Urinary tract infection (UTI) occurs when bacteria enter and invade the urinary system. Most of the time bacteria enter through the urethra and ascend upwards to invade the urinary bladder, ureters or kidneys. 

Sometimes bacteria may invade the urinary system from the neighboring organs or migrate via the blood from a remote place in the body. Repeated attacks of urinary tract infections especially with involvement of the kidneys for a prolonged time can cause permenant kidney damage. 

Signs and symptoms of UTI 
Sign and symptoms depend upon the type, severity and site of the infection. 
Pain in the lumber regions will occur if the infection is in the kidneys. Supra pubic and urethral pain will occur when bacteria settles down in the urinary bladder or in the urethra respectively.

• Fever associated with rigors in severe infection.
• Foul smelling urine.
• Turbid urine.
• Urethral discharge.
• Frequency of micturation, especially when infection is in the urinary bladder.
• Burning micturation.
• Predisposition to urinary tract infection.
• Females are more prone to develop UTI because of their short urethral length.
• Hence bacteria can ascend easily to the bladder and then to the kidneys.

In pregnant women, the movements of the ureters (peristaltic movements) which propel the urine towards bladder are inadequate, so there is urinary stagnation and these women are prone to develop UTI. Urinary tract infections in pregnant women not only produce complications for the mother but can endanger the life of the baby as well. 

Sexually active women develop lacerations around their urethra during intercourse. These lacerations are a good place for the growth of bacteria which can then ascends up the urethra and can cause infection of the urinary bladder and kidneys. This type of infection of the urinary bladder is very common in newly married females and is called “Honeymoon Cystitis”. 

Diabetic patients possess a decreased body resistance. A diabetic patient’s urine has sugar in it which provides a good culture medium for the growth of bacteria. 

Any obstruction in the flow of the urine. An enlarged prostate in old gentlemen can cause obstruction in the urinary bladder resulting in stagnation of urine. 

This predisposes a person to a UTI. 

Any abnormality in the urinary tract that interferes in the normal flow of the urine. Stones in the urinary tract provide a place where bacteria can grow easily. Anybody who has undergone urinary tract instrumentation like catheterization is prone to develop UTI. 

What should be done in UTI? 

When UTI is suspected, a complete urine examination should be done to confirm the diagnosis by the presence of pus cells and bacteria in the urine. Urine should be sent for culture and sensitivity. This test takes 2-3 days to report. After sending the urine sample for culture & sensitivity, empirical treatment with antibiotics is started which may be changed later according to the culture & sensitivity report. 

Abnormality in the urinary tract like obstruction or stone should be suspected, if especially a young male is suffering from UTI and also if there are repeated episodes of UTI in any person. A detailed urological examination and investigations like ultrasound and special type of X-ray called as IVU may be required. 

If an obstruction due to enlarged prostate gland in an elderly patient or a stone is found, it should be treated accordingly to avoid further episodes of infection.