Urinary tract infection (UTI)
Definition
A urinary tract infection (UTI) is an infection in any part of your
urinary system — your kidneys, ureters, bladder and urethra.
Most infections involve the lower urinary tract — the bladder
and the urethra.Women are at greater risk of developing a UTI
than men are. Infection limited to your bladder can be painful
and annoying. However, serious consequences can occur if a
UTI spreads to your kidneys.Doctors typically treat urinary tract
infections with antibiotics. But you can take steps to reduce your
chances of getting a UTI in the first place.
Symptoms
Urinary tract infections don't always cause signs and symptoms,
but when they do they may include:
-A strong, persistent urge to urinate
-A burning sensation when urinating
-Passing frequent, small amounts of urine
-Urine that appears cloudy
-Urine that appears red, bright pink or cola-colored — a sign of
blood in the urine
-Strong-smelling urine
-Pelvic pain, in women — especially in the center of the pelvis
and around the area of the pubic bone
-UTIs may be overlooked or mistaken for other conditions in
older adults.
Types of urinary tract infection
Each type of UTI may result in more-specific signs and
symptoms, depending on which part of your urinary tract is
infected.
-Kidneys (acute pyelonephritis)
Upper back and side (flank) pain
High fever
Shaking and chills
Nausea
Vomiting
-Bladder (cystitis)
Pelvic pressure
Lower abdomen discomfort
Frequent, painful urination
Blood in urine
-Urethra (urethritis)
Burning with urination
Discharge
What are the causes of urinary tract infections?
Normal urine is sterile. It contains fluids, salts and waste
products, but it is free of bacteria, viruses and fungi. An
infection occurs when microorganisms, usually bacteria from the
digestive tract, cling to the opening of the urethra and begin to
multiply. Most infections arise from one type of bacteria,
Escherichia coli (E. coli), which normally lives in the colon.
In most cases, bacteria first begin growing in the urethra. An
infection limited to the urethra is called urethritis. From there
bacteria often move on to the bladder, causing a bladder
infection (cystitis). If the infection is not treated promptly,
bacteria may then go up the ureters to infect the kidneys
(pyelonephritis).
The urinary system is structured in a way that helps ward off
infection. The ureters and bladder normally prevent urine from
backing up toward the kidneys, and the flow of urine from the
bladder helps wash bacteria out of the body. In men, the prostate
gland produces secretions that slow bacterial growth. In both
sexes, immune defenses also prevent infection. Despite these
safeguards, infections still occur.
Eating too much salt does not cause a urinary tract infection;
a high-salt diet is a risk factor for hypertension and coronary
artery disease. Most urinary tract infections are caused by
bacteria, especially by Escherichia coli,
The primary organs of the urinary system are the kidneys, which
are bean-shaped organs that are located just below the rib cage
in the middle of the back. The kidneys remove urea — waste
product formed by the breakdown of proteins — from the blood
through small filtering units called nephrons, according to the
Cleveland Clinic. Each nephron consists of a ball formed of
small blood capillaries, called a glomerulus, and a small tube
called a renal tubule. Urea, together with water and other waste
substances, forms the urine as it passes through the nephrons
and down the renal tubules of the kidney. From the kidneys,
urine travels down two thin tubes, called ureters, to the bladder.
The ureters are about 8 to 10 inches long (20 to 25 centimeters),
according to the Cleveland Clinic.
Muscles in the ureter walls continuously tighten and relax to
force urine away from the kidneys, according to the NIH. A
backup of urine can cause a kidney infection. Small amounts of
urine are emptied into the bladder from the ureters about every
10 to 15 seconds.
The bladder is a hollow, balloon-shaped organ that is located in
the pelvis. It is held in place by ligaments attached to other
organs and the pelvic bones, according to the Kidney & Urology
Foundation of America. The bladder stores urine until the brain
signals the bladder that the person is ready to empty it. A
normal, healthy bladder can hold up to 16 ounces (almost half a
liter) of urine comfortably for two to five hours.
To prevent leakage, circular muscles called sphincters close
tightly around the opening of the bladder into the urethra, the
tube that allows urine to pass outside the body. The only
difference between the female and male urinary system is the
length of the urethra, according to Merck Manuals. In females,
the urethra is about 1.5 inches (3.8 cm) to 2 inches (5.1 cm) long
and sits between the clitoris and the vagina. In males, it runs the
length of the penis, is about 8 inches (20 cm) long and opens at
the end of the penis. The male urethra is used to eliminate urine
as well as semen during ejaculation. the urinary system also
maintains the homeostasis of water, ions, pH, blood pressure,
calcium...
Maintenance of Homeostasis
The kidneys maintain the homeostasis of several important
internal conditions by controlling the excretion of substances out
of the body.
-Ions. The kidney can control the excretion of potassium,
sodium, calcium, magnesium, phosphate, and chloride ions into
urine. In cases where these ions reach a higher than normal
concentration, the kidneys can increase their excretion out of the
body to return them to a normal level. Conversely, the kidneys
can conserve these ions when they are present in lower than
normal levels by allowing the ions to be reabsorbed into the
blood during filtration.
-pH. The kidneys monitor and regulate the levels of hydrogen
ions (H+) and bicarbonate ions in the blood to control blood pH.
H+ ions are produced as a natural byproduct of the metabolism
of dietary proteins and accumulate in the blood over time. The
kidneys excrete excess H+ ions into urine for elimination from
the body. The kidneys also conserve bicarbonate ions, which act
as important pH buffers in the blood.
-Osmolarity. The cells of the body need to grow in an isotonic
environment in order to maintain their fluid and electrolyte
balance. The kidneys maintain the body’s osmotic balance by
controlling the amount of water that is filtered out of the blood
and excreted into urine. When a person consumes a large
amount of water, the kidneys reduce their reabsorption of water
to allow the excess water to be excreted in urine. This results in
the production of dilute, watery urine. In the case of the body
being dehydrated, the kidneys reabsorb as much water as
possible back into the blood to produce highly concentrated
urine full of excreted ions and wastes. The changes in excretion
of water are controlled by antidiuretic hormone (ADH). ADH is
produced in the hypothalamus and released by the posterior
pituitary gland to help the body retain water.
-Blood Pressure The kidneys monitor the body’s blood
pressure to help maintain homeostasis. When blood pressure is
elevated, the kidneys can help to reduce blood pressure by
reducing the volume of blood in the body. The kidneys are able
to reduce blood volume by reducing the reabsorption of water
into the blood and producing watery, dilute urine. When blood
pressure becomes too low, the kidneys can produce the enzyme
renin to constrict blood vessels and produce concentrated urine,
which allows more water to remain in the blood.
Filtration
Inside each kidney are around a million tiny structures called
nephrons. The nephron is the functional unit of the kidney that
filters blood to produce urine. Arterioles in the kidneys deliver
blood to a bundle of capillaries surrounded by a capsule called a
glomerulus. As blood flows through the glomerulus, much of the
blood’s plasma is pushed out of the capillaries and into the
capsule, leaving the blood cells and a small amount of plasma to
continue flowing through the capillaries. The liquid filtrate in
the capsule flows through a series of tubules lined with filtering
cells and surrounded by capillaries. The cells surrounding the
tubules selectively absorb water and substances from the filtrate
in the tubule and return it to the blood in the capillaries. At the
same time, waste products present in the blood are secreted into
the filtrate. By the end of this process, the filtrate in the tubule
has become urine containing only water, waste products, and
excess ions. The blood exiting the capillaries has reabsorbed all
of the nutrients along with most of the water and ions that the
body needs to function.
Storage and Excretion of Wastes
After urine has been produced by the kidneys, it is transported
through the ureters to the urinary bladder. The urinary bladder
fills with urine and stores it until the body is ready for its
excretion. When the volume of the urinary bladder reaches
anywhere from 150 to 400 milliliters, its walls begin to stretch
and stretch receptors in its walls send signals to the brain and
spinal cord. These signals result in the relaxation of the
involuntary internal urethral sphincter and the sensation of
needing to urinate. Urination may be delayed as long as the
bladder does not exceed its maximum volume, but increasing
nerve signals lead to greater discomfort and desire to urinate.
Urination is the process of releasing urine from the urinary
bladder through the urethra and out of the body. The process of
urination begins when the muscles of the urethral sphincters
relax, allowing urine to pass through the urethra. At the same
time that the sphincters relax, the smooth muscle in the walls of
the urinary bladder contract to expel urine from the bladder.
