***Please know that I'm a student midwife and my education is every growing. This is my current Practice Guidelines for Urinary Tract Guidelines. I cannot say it is definite or complete. Please seek care from your provider of choice.***
Urinary Tract Infections (UTI)
Urinary
Tract Infections (UTI) are the most common bacterial infection in adult women.
They are 14 times more common in women than they are men. By age 24
approximately 1/3 of women have been diagnosed with a UTI and prescribed
antibiotics by a doctor. UTI’s are more common in pregnancy. 5-10% of UTI’s are
asymptomatic. They are caused by bacteria entering your system. The most common
ways bacteria enter your system is improper wiping, sexual intercourse and
holding your urine.
Signs and Symptoms:
*
Sub- or suprapubic aching pain
*
Burning upon urination
*
Cramps
*
Fever or low grade fever
*
General fatigue (common if the
infection is well established)
*
Lower backache (may indicate kidney
involvement)
*
Frequent urination
*
Small amount of urine output
*
Incontinence
*
Cloudy and/or unusual smelling urine
If
it spreads to your kidneys:
*
Chills/shaking/night sweats
*
Fatigue/general ill feeling
*
Fever of 101°F or more
*
Flushed, warm or reddened
*
Mental changes (confusion in elderly
is common
*
Nausea and vomiting
Complications of a
UTI:
*
Miscarriage
*
Kidney infections
*
Preterm labor
*
Preterm ROM
*
Preterm birth
*
Uterine infections
Conditions That May
Mimic a UTI:
*
Early sign of an ectopic pregnancy
*
Premature labor
*
Torsion of the pregnant uterus (rare)
*
Incarceration or sacculation of the
uterus (rare)
Diagnosis and
Treatment:
Diagnosis: When
you do all prenatal care you should test a woman’s urine at every visit. You
can observe it for clarity, color and smell. When you read the urine test
analysis strip, make sure you have first let it set for the specific time it
needs to rest before being read.
When
reading the test strip you will find that the leukocytes and nitrites will be
elevated. The best urine for getting an accurate reading is after not having
urinated for several hours. The reason these are elevated is because leukocytes
(or White Blood Cells) are produced in relation to an infection. Certain
bacteria (like the one that causes the UTI) change nitrates to nitrites. If the
test is positive for both it means there is bacteria present in your urine
likely causing an infection.
More than 500mg of Vitamin C in
the past 24 hours may give a false positive for nitrites. And tetracycline may
cause a false positive for leukocytes.
Prevention and Treatment:
The best treatment for any type of
illness is prevention. To help prevent a UTI make sure to wipe properly (front
to back), urinate before and after any sexual contact, watch your diet and
lifestyle, wear cotton undergarments and urinate when you feel the urge to,
never hold it.
Traditional
Treatment Methods:
*
Antibiotics- Common ones are:
trimethoprim-sulfamethoxazole, amoxicillin, Augmentin, doxycycline and
fluoroquinolones.
*
Increase water intake
Alternative/Holistic
Methods:
*
¼ tsp baking soda in water 3x daily
for 3 days.
*
Cranberry pills
*
Hydration and frequently empty the
bladder
*
Uva-ursi- 2 capsules 4x a day for 3-5
days then recheck urine
*
Rinse with a vinegar and water mix
Reasons Why Women
Have More UTIs:
Common
reasons that women have more UTI’s in general are:
*
Relatively short urethra
*
External 3rd of the urethra
is close to the rectum
*
Friction during sex allows bacteria
into the urethra easier
*
Pregnancy hormones cause the urethra
to be a bit more open than normal, which also alters the tone and movement of
it
*
Sugar in the urine and bladder compression
because of the growing fundus
