Urinary Tract Infections and Infertility.
Dr. Pooja Kumari, Ph.D., Department of Zoology, Aligarh Muslim University, India.
Background: One of the most prevalent infections affecting women is a urinary tract infection (UTI). In addition to being caused by bacteria that originate in the digestive system, UTIs frequently accompany vaginal infections (Czajkowski et al., 2021). Female patients undergoing perioperative care, postmenopausal women, diabetics, epileptics, and pregnant women are among the patient populations covered by the article regarding the frequency of UTIs (Al Lawati et al., 2024). Reports depict that 25% of all microbial infections in women occur in their urinary tract. Further 50-60% of women develop at least one UTI in their lifetime with 20-30% women experiencing recurrent UTIs. The urinary system consists of a bladder, a pair of kidneys, ureters and the urethra (Medina et al., 2019).
As per scientific evidence Chlamydia trachomatis infection is the most commonly reported sexually transmitted bacterial infection in Indian population and worldwide. Majority of women are asymptomatic; however, untreated and persistent infections can lead to the pelvic inflammatory disease and infertility (Öztürk and Murt, 2020). Most infections involves the lower part of the urinary tract. Some women experience UTIs regularly, a condition known as recurrent urinary tract infection (RUTIs) caused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and Staphylococcus saprophyticus, the most frequent causative agent being E. coli (Ackerson et al., 2024).
Risk factors:
Any person, regardless of their age or gender, is susceptible to developing a UTI. Urinary tract infections (UTIs) can occur for a variety of reasons, but poor personal hygiene is among the most fundamental. Both genital and personal hygiene are encompassed in this. One of the leading causes of urinary tract infections (UTIs) in women is the use of unclean sanitary napkins. In addition to diabetes, bowel incontinence, kidney stones, chemotherapy, or HIV can all lower the immune system, which can lead to a weakened immune system and, ultimately, a UTI. A UTI is more likely to occur in pregnant and menopausal women. Using contraceptive diaphragms or spermicides, having sexual relations more frequently or intensely, or having sexual relations with more than one partner may all increase a woman’s risk of UTIs. Additional risk factors for UTIs while hospitalized include the use of antibiotics to treat infections and the presence of a urinary catheter, both of which can alter the normal bacteria that live in the body (Storme et al., 2019).
Symptoms:
Most cases of UTI are asymptomatic, although UTIs do not pose a life-threatening threat, but they can cause long-term damage to the urinary tract, especially in cases of chronic recurrent renal infections and infections of the upper urinary tract. If septicaemia (bacteria entering the bloodstream) develops as a result of certain unusual acute kidney infections, the condition can be fatal (Kaur and Kaur, 2021). Depending on factors such as age, gender, and the specific area of the urinary tract affected, the symptoms of a UTI can differ. Urinary tract infections (UTIs) are characterized by a strong and frequent need to urinate, urine that is cloudy, bloody, or strongly scented, pain or burning sensation during urination, excruciating pain in the urethra during micturition, back pain, nausea, vomiting, muscle and abdominal pains, and a scalding sensation in the urethra. Side pain and fever are possible symptoms of kidney infections or catheters (Abou Heidar et al., 2019).
Diagnosis:
Diagnostic tests vary depending upon the complexity and symptoms of the infection. Urine analysis involves inspection of urine color and clarity as well as observation under the microscope. Urine culture is another test used to detect the type of bacteria that has caused infection. Molecular PCR technique has been employed lately for diagnosis of UTI using antibiotic resistant markers. A doctor prescribes specific antibiotics based on the results of the above tests (Kelly, 2023).
Treatment:
Prescription of medicines depends upon the cause and severity of infection as well as the health of the patient. For patients with frequent UTIs, low dose antibiotics are recommended for six months. A single dose of antibiotic post sexual intercourse is prescribed if infection is related to sexual activity. Vaginal estrogen therapy may be advised in postmenopausal women. For patients with severe UTIs, intravenous injections of antibiotics are prescribed. Doctors must compulsorily be consulted before taking any medication (Price et al., 2018).
Prevention:
Proper personal hygiene is the most important of several steps women can take to reduce their risk of urinary tract infections (UTIs). It is possible for pathogens to enter the urinary tract through the urethra during sexual intercourse via the anal and genital routes. This is another factor that puts women at risk of urinary tract infections. Urinating after sexual activity, washing one’s genital and anal regions before and after, maintaining proper hydration, and drinking lots of water can all help reduce the risk of urinary tract infections (UTIs) caused by sexual intercourse. The aforementioned methods are effective in cleansing the urinary tract of bacteria. There is an increased risk of urinary tract infections (UTIs) when using a diaphragm as a method of birth control. Because of its placement, the diaphragm prevents the bladder from emptying entirely, which means that bacteria and urine are retained (Mancuso et al., 2023). As with inflammation of the genitourinary tract, the use of spermicides raises the risk of sex-related UTIs. Therefore, diaphragms and spermicides should not be used as methods of birth control. Creams containing estrogen could help menopausal women prevent vaginal infections. Uncontrolled diabetes increases urinary tract infection risk. When blood sugar rises, excess sugar is excreted through urine, which promotes urinary tract bacteria growth. Thus, diabetics should take blood sugar-lowering medications to avoid UTIs. Unclean and unchanged pads and tampons during menstruation increase the risk of UTIs (Tamadonfar et al., 2019).
Author:
Dr. Pooja Kumari, Ph.D
Department of Zoology, Aligarh Muslim University, India.
Reference:
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Edited and updated on December 1, 2024 by Sunanda Kulshrestha, Ph.D. (Department of Biotechnology, GLA University, Mathura, Uttar Pradesh, India).