Bladder Infection

Cause

A bacterial bladder infection usually occurs when bacteria enter through the urethra and begin to multiply. This can occur in women as a result of sexual intercourse. During sexual activity, bacteria are introduced via the urethra into the bladder. But sexual inactive girls and women are also susceptible to infections of the urinary tract, because the female genital area often houses bacteria that can lead to a bladder infection.
Most cases of bladder infection are caused by the bacterium Escherichia coli, a species that is very frequently found in the genital area. Although bacterial infections are the most common cause of bladder infection, other factors can also lead to this condition. A bladder infection is not contagious.

Symptoms

The following signs and symptoms may occur in a bladder infection:

• A strong, persisitent urge to urinate.
• A burning sensation when peeing.
• Frequent small amounts of urination.
• Blood in the urine.
• Turbid or strong smelling urine.
• Discomfort in the pelvic region.
• A feeling of pressure in the abdomen.
• (Mild) fever.

Bedwetting in young children can also be a sign of bladder infection. When they are treated quickly and correctly, bladder infections rarely cause complications. But without treatment they can cause complications, such as kidney infection and blood in the urine.

Diagnosis

When bladder infection is suspected, the doctor may order for a urinalysis to determine the composition of the urine. There is primarily sought for bacteria, red blood cells, proteins and pus in the urine.
Another examination is cystoscopy. This is an inspection of the bladder with a thin tube with a camera (cystoscope) which can be inserted through the urethra into the bladder. This way, the doctor can also take a tissue biopsy for examination in the laboratory.
Imaging techniques, such as X-ray or ultrasound, are only needed when no evidence of infection was found. They may confirm or exclude other possible causes of a bladder infection, such as a tumor or structural defects in the bladder.

Treatment

An acute bladder infection, caused by a bacterial infection, is in first instance treated with antibiotics. What medicines are used and for how long, depends on the overall health of the patient and the bacteria found in the urine. The symptoms usually disappear within a few days after start of the treatment. In case of recurring infections, prolonged antibiotic treatments may be needed.
In case of a chronic bladder infection, the cause of the inflammation is uncertain. No single treatment works best for all cases. Commonly used treatments include interventions to the bladder, such as bladder distension (injecting water in the bladder so that it expands), surgery, nerve stimulation and medicines that are taken by mouth or injected directly into the bladder.

Prognosis

Simple bladder infections usually heal with antibiotics without any problems. In some cases, untreated bladder infection can rise up to the kidneys, causing a kidney infection. In case of a complicated bladder infection, prospects depend on the clinical situation. Patients can get seriously ill if the infection spreads through the urinary tract to the blood.

Considerations

• In women, it may help to prevent bladder infection by wiping toilet paper from front to back and to pee after having sexual intercourse.
• Some women, who have two or more bladder infections a year, take an antibiotic after sexual encounters in order to prevent infection.
• Other measures that could help prevent bladder infection include going to the toilet as soon as one feels urge to pee and drinking a lot.
• Some studies suggest that drinking cranberry juice may lower the risk of bladder infection.

Facts

• The term ‘cystitis’ is derived from the Latin word cyst (fluid-filled vesicle). The suffix -itis indicates that it is an inflammation.
• The prevalence of bladder infection is 7% in women and 1% in men.
• The condition mainly occurs in women aged 15 to 24 years and women older than 60 years.
• Bladder infection is the most common problem, for which women visit their general practitioner.
• A chronic bladder infection is not common.