Urinary tract infection (UTI)Peshab ki nali ka infection (UTI)

UTI kya hai

Peshab ka nizam (urinary tract) woh nizam hai jo peshab banata hai aur usay jism se bahar nikalta hai. Is ke chaar hissay hain: gurday, jo khoon ko saaf kar ke peshab banatay hain; ureters, patli naliyan jo peshab ko neechay masanay tak le jati hain; masana, jahan peshab jama hota hai; aur peshab ki nali (urethra), jo peshab ko jism se bahar le jati hai.

Peshab ki nali ka infection, ya UTI, tab hota hai jab jaraseem, aam tor par woh bacteria jo pichhli sharamgah (back passage) ke aas paas ki jild par rehtay hain, peshab ki nali mein daakhil ho kar barhne lagtay hain. Zyada tar infection masanay tak mehdood rehta hai. Doctor isay cystitis kehte hain. Kabhi kabhi jaraseem oopar aik ya dono gurdon tak pohanch jatay hain aur gurday ka infection (pyelonephritis) kar detay hain, jo zyada sangeen hai.

Mehdood (localised) aur poore jism wala (systemic) UTI

Ab doctor UTI ko do qismon mein taqseem karte hain, is buniyad par ke infection aap par kaise asar karta hai:

• Mehdood (localised) UTI masanay tak rehta hai. Alamaat sirf peshab ke nizam mein mehsoos hoti hain, jaise jalan, baar baar peshab aana aur pait ke nichlay hissay mein dard. Is ka ilaaj aam tor par ghar par ho jata hai.
• Poore jism wala (systemic) UTI poore jism par asar karta hai. Is mein bukhaar, kanpkanpi aur tabiyat bohat kharab hona jaisi alamaat hoti hain, masanay ki alamaat ke saath ya un ke baghair. Is ki misaalein gurday ka infection, prostate ka infection, aur khoon mein phail jane wala infection (urosepsis) hain. Systemic UTI mein khoon ke tests, scan, drip se antibiotics aur hospital mein rehna par sakta hai.

Dono qismein auraton aur mardon dono ko ho sakti hain. Kuch baatein kisi bhi UTI ka ilaaj mushkil bana deti hain ya us ke dobara hone ka imkaan barha deti hain. Maslan:

• Aap hamila (pregnant) hain.
• Aap ko catheter ya stent laga hai, ya gurday ya masanay mein pathri hai.
• Koi cheez peshab ke aasani se behne mein rukawat hai, jaise barha hua prostate ya peshab ki nali ka tang hona.
• Aap ka masana poori tarah khali nahi hota.
• Aap ki sugar (diabetes) qaboo mein nahi, ya aap ki qudrati qoowat-e-mudafiat (immune system) kamzor hai.
• Haal hi mein aap ke peshab ke nizam ka koi operation ya procedure hua hai.

Agar in mein se koi baat aap par laagu hoti hai, to aap ko mazeed tests aur lamba ilaaj darkaar ho sakta hai, aur aap ke urologist asal wajah dhoond kar us ka ilaaj karna chahein ge.

Yeh kitna aam hai

UTI sab se aam infections mein se aik hai. Yeh mardon ke muqablay mein auraton mein kaheen zyada hota hai, kyunke aurat ki peshab ki nali chhoti hoti hai aur us ka muh pichhli sharamgah ke qareeb hota hai, is liye jaraseem ko kam faasla tay karna parta hai. Bohat si auraton ko zindagi mein kam az kam aik dafa UTI hota hai, aur kuch ko baar baar hota hai.

Mardon mein, khaas tor par jawan mardon mein, UTI kam hota hai. Jab kisi mard ko UTI ho, to aksar us ki koi wajah hoti hai, jaise prostate ka masla ya masanay ka poori tarah khali na hona, is liye aam tor par is ka muaina zaroori hai.

Umar barhne ke saath, hamal ke dauran, aur sugar ya catheter wale afraad mein bhi UTI ka imkaan barh jata hai.

Aam alamaat

Masanay ka infection (cystitis): mehdood UTI

• Peshab karte waqt jalan ya chubhan.
• Baar baar peshab ki hajat, kabhi kabhi thora thora peshab aana.
• Achanak aur shadeed hajat ke fauran jana pare.
• Pait ke nichlay hissay mein dard ya dabao.
• Gadla ya tez boo wala peshab.
• Peshab mein khoon.

Gurday ka infection aur doosre systemic UTI

• Bukhaar, sardi lagna ya kanpkanpi.
• Kamar ya pehlu mein dard, pasliyon ke bilkul neechay.
• Matli ya ulti.
• Tabiyat bohat zyada kharab mehsoos hona. Masanay ki alamaat ho bhi sakti hain aur nahi bhi.

Buzurgon mein UTI aksar aam alamaat nahi deta. Is ke bajaye woh uljhan ka shikaar ho saktay hain, ghair maamooli tor par ghunodgi mein reh saktay hain, gir saktay hain, ya bas beemar lag saktay hain. Catheter wale afraad mein kabhi kabhi sirf bukhaar hi alamat hoti hai. Peshab mein jalan ka matlab hamesha infection nahi hota: garmi mein bohat garha peshab aur kuch doosri beemariyan bhi jalan ka sabab ban sakti hain, isi liye peshab ka test zaroori hai.

Tashkhees kaise hoti hai

Doctor aap se alamaat ke baare mein poochein ge aur aap ke pait aur kamar ka muaina kar saktay hain. Aam tor par yeh tests kiye jatay hain:

• Peshab ka dipstick test, aik jaldi hone wala strip test jo peshab mein infection ki alamaat dekhta hai. Yeh mufeed hai, lekin akela hamesha durust nahi hota.
• Peshab ka culture, jis mein namoona laboratory bheja jata hai taake jaraseem ko ugaya ja sake aur pata chale ke kaun si antibiotic us par asar karegi. Behtar hai ke namoona antibiotic shuru karne se pehle diya jaye. Is ka nateeja aane mein kuch din lagtay hain.
• Khoon ke tests, agar aap ki tabiyat kharab ho ya gurday ke infection ka shak ho, taake infection ki alamaat dekhi ja sakein aur pata chale ke gurday kitna theek kaam kar rahe hain.

Peshab ka achha namoona kaise dein: haath dhoyein aur peshab ki nali ke muh ke aas paas ki jagah dhoyein. Peshab ka pehla hissa toilet mein karein, phir darmiyani hissa saaf dabbay mein lein, dabbay ke andar haath lagaye baghair, aur baqi toilet mein karein.

Agar aap mard hain, ya infection systemic hai, baar baar hota hai, ya ilaaj se theek nahi hota, to aam tor par mazeed tests darkaar hotay hain. In mein yeh shamil ho saktay hain:

• Ultrasound gurdon aur masanay ka, taake pathri, rukawat ya soojan dekhi ja sake, aur yeh bhi ke masana poori tarah khali hota hai ya nahi.
• CT scan, agar pathri ya rukawat ka shak ho, ya systemic infection shadeed ho.
• Cystoscopy, patli camera se masanay ke andar dekhna, jo aam tor par infection theek hone ke baad kiya jata hai.

Ilaaj ke tareeqay

Ilaaj is baat par munhasir hai ke infection kahan hai, mehdood hai ya systemic, aap ki tabiyat kitni kharab hai, aur koi aisi baat to nahi jo ilaaj mushkil banaye. Aham tareeqay yeh hain:

Aap ke liye sahi ilaaj ka faisla aap ke doctor karein ge. Antibiotic khud se shuru, band ya tabdeel na karein.

UTI ke dobara hone ka imkaan kam karna

Yeh aasan iqdamaat doosre infection ka imkaan kam kar saktay hain:

• Din bhar kaafi pani piyein, khaas tor par garmi mein, taake peshab ka rang halka rahe. Safar ya bahar kaam karte waqt pani saath rakhein.
• Peshab na rokein. Jab hajat ho to peshab kar lein, aur itminan se masana poori tarah khali karein. Lamba safar, masroof din aur saaf toilet na milna is ko mushkil bana deta hai, lekin der tak peshab rokne se jaraseem ko barhne ka waqt milta hai.
• Humbistari (sex) ke baad jald peshab karein. Is se woh jaraseem nikal jatay hain jo peshab ki nali ki taraf dhakel diye gaye hon.
• Safai ka khayal rakhein. Auratein toilet ke baad aagay se peechay ki taraf saaf karein ya pani se dhoyein, taake pichhli sharamgah ke jaraseem aagay na aayein.
• Khushbu wale sabun, spray aur douche sharamgah par istemal na karein, kyunke yeh jild mein kharash paida kar saktay hain.
• Qabz se bachein, kyunke is se masanay ka khali hona mushkil ho jata hai.
• Sugar (diabetes) qaboo mein rakhein. Peshab mein sugar jaraseem ko barhne mein madad deti hai.
• Agar aap ko catheter laga hai, to usay saaf rakhein, bag ko masanay ki satah se neechay rakhein, aur usay waqt par badalwayein.

Agar aap ko baar baar UTI hota hai, to aap ke urologist wajah talash karein ge aur bachao ke tareeqon par baat kar saktay hain. In mein kuch arsay tak kam dose wali antibiotic, menopause ke baad auraton ke liye vagina mein lagane wali hormone cream, aur kuch aise ilaaj shamil ho saktay hain jo antibiotic nahi hain. Sahi tareeqa aap ki soorat-e-haal par munhasir hai.

Follow-up

• Agar antibiotic shuru karne ke do teen din mein behtari shuru na ho, ya kisi bhi waqt tabiyat bigray, to dobara doctor ko dikhayein.
• Course poora karein, aur bachi hui antibiotic agli dafa ke liye na rakhein.
• Agar ilaaj ke kuch arsay baad alamaat wapas aa jayen, ya baar baar infection ho, to dobara jayein. Baar baar hone wale UTI ka muaina urologist ko karna chahiye.
• Jo tests bataye jayen woh zaroor karwayein, jaise dobara peshab ka culture ya scan.
• Agar infection theek hone ke baad bhi peshab mein khoon aata rahe, to zaroor batayein. Is ka muaina hamesha zaroori hai, chahe dard na ho.

Aam sawalaat

What a UTI is

The urinary tract is the system that makes urine and carries it out of the body. It has four parts: the kidneys, which filter the blood to make urine; the ureters, thin tubes that carry urine down to the bladder; the bladder, which stores it; and the urethra, the tube that carries urine out of the body.

A urinary tract infection, or UTI, happens when germs, usually bacteria that normally live on the skin around the back passage, get into the urethra and multiply. Most infections stay in the bladder. Doctors call this cystitis. Sometimes the germs travel further up to one or both kidneys and cause a kidney infection (pyelonephritis), which is more serious.

Localised and systemic UTIs

Doctors now divide UTIs into two groups, based on how the infection affects you:

• A localised UTI stays in the bladder. The symptoms are felt in the urinary tract itself, such as burning, going often and lower tummy pain. It can usually be treated at home.
• A systemic UTI affects the whole body. It causes signs such as fever, shivering and feeling very unwell, with or without bladder symptoms. Examples are a kidney infection, an infection of the prostate, and an infection that has spread into the blood (urosepsis). A systemic UTI may need blood tests, a scan, antibiotics through a drip, and a stay in hospital.

Both types can happen in women and men. Some things make any UTI harder to treat or more likely to come back. For example:

• You are pregnant.
• You have a catheter, a stent, or a kidney or bladder stone.
• Something is stopping urine from flowing freely, such as an enlarged prostate or a narrowing of the urethra.
• Your bladder does not empty fully.
• You have diabetes that is not well controlled, or a weakened immune system.
• You have recently had an operation or procedure on your urinary tract.

If any of these apply to you, you may need more tests and a longer course of treatment, and your urologist may want to find and treat the underlying cause.

How common it is

UTIs are one of the most common infections of all. They are much more common in women than in men, because a woman's urethra is shorter and its opening is closer to the back passage, so germs have less distance to travel. Many women have at least one UTI in their lifetime, and some get them again and again.

UTIs are less common in men, especially younger men. When a man does get one, there is often an underlying reason, such as a problem with the prostate or a bladder that does not empty fully, so it usually needs checking.

UTIs also become more likely with age, during pregnancy, and in people with diabetes or a catheter.

Common symptoms

Bladder infection (cystitis): a localised UTI

• Burning or stinging when passing urine.
• Needing to go often, sometimes passing only small amounts.
• A sudden, urgent need to go.
• Pain or pressure low in the tummy.
• Cloudy or strong-smelling urine.
• Blood in the urine.

Kidney infection and other systemic UTIs

• Fever, chills or shivering.
• Pain in the back or side, just below the ribs.
• Feeling sick or vomiting.
• Feeling generally very unwell. Bladder symptoms may or may not be present.

In older people, a UTI may not cause the usual symptoms. Instead they may become confused or unusually drowsy, have a fall, or simply seem unwell. In people with a catheter, a fever may be the only sign. Burning when passing urine does not always mean infection: very concentrated urine in hot weather and some other conditions can cause it too, which is why a urine test matters.

How it is diagnosed

Your doctor will ask about your symptoms and may examine your tummy and back. The usual tests are:

• Urine dipstick test, a quick strip test that checks the urine for signs of infection. It is useful, but not always accurate on its own.
• Urine culture, where a sample is sent to the laboratory to grow the germ and find out which antibiotics will work against it. Ideally the sample is given before antibiotics are started. The result takes a few days.
• Blood tests, if you are unwell or a kidney infection is suspected, to look for signs of infection and check how well your kidneys are working.

Giving a good urine sample: wash your hands and the area around the opening of the urethra. Pass the first part of your urine into the toilet, then catch the middle part in the clean container without touching the inside, and finish in the toilet.

Further tests are usually needed if you are a man, if the infection is systemic, keeps coming back, or does not get better with treatment. These may include:

• Ultrasound scan of the kidneys and bladder, to look for stones, a blockage or swelling, and to check whether the bladder empties fully.
• CT scan, if a stone or blockage is suspected, or a systemic infection is severe.
• Cystoscopy, a look inside the bladder with a thin camera, usually done once the infection has cleared.

Treatment options

Treatment depends on where the infection is, whether it is localised or systemic, how unwell you are, and anything that makes it harder to treat. The main options are:

Your doctor will decide the right treatment for you. Don't start, stop or change antibiotics on your own.

Reducing the chance of UTIs coming back

These simple steps can lower the chance of another infection:

• Drink enough through the day, especially in hot weather, so your urine stays pale. Carry water with you when travelling or working outdoors.
• Don't hold on. Pass urine when you feel the need, and take your time to empty your bladder fully. Long journeys, busy workdays and a lack of clean toilets can make this hard, but holding urine for a long time gives germs time to grow.
• Pass urine soon after sex. This helps flush out any germs pushed towards the urethra.
• Keep the area clean. Women should wipe, or wash with water, from front to back after using the toilet, so germs from the back passage are not carried forwards.
• Avoid scented soaps, sprays and douches on the genital area, which can irritate the skin.
• Avoid constipation, which makes it harder for the bladder to empty.
• Keep diabetes well controlled. Sugar in the urine helps germs to grow.
• If you have a catheter, keep it clean, keep the bag below the level of your bladder, and have it changed on time.

If you keep getting UTIs, your urologist will look for a cause and may discuss ways to prevent them. These can include a low-dose antibiotic taken over a longer period, a hormone cream used in the vagina for women after the menopause, and some treatments that are not antibiotics. The right choice depends on your situation.

Follow-up

• See your doctor again if you are not starting to improve within a couple of days of starting antibiotics, or if you get worse at any point.
• Finish the course, and don't keep leftover antibiotics for next time.
• Go back if symptoms return soon after treatment, or if you keep getting infections. Repeated UTIs should be looked into by a urologist.
• Have any tests you are asked to have, such as a repeat urine culture or a scan.
• Report blood in the urine that continues after the infection has cleared. It always needs checking, even if it is painless.

Common questions