Urinary Tract Infections
Information, Resources & Education for Husbands & Dads

What is a urinary tract infection (UTI)?

A UTI is an infection anywhere in the urinary tract. Your urinary tract includes the organs that collect and store urine and release it from your body. They are the

• kidneys

• ureters

• bladder

• urethra

• What is a kidney?  Your kidneys collect wastes and extra water from your blood to make urine.
  
  

• What is a ureter?  The ureters carry the urine from your kidneys to your bladder.
  

• What is a bladder?  Your bladder stores the urine and squeezes it out when full.
  
  

• What is a urethra? The urethra carries the urine out of your bladder when you urinate.

What causes a Urinary Tract Infection?

Usually, a UTI is caused by bacteria that can also live in the digestive tract, in the vagina, or around the urethra, which is at the entrance to the urinary tract. Most often these bacteria enter the urethra and travel to the bladder and kidneys. Usually, your body removes the bacteria, and you have no symptoms. However, some people seem to be prone to infection, including women and older people.

Women are more likely to get UTIs than men are.

When should I see my doctor?

You should see your doctor if you have any of these signs or symptoms:

• burning feeling when you urinate
  

• frequent or intense urges to urinate, even when you have little urine to pass
  

• pain in your back or lower abdomen
  

• cloudy, dark, bloody, or unusual-smelling urine
  

• fever or chills

Women are more likely to get UTIs than men are. When men get UTIs, however, they're often serious and hard to treat. UTIs can be especially dangerous for older people and pregnant women, as well as for those with diabetes and those who have difficulty urinating.

What will happen at the doctor's office?

The doctor may ask you how much fluid you drink, and if you have pain or a burning feeling when you urinate, or if you have difficulty urinating. Women may be asked about the type of birth control they use. You'll need to urinate into a cup so the urine can be tested. In addition, your doctor may need to take pictures of your kidneys with an x ray or ultrasound and look into your bladder with an instrument called a cystoscope.

• Urine tests. Your urine will be checked under a microscope for bacteria and infection-fighting cells. The doctor may order a urine culture. In this test, bacteria from the urine are allowed to grow in a lab dish so the exact type of bacteria can be seen and the precise type of medicine you need can be chosen.
  

• Images. The doctor may use either x rays, sound waves (ultrasound), or CT scan to view your bladder or kidneys. These pictures can show stones, blockage, or swelling.
  

• Cystoscope. The urethra and bladder can be seen from the inside with a cystoscope, which is a thin tube with lenses like a microscope. The tube is inserted into the urinary tract through the urethra.
  

How are UTIs treated?

Once it is determined that your symptoms have been caused by an infection, your doctor will prescribe an antibiotic. Antibiotics can kill the bacteria causing the infection. The antibiotic prescribed will depend on the type of bacteria found.

For simple infections, you'll be given 3 days of therapy. For more serious infections, you'll be given a prescription for 7 days or longer. Be sure to follow your instructions carefully and completely. If you have any allergies to drugs, be sure your doctor knows what they are.

Will UTIs come back?

Sometimes. Most healthy women don't have repeat infections. However, about one out of every five women who get a UTI will get another one. Some women get three or more UTIs a year. Men frequently get repeat infections. Anyone who has diabetes or a problem that makes it difficult to urinate may get repeat infections.

If you get repeat infections, talk with your doctor about special treatment plans. Your doctor may refer you to a urologist, a doctor who specializes in urinary problems. Your doctor may have you take antibiotics over a longer period to help prevent repeat infections. Some doctors give patients who get frequent UTIs a supply of antibiotics to be taken at the first sign of infection. Make sure you understand what your doctor tells you about taking the antibiotic and do exactly that.

Men may need to take antibiotics for a longer time. Bacteria can hide deep in prostate tissue. Men shouldn't take their spouse's pills and think they will cure the infection. See a doctor for treatment that fits your needs.

How can I keep from getting more UTIs?

Changing some of your daily habits may help you avoid UTIs.

• Drink lots of fluid to flush the bacteria from your system. Water is best. Try for 6 to 8 glasses a day.
  

• Drink cranberry juice or take vitamin C. Both increase the acid in your urine so bacteria can't grow easily. Cranberry juice also makes your bladder wall slippery, so bacteria can't stick to it.
  

• Urinate frequently and go when you first feel the urge. Bacteria can grow when urine stays in the bladder too long.
  

• Urinate shortly after sex. This can flush away bacteria that might have entered your urethra during sex.
  

• After using the toilet, always wipe from front to back, especially after a bowel movement.
  

• Wear cotton underwear and loose-fitting clothes so that air can keep the area dry. Avoid tight-fitting jeans and nylon underwear, which trap moisture and can help bacteria grow.
  

• For women, using a diaphragm or spermicide for birth control can lead to UTIs by increasing bacteria growth. If you have trouble with UTIs, consider modifying your birth control method. Unlubricated condoms or spermicidal condoms increase irritation and help bacteria cause symptoms. Consider switching to lubricated condoms without spermicide or using a nonspermicidal lubricant.
  

Hope Through Research

Scientists supported by the National Institutes of Health are working on a vaccine to help prevent UTIs. The vaccine may be a suppository to place in the vagina or a pill to make the body's infection-fighting cells stronger.

UTI Glossary

antibiotic (AN-tee-by-AH-tik): A medicine that kills bacteria.

bacteria (bak-TEER-ee-uh): Tiny organisms that cause infection or disease.

bladder (BLAD-ur): The balloon-shaped organ inside the pelvis that holds urine.

cystoscope (SIS-toh-scope): A tube-like instrument used to look inside the urethra and bladder.

kidney (KID-nee): One of two bean-shaped organs that filter wastes from the blood. The kidneys are located near the middle of the back. They send urine to the bladder through tubes called ureters.

prostate (PRAH-state): In men, a walnut-shaped gland that surrounds the urethra at the neck of the bladder. The prostate supplies fluid that goes into semen.

suppository (suh-POZ-ih-tor-ee): Solid medicine formed in the shape of a small cone or cylinder to be placed in a body cavity like the vagina or rectum.

ureters (YOOR-uh-turs): Tubes that carry urine from the kidneys to the bladder.

urethra (yoo-REE-thrah): The tube that carries urine from the bladder to the outside of the body.

urinary (YOOR-ih-NEHR-ee) tract: The system that takes wastes from the blood and carries them out of the body in the form of urine. The urinary tract includes the kidneys, ureters, bladder, and urethra.

urologist (yoo-RAH-luh-jist): A doctor who specializes in urinary problems.

National Kidney and Urologic Diseases Information Clearinghouse

3 Information Way
Bethesda, MD 20892–3580
Email: This e-mail address is being protected from spambots, you need JavaScript enabled to view it

The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1987, the Clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. The NKUDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases.

Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.

This publication is not copyrighted. The Clearinghouse encourages users of this fact sheet to duplicate and distribute as many copies as desired.

What is Overactive Bladder Syndrome?

Overactive Bladder Syndrome, is also called or referred to as "Urinary Incontinence."

Overactive Bladder Syndrome is diagnosed when a person has loss of bladder control. Symptoms of Overactive Bladder Syndrome can range from mild leaking to uncontrollable wetting. It can happen to anyone, but it becomes more common with age and is more common in women.

Most bladder control problems happen when muscles are too weak or too active. If the muscles that keep your bladder closed are weak, you may have accidents when you sneeze, laugh or lift a heavy object. This is stress incontinence. If bladder muscles become too active, you may feel a strong urge to go to the bathroom when you have little urine in your bladder. This is urge incontinence or overactive bladder. There are other causes of incontinence, such as prostate problems and nerve damage.

Treatment depends on the type of problem you have and what best fits your lifestyle. It may include simple exercises, medicines, special devices or procedures prescribed by your doctor, or surgery. 

Around 16% of adults have symptoms of overactive bladder (urgency with frequency and/or urge incontinence). The prevalence increases with age.


What is "vulvovaginitis"?

Vulvovaginitis is an inflammation of all or part of the external vulva (labia majora, labia minora, clitoris, and/or entrance to the vagina) and the vagina.  The inflammation, redness and rubor - which is a response of body tissues to injury or irritation; are generally characterized by pain, swelling, redness and heat.

What is "vulvar health"?

Vulvar health is a term that covers the many health issues of a woman's - or young girl's vulva.  This includes vulva care, gynecology, feminine hygiene, vaginal health/hygiene, menstruation, and the changes in women's vulvas from menarche to menopause. 

Husbands and fathers - as well as women and mothers need to learn more about vulva health, to provide the care and support the special women in their lives may need. Husbands and fathers have a unique role in providing the healthcare and knowledge, especially those single dad's that have young daughters.  

Vulva health is an area that is related to the health and care of the vulva. Many men and women are afraid to use the term "vulva" due to its' technical, and medical sound, and most simply prefer to call the vulva a "vagina."  Yet that would be incorrect.  The vagina is just one part of the vulva. Nobody, with the exception of a doctor, can see a woman's vagina, and only he/she can see a woman's vagina by looking into the vagina, using a special instrument called a speculum.  

It's time to begin calling a "spade a spade."  When mother's and fathers are bathing, or toilet training their daughters, they should explain that the vulva, which is on the outside, has several parts, and that her vagina, is on the inside.   

What is/are Vulvar Diseases?

Vulvodynia-chronic vulva discomfort, vulvar vestibulitis, dysesthetic vulvodynia

Vulvar dystrophy-broad term to describe various epithelial changes.  In 1987-ISSVD International Society Studies of Vulvar disease found the following symptoms; a. nonneoplastic.  b.intraepithelial neoplasms - spuamous cell CIS c. nonsquamous intraepithelial neoplasia

LESIONS AND DISEASES

HSV

Women with HSV reports flu like symptoms, pain, itching, UTI symptoms, vaginal discharge, sores on labia, anus, perineum, buttocks, thighs, dyspareunia Vesicles, ulcers, pustules, tender adenopathy, 70% will have lesion in vagina

Syphilis

Women with syphilis report painless sores in vulvovaginal area.  Primary - red, round, firm ulcer with granular base with well-formed edges. Secondary- moist, mucus lesions which resemble herpes. Moist cutaneous lesions called condyloma lata, appear flat and gray. Adenopathy, maculopapular rash.

Condyloma Acuminata

Women with CA report new bump: itching, generalized pruritus, last pap.  Warty, flesh colored, sharp and pointed, cauliflower, + acetowhite

Candidiasis

Women with candidiasis report burning, itching, discharge, dyspareunia, vulvar edema, h/o diabetes, high carbohydrate diet, use of AB, frequent intercourse, h/o steroids, HIV.

Bartholin's Gland Infection

Women with barthloin's gland infections eportr unilateral bump. Reports active sex, recent trauma, new sexual partner leading to infections, fever, complaints of pain with intercourse, warmth, tender to touch, difficulty walking, sitting. H/O Crohn’s disease.

Contact Dermatitis

Women with contact dermatitis report vulvovaginal itching, rash, and increased incidence when wearing tight pants.  The vulva skin is red, inflamed, edematous, vesicles or bullae if severe, weeping, crusting and lichenification. 

Lichen Sclerosus

Women with LS report vulvovaginal itching, familial linkage, edema, superficial ulcers, burning, area feels different.  Women with LS in all ages, show symptoms in clitoris, prepuce, labial majora, minora, edema, scarring, color, appearance of tissue paper of skin.

Lichen Planus - Women with lichen planus report vulvar itching, burning, with vulvovaginitis symptoms on mucosal surface of vulva. Dyspareunia, painful erosive areas. Bleeding on contact, stenosis of introitus. The vulva has white raised lesion with reticular, lacy pattern. Erosive reddened area bordered by reticular white epithelium. External labia has appearance of lichen sclerosus + acetowhite. Other signs may appear in her mouth.

Vulvar Neoplasm-Melanoma - affects mostly postmenopausal women that affects the clitoris and labia majora. Usually no symptoms.

Vulvar Intraepithelial Neoplasm -  Pruritus, vulvar burning, pain, discharge, bleeding, may report urethra, vaginal and anal symptoms.  White, dk, red, ulcerated, raised warty, or nodular lesions. Labia mayora most common site, minora, clitoris and perineum. 

Vulvodynia (Vulvar Pain Syndrome) - Various levels of burning, stinging, pain, dryness, irritation, rawness. No pruritus. May report long term hx.

Vulvar Vestibulitis is a burning, dysuria, frequency, with repeated yeast infections or HPV.  Significant/severe pain with touch or attempting intercourse.

Paget's Disease

Vulvar Pruritis, usually affecting older women. The vulva appears red/tan with scaly lesions.

What is Vulvar Cancer?

Vulvar cancer is cancer that is found in and on the vulva. 

What is Vulvar Vestibulitis?

Vulvar Vestibulitis is a condition which causes redness and pain of the vestibule. Vestibulitis is an inflammation of this skin and the mucous secreting glands found in the skin. The mucous secreting glands are called the lesser vestibular glands.  

Vulvar Vestibulitis may include all the area around the opening of the vagina but is normally seen in the lower part of the vaginal opening.
 

Vulvar vestibulitis occurs in women of all ages. It can occur in women who are sexually active and also in women who have never been sexually active.  

Many women with this problem have suffered physically and emotionally for months or years, have seen a number of physicians, and have tried many unsuccessful treatments in search of relief.  

What are the signs and symptoms of Vulvar Vestibulitis?

*  Severe pain with pressure (for example: biking, exercise, tight fitting clothes ).

*  Vaginal entry such as tampon use or intercourse. 

*  Burning, stinging, irritation, or raw sensation within the vestibular area.

* Vestibular redness 

*  The urge to urinate frequently or suddenly.   

How is vulvar vestibulitis diagnosed (identified)?

Your doctor or health care provider will examine the vulva and vestibule to identify the common skin changes seen with vulvar vestibulitis. Pain is usually felt if the vestibule area is touched with a cotton tipped applicator. A sample of your vaginal discharge is collected and tested to rule out infection.

What causes vulvar vestibulitis? 

The exact cause is unknown, but many studies are being conducted to determine the cause of vulvar vestibulitis.  

The following factors have been associated with vulvar vestibulitis:

*  HPV (Human Papilloma Virus)
*  Chronic Yeast Infections
*  Chronic bacterial infections 
*  Chronic changes of pH (acid-base balance in the vagina)
*  Chronic use of chemicals/irritants such as detergents, soaps, spermicides or lubricants.

What is a Vaginal Vault Prolapse?

The vaginal vault is the area at the top of the vagina, next to and adjacent to the cervix. It can only “fall” or descend downwards toward the introitus, or the entrance of the vagina, after a woman's womb has been removed (hysterectomy). Vaginal Vault Prolapse occurs in about 15% of women who have had a hysterectomy for uterine prolapse, and in about 1% of women who have had a hysterectomy for other reasons.

What is Pelvic Organ Prolapse?

Pelvic Organ Prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Organ Prolapse may also be called; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse, uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginal wall prolapse.

What is Pelvic Prolapse?

Pelvic Prolapse is another term used for "pelvic organ prolapse."  Pelvic prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Prolapse may also be called; genital prolapse, pelvic relaxation, uterine prolapse, uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginal wall prolapse.

What is a Prolapsed Uterus?

A Prolapsed Uterus refers to a collapsed uterus, or descended uterus, or other change in the position of the uterus in relation to the surrounding structures within the pelvis. The pelvis contains many soft tissue structures vital to normal body functions, supported primarily by the diaphragms, layers of muscles, fibrous coverings called fasciae, and various ligaments and tendons. These soft tissues of the pelvis derive their ultimate support from the bony pelvis. 

A Prolapsed Uterus may be one of three types, depending on the severity:

• First-degree prolapse occurs when the uterus sags downward into the upper
vagina.

• Second-degree prolapse occurs when the cervix is at or near the outside of the
vagina.

• Third-degree prolapse (sometimes referred to as total prolapse) occurs when the entire uterus extends outside the vagina.