Bladder infection has long-term health consequences if left unchecked: Experts on UTIs in women

Urinary tract infections or UTIs are a common occurrence mainly affecting women's health. According to a 2020 study published in the International Journal of Pharmaceutical Sciences and Research, UTIs occur in both men and women, but the incidence rate in women is higher when compared to men. Nearly half of the women population experience at least one episode of UTI in their lifetime, with 20-40 percent of them exhibiting recurrent episodes.

Several studies in the past have recorded a higher prevalence of such infections among females in different parts of India. As Dr Manzer Altamash Shaikh, consultant obstetrician, gynaecologist and fertility specialist at Masina Hospital explains, the urinary tract or system comprises of kidneys, ureters, bladder and urethra and infections of any of these parts is called as urinary tract infection. The commonest UTI is infection of the bladder and is generally termed as urinary tract infection or UTI.

However, Dr Manjiri Mehta, consultant gynaecologist and obstetrician at Hiranandani Hospital cautions, "Bladder infection is essentially limited to the urinary bladder and has no progression to the upper organs. Hence, these terms should not be used interchangeably."

Mid-day Digital reached out to city-based experts Shaikh and Mehta to understand more about the bladder infection and its impact on health.

What are the most common causes of bladder infection among women?

Shaikh: Infections of the bladder are more common in women due to shorter length of the urethra that means the bacteria have a shorter length to travel to bladder and proximity of the urethral opening to vaginal and anal orifice which help the bacteria from bowel to reach the urethra and the bladder. It could be due to washing from back to front after defecation. In younger women increased sexual activity is a major risk factor. In older women, general debility, diabetes, antibiotic use or catheterisation predisposes to bladder infection.

The act of urination flushes out bacteria from the urethra and prevents them from ascending to the bladder. In metro cities like Mumbai due to busy work culture and sometimes due to unhygienic state of health faucets women avoid drinking water, this coupled with hot and humid weather results in women urinating less frequently resulting in increased chances of getting urinary tract infections.

Mehta: Poor hygiene, use of harsh skin products, diabetes, post-coital infections (occurring during or after sexual intercourse), use of vaginal diaphragm and non-lubricated condoms can also lead to UTIs. It can occur throughout the year, but we do see a small rise during summer. This is due to multiple factors like sweating, lack of adequate water intake and dehydration. The lifetime incidence of UTI is 50-60 per cent. This happens most commonly in the age group of 18-30 years.

What are the common symptoms?

Mehta: Common symptoms of bladder infection are:

1. Increased frequency of passing urine

2. Painful urination

3. Burning sensation while passing urine

4. Passing urine frequently but just few drops

5. Cloudy or blood-tinged urine in severe cases

6. Pain in the suprapubic region (centre of lower abdomen)

7. Mild fever, body ache and nausea

The prevalence is mainly observed among which age-groups of women? Are children equally susceptible?

Shaikh: The prevalence of urinary tract infection increases with age and in women more than 65 years the rate is almost doubled. It is more common in women during the reproductive age group and elderly women however it can be seen during childhood as well.

In women of reproductive age group, in addition to above mentioned risk factors, others include unclean sanitary practices during menstruation, catheterisation, kidney stones, using diaphragm or sponges as birth control etc. In young girls, the commonest cause is immature lining of the urethra and the bladder.

How does it affect the menstrual cycle and pregnancy?

Shaikh: Urinary tract infections per say do not affect menstruation except for pain and discomfort. UTI during pregnancy can have serious sequelae. UTIs are one of the commonest reasons for preterm labour, infection of the ureters and kidneys, needing hospitalisation and intravenous antibiotics.

UTIs if not treated effectively have a very high recurrence rate especially in pregnancy. Recurrent UTIs can cause ascending bacterial infection in the kidneys leading to severe pain and pyelonephritis, infection in the blood and even high blood pressure.

What are the long-term impacts of a prolonged bladder infection in women? Elaborate

Mehta: In many cases, UTI remains undiagnosed, and in other cases, the treatment process is not completed entirely. Although UTI can be simple to treat, it can affect the well-being and health of a person in the following ways:

1. UTI can damage the bladder (urine bag) and progress to other organs, including the kidneys.

2. When it affects the kidneys, it can cause severe problems, including Pyelonephritis, an inflammation caused by bacterial infection. Also, repeated kidney infections can lead to permanent damage to the organ.

3. Undiagnosed UTI can also lead to blood infection, causing Septicemia - a life-threatening condition that can even lead to septic shocks and requires immediate medical attention.

Please list important measures to prevent the infection.

Shaikh and Mehta suggest a few lifestyle and dietary changes, which can help women in preventing UTI:

1. Drink a lot of fluids, especially water, as it dilutes urine, which means when a person pees more frequently, it will most likely flush out the infection.

2. Do not hold urine in the bladder for a long time.

3. Use water or an intimate wipe to clean your intimate area from front to back after passing urine or motions. This will prevent the bacteria from anus (opening for stool) spreading near the urethra (urinary opening). These bacteria are the commonest cause of UTI.

4. Avoid using irritating skin care products like powders, creams, and douches. This may irritate the skin and urinary opening, which makes a person prone to getting UTI.

5. Urinate and wash before and after having sex.

6. Change the type of birth control method that a person is using, like a diaphragm, and unlubricated condoms, which can sometimes be a cause of UTI.

7. Dry thoroughly after washing and don't wear damp undergarments. Frequently change sanitary napkins or tampons.

Are there any readily available antibiotics that one can keep ready in an emergency?

Mehta: Urine infections should not be treated with any random kind of antibiotics. The best way to treat a UTI is to consult a specialised doctor who will ask you about your symptoms (frequent, burning, and painful urination), diagnose the condition after the necessary tests and then start you on the correct medication. It is important to remember that random, uncontrolled, unauthorised use of antibiotics leads to resistance in the microbes and makes treatment more difficult.

Also Read: A new technology aims to detect early-stage Alzheimer's disease: Report