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Urinary
Tract Infection
Urinary tract infections (UTIs) are caused by bacteria that
invade the urinary system and multiply, leading to an infection.
UTIs are very common; approximately 8 to 10 million people
seek professional medical assistance annually for this disease.
Women are affected more than men, although men and children
can get UTIs. Approximately one woman in five will have a
urinary tract infection in her lifetime.
Most infections are not serious and can be easily treated
with antibiotics. However, if left untreated, some infections
can result in kidney damage and even death. This is why it
is so important to seek appropriate medical treatment if a
UTI is suspected.
There are three types of urinary tract infection:
- urethritis (infection of the urethra)
- cystitis (infection of the bladder)
- pyelonephritis (infection of the kidneys)
The urinary tract can be infected from above by bacteria
from another part of the body that enter the kidney through
the bloodstream, or a UTI can occur from bacteria entering
the urethra. Infection from above is most often seen in newborn
babies with a systemic infection known as sepsis. Infection
from below is much more common in both children and adults.
Urinary Tract
The urinary tract is made up of the kidneys, two ureters,
the bladder, and urethra. The major components are the kidneys,
a pair of bean-shaped organs located below the ribs near the
middle of one's back. The kidneys comprise a complex filtration
system made up of individual nephrons that work together to
remove waste products from the blood, which are eliminated
from the body in the form of urine. The kidneys also function
to maintain a stable balance of salts and other substances
in the blood, as well as to produce a hormone erythropoietin,
which triggers the production of red blood cells in the bone
marrow.
The ureters are tube-like structures that transport the urine
from the kidneys to the bladder where the urine is stored.
Muscles called sphincters tighten around the urethra to prevent
urine from leaking out. There are two sphincters: the internal
is not controlled consciously, while the external sphincter
is under voluntary control. The bladder is elastic and expands
as it fills with urine. When the bladder reaches a certain
capacity, which differs for each individual, the brain sends
impulses to the internal sphincter to relax and other impulses
to a muscle called the detrusor to contract and expel the
urine out the urethra. This process is under the voluntary
control of the individual, who can hold the urine until social
circumstances allow for urination. (Loss of this control is
urinary incontinence.)
Urine is normally "sterile," meaning that it usually
contains no bacteria. The body accomplishes this through several
methods. First, the two sphincter muscles that prevent urine
leaking from the bladder to the urethra, also prevent the
bacteria that normally colonize the skin from ascending through
the meatus (the opening in the urethra) into the bladder.
Second, the length of the urethra makes it difficult for bacteria
to get to the bladder. The fact that women have a much shorter
urethra than men accounts for the fivefold increase of UTIs
among women compared to men. Finally, if bacteria do make
it to the bladder, the body is equipped with valves where
the ureters empty into the bladder, a region known as the
trigone. These valves prevent urine and any bacteria from
backing up into the kidneys. Further, the bladder almost completely
empties when urination occurs, so that any bacteria present
should be excreted as well. Despite these defense mechanisms,
infections sometimes occur.
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