the symptoms of urinary tract infection?
A: Frequent, urgent, painful urination, and in severe cases, bloody urine in the naked eye. If the kidneys are involved, there will be back pain and even fever.
Urinary tract infections are divided into upper urinary tract infections and lower urinary tract infections according to where they occur. The “upper” refers to the kidneys and ureters, while the “lower” refers to the bladder and urethra, and their symptoms may differ. Lower urinary tract infections are more common, and upper urinary tract infections are more complicated to treat.
2.What tests should be done for urinary tract infections?
A: ① Simple urinary tract infections usually only have routine urine tests: nitrite (NIT) and leukocyte esterase (LEU) are often positive (refer to my previous article “Teaching you to read the “+” sign in routine urine reports” for details).
②The urine sediment test usually shows white blood cells (WBCs), but the absence of WBCs does not mean that there is no infection.
③ Urine culture is the most important test to determine the type of bacteria and sensitive drugs. The most common pathogenic bacteria is Escherichia coli.
3.How to make the test result more accurate?
A: ①Mid-stage urine should be used when collecting urine.
Because the urine at the beginning may be contaminated, a small amount of urine should be discharged first before using a urine cup to collect it. Older people and children often do not pay attention to this point, resulting in inaccurate test results.
②Females should avoid menstrual periods for the test.
③If the urine is used for culture, it is best to use clean post-catheterization (ask your nurse sister to assist you with this).
④You should not use antibiotics or stop using antibiotics for a few days before doing urine culture.
4.I don’t want to go to the hospital and line up for a doctor, is it okay to buy and eat the medicine by myself?
A: It is highly recommended to go to a regular hospital first to have a regular doctor evaluate you before considering treatment options. If you have repeated infections and have been sick for a long time, you should not take random medication. Casual abuse of antibiotics is never a good habit. The state requires a doctor’s prescription to purchase antibiotics at a pharmacy, but if you are able to purchase them on your own, the quinolones are preferred (but remember they are prohibited for adolescents, children and pregnant women), or second-generation cephalosporins, or furantoin, or fosfomycin. One drug is sufficient for purely acute infections, and most bacteria can be invisible after 3 days of treatment. Topical estrogen can be added in postmenopausal women. Some proprietary Chinese medicines can supplement the treatment with good results. There are also treatments for alkalinizing the urine and bladder decongestion. The duration of medication varies from 3 days to 1 week depending on the condition, and can be shorter for women and longer for men.
5.What else should I pay attention to besides taking medication?
A: ① Drink more water, very important. Adequate drinking water can form abundant urine, which has a self-cleaning effect on the urinary tract. As a personal opinion, I often recommend that patients keep drinking more than 2,500 ml of water every day, and plain water is the most convenient, healthy and effective beverage.
② Eat a light diet, abstain from alcohol and spices.
③Keep the perineum clean, and female patients should remember to wipe in the direction from front to back after defecation.
④ Pay attention to rest. Decreased resistance is a common cause of infection. Many student girls drive all night before the exam and are busy taking medication after the exam.
⑤ Avoid holding urine.
⑥Avoid sexual activity during the infection.
6.What kind of people are prone to urinary tract infections?
A: ①Female. The female urethra has several characteristics: short, straight, wide, and adjacent to the vagina and anus. Due to these physiological anatomical reasons, women have become the mainstay of patients with urinary tract infections. They are especially prone during menstruation, menopause and during sexual intercourse. Retrograde infections are more common during pregnancy due to the hormonal effects of the body and the enlarged uterus pressing on the bladder. The vast majority of women experience at least one urinary tract infection in their lifetime.
People with low resistance or diseases of their own urinary tract structure: infants, the elderly, diabetics or paraplegics.
7.How should I be reviewed after treatment of urinary tract infection?
A: ①For women with simple urinary tract infection, only routine urine examination should be done.
②Women who develop recurrent urinary tract infection within two weeks need to have urine culture and a detailed and systematic examination of the urinary system.
③A recurrent infection in an elderly person requires a detailed and systematic examination of the urinary system.
④Men with urinary tract infections require detailed and systematic examination of the urinary system.
⑤ Children with urinary tract infections, such as girls with more than 2 infections and boys with 1 infection, should undergo ultrasound examination of the urinary tract and, if possible, cystourethrography to rule out congenital diseases.