Causes of urinary infections
Most urinary infections are caused by bacteria, most of which exist normally on the human body. Examples of such bacteria include E. Coli, Klebsiella and Streptococci.
Rarer causes of urine infections include tuberculosis and certain parasites such as schistosomiasis.
Certain risk factors can predispose to the development of urinary infections:
- Bladder drainage problems, such as:
- Prostate enlargement
- Spinal injury or spina bifida
- Neurological problems like stroke or multiple sclerosis
- Stones in the kidney or bladder
- Urine reflux (in children)
- Catheters or other tubes in the urinary system
- Immune deficiency
- Women are generally more susceptible to urinary infections because of anatomical factors
Types of infections and their symptoms
Urine infections usually start from the bladder, in which case they may be referred to as cystitis. This leads to symptoms such as painful and frequent urination, urinary bleeding and abdominal pain.
If the infection goes up and affects the kidney, it is referred to as pyelonephritis. This causes fevers and pain in the flank or back in addition to the above symptoms. Pyelonephritis can become severe or life-threatening, and should be treated promptly and urgently.
In men, urinary infections can spread to involve the genital organs. If the testicles are affected, they can become swollen and painful, and this is referred to as epididymo-orchitis. Infection of the prostate is referred to as prostatitis, and causes fever, pelvic & rectal pain and occasionally urinary blockage. Some infections of the prostate may be difficult to get rid off, and thus can cause repeated attacks.
Tests for urinary infections
Urine tests can confirm the infection, but also provide valuable information regarding the bacteria causing the infection and which antibiotics may be effective.
Further tests are required in selected patients. Generally, women suffering repeated attacks of infection and men with and unexplained infection need to have further tests.
Testing for the causes of urine infections can include scans of the kidneys and a cystoscopy.
Vasectomy is a surgical procedure undertaken to divide the vasa (the tubes that carry the aperm from the testicles) with the aim of providing permanent contraception. It is suitable for men who are sure they have completed their family. For practical purposes, vasectomy is not reversible, and it requires expensive and difficult medical procedures (with no guarantee of success) to subsequently father children.
Vasectomy is carried out as day-case surgery, usually under general anaesthetic. Two small incisions are made in the scrotum and a section of the vas is cut out on either side, with the ends tied and separated. Sperm remains in the system for 3 to 6 months, and until tests confirm the absence of sperm, contraceptives should be continued. There are rare instances of the procedure failing as a result of the vas joining up again, in which case sperm persists after surgery.
Painkillers are required for the first few days after surgery, and restrictions apply to heavy lifting and physical exertion. Some bruising is common, but extensive bruising or swelling needs to be checked. After vasectomy, some men experience an ache in the testicle or develop a small pea-sized lump at the site of surgery. This is rarely a significant problem.