Dear Doctor,

Of late I’ve had pain in my abdomen and the need to pee often. The urine is usually never really there and there’s a sensation that comes with it. Is this some sort of infection?  I’ve heard of UTIs. Is this the case?  What causes them?

Monica

Dear Monica,

With the symptoms you have described, it seems that you are suffering from cystitis, i.e. infection of the urinary bladder. It is part of urinary tract infection (UTI).

Women are more prone than men to develop UTI due to multiple reasons. They have a short length of urethra (tube connecting urinary bladder to exterior). This makes it easy for microbes from exterior to enter the bladder. Sexual intercourse, particularly with an infected partner, is also a risk factor for UTI, due to close proximity of the bladder with pelvic parts.

Dampness over the private parts, as in menstruation, can cause infecting germs to enter the urinary bladder. The risk is increased with poor menstrual hygiene, when sanitary pads are not changed for a long time. Nylon undergarments also enhance the risk for cystitis.

Using dirty public toilette with contaminated seats is yet a risk factor for UTI. It can occur post-delivery due to trauma to perineum, thus facilitating entry of germs inside the pelvic parts and bladder.

Women with immune depression, like uncontrolled diabetes, HIV/AIDS infection, are more prone to develop UTI due to presence of one or more risk factors.

Diagnosis is based on finding microbes microscopically in a sample of urine. Ideal sample is the one taken from the urine first passed in the morning, as during overnight germs tend to concentrate in the bladder. It should be a midstream sample, after discarding first few drops. This is done to avoid getting false positive results from urine contaminated with perineal surface.

UTI manifests as pain over lower abdomen, frequency and urgency of urination, fever, body ache, nausea and or vomiting—one or more of these symptoms. In case of associated pelvic infection, there would be vaginal discharge and or itching.

Prevention lies in drinking adequate amount of water. This ensures that the bladder is flushed very well, thus removing the microbes. One should keep herself dry and clean during menstruation. Nylon undergarments should be replaced by cotton ones. After sexual intercourse, one should pass urine and wash the genital parts. This ensures that no infecting germs are left to contaminate the urinary bladder.

Treatment of UTI is by suitable antibiotics. However, it should be remembered that antibiotics cure the present existing infection, but do not prevent future infection. Hence, after getting cured, one should be careful to prevent another episode of infection.

Dr. Rachna   Pande is a specialist in internal medicine.