Urinary tract infections (or urinary tract infections, UTIs) account for a large percentage of daily urology outpatients and are the most common infectious disease. Even in the United States, up to 15% of community antibiotic prescriptions are for the treatment of urinary tract infections, showing the prevalence. Given the commonality of many of the questions that people usually ask, today we will talk about common questions about simple urinary tract infections.
1.How many types of urinary tract infections are there?
①If divided according to the site of production: upper urinary tract infection and lower urinary tract infection. The “upper” refers to the kidneys and ureters, while the “lower” refers to the bladder and urethra. “Lower” is more common than “upper”, and “upper” is more complicated than “lower”.
②If the complexity is divided into: simple, complex, and severe (urinary sepsis). The first one can be seen on an outpatient basis, while the latter two sometimes require inpatient treatment or even resuscitation.
2.What kind of people are prone to urinary tract infections?
①Female. The female urethra has several characteristics: short, straight, wide, and adjacent to the vagina and anus. Due to these physiological anatomical reasons, women become the mainstay of urinary tract infection patients. 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.
3.What are the symptoms of urinary tract infection?
Frequent, urgent, painful urination, and in severe cases, blood in the eyes. If the kidneys are involved, there will be back pain and even fever.
4.What tests should be done for urinary tract infection?
① Simple urinary tract infections usually only have routine urine tests: nitrite (NIT) and leukocyte esterase (LEU) are often positive (for details, please refer to my previous article “Teaching you to read the “+” sign in routine urine reports”).
②The urine sediment test usually shows white blood cells (WBC), but the absence of WBC is not the same as saying 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.
5.How to make the test results more accurate?
①Mid-stage urine should be used when collecting urine.
Because the initial urine may be contaminated, a small amount of urine should be discharged first, and then the urine cup should be used to collect the urine. 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 post-cleaning catheterization (ask the nurse to assist you with this).
④You should not use antibiotics or stop using antibiotics for a few days before doing urine culture.
6.I don’t want to go to the hospital and line up for a doctor, is it okay to buy and take the medicine by myself?
It is strongly recommended that you go to a regular hospital and let 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 any 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 that 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 the duration of medication can be shorter for women and need to be longer for men.
7.What else should I pay attention to besides taking medication?
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 per day, you just drink cool white, drink too much, fat I can not afford to take responsibility.
② Light diet, quit drinking, quit spicy, quit hot pot.
③ keep the perineum clean, female patients remember to wipe in the direction from front to back after the stool.
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. Spring Festival, traffic jams, airplanes, long car rides, playing chess, playing DotA …… you do not hold.
⑥Avoid sexual activity during the infection.
8.How should I review the urinary tract infection after treatment?
①Women with simple urinary tract infections can just have a routine urine examination.
②Women with recurrent urinary tract infections within two weeks need to have a 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.