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Recurrent Urinary Infections– Seek Help of a Nephrologist!

Nov 11 , 2020 | 1 min read

There are many reasons behind recurrent infections of the urinary tract in adults. Dr. Alka Bhasin, Director – Nephrology, Max Smart Super Speciality Hospital, Saket, gives some questions, which could help you identify the problem and seek immediate medical intervention.

Is the urinary microbe the same in each instance or varying?
Is the microbe causing the urinary infection truly identified by the laboratory and significant?
Is there urinary incontinence? As this can promote infection or be a consequence of the infection.
Are there accompanying symptoms of burning in the urine, voiding very frequently, urgency, pain over the kidneys, fever? Are there accompanying pus cells in the urine?
Any accompanying visible blood in urine? – This could be due to cystitis, a stone in the urinary system, prostate enlargement, trauma of the urethral passage, sloughed dead tissue passing out from the kidney.

5 Alarming Signals of UTI’s

In women—any untreated vaginal infection or pelvic inflammatory disease, recent gynaecological intervention/pap smear, prolapsed of bladder/uterus/rectum, use of intrauterine contraceptive device to be looked for with a thorough evaluation.
In men – any prostatitis, balanitis, epididymo-orchitis, inguinal hernia, hydrocele to be looked for.
Recent unprotected sexual activity could be a repeated trigger.
Recent / repeated urological interventions such as a urinary catheter placement, external catheter placement, cystoscopic examination, urodynamics study, surgery on the urinary tract may be important factors.
Lack of correct treatment for the bacteria responsible for the urinary infection – I am referring in particular to use of inappropriate antibiotic (multidrug resistant bacteria are increasingly common in the community and require specialised intravenous antibiotics only), inadequate duration of antibiotic course (minimum 2-3 week course of appropriate antibiotic is needed for kidney infection), improper interpretation of the urine culture report.
Need to evacuate pus from the site by needle aspiration so that antibiotic penetration occurs better.
Need to remove the offending stone causing obstruction or otherwise
Unable to use a preventive low-dose antibiotic wherever indicated.
Patient factors such as poorly controlled diabetes, use of immunological suppressants/chemotherapy, the doses of which may need to be reduced or eliminated.
Recent diarrhea and faecal incontinence are triggers to the increase of microbes into the urinary space.