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The Mystery Of The Stubborn Urinary Tract Infection

How to avoid them. How to treat them. And what happens if they're ignored.

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Elena Scotti
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If you’ve read the news over the last several months, you’ve heard the sensationalized story of 65-year-old actress Tanya Roberts. Early news reports declared her dead, then alive, then dead again. But the other real story is what she succumbed to — complications from a urinary tract infection. This information sent many women reeling — you mean you can die from a UTI?

You can when a urinary tract infection eventually spreads to other parts of the body. An untreated UTI can become deadly if it goes unnoticed.

Nearly every woman has heard of a urinary tract infection, and countless women have experienced one. But what exactly is a urinary tract infection in women? They’re infections in any part of your urinary system — kidneys (pyelonephritis), bladder (cystitis) or urethra (urethritis). They occur more commonly in women (our urethras are shorter compared with men’s), and all women are at risk, particularly sexually active and/or postmenopausal women.

Simply put, bacteria from the outside world have a shorter distance to travel to affect our urinary tracts. UTIs usually happen when bacteria enter the urinary tract via the urethra and then multiply in the bladder. Typically, urination flushes out bacteria before they reach the bladder, but sometimes the body’s natural defenses fail to prevent a symptomatic infection. Patients with other medical problems, particularly diabetes, are at higher risk. Sometimes a lack of typical symptoms prevents the patient from seeking care, and that untreated bladder infection may ascend and affect the kidneys. If this happens, typically a patient starts to feel unwell and may become feverish.

At this point, the infection can enter the bloodstream, leading to a condition called bacteremia — the presence of bacteria in the blood — and sepsis, a life-threatening complication in which the body exhibits an extreme immune response to the infection. From there, the infection in the bloodstream can affect any vital organ.

It’s important to note that this dire series of events is very rare in someone who is otherwise healthy and in tune with their own body. Once you’ve reached the stage of chills, fever or flank pain, most people know to seek medical help and are able to stop the infection before it becomes more serious.

If the infection is limited to the bladder, it can be painful and annoying. You may experience burning, urinary urgency (feeling like you have to go NOW), urinary frequency (feeling like you have to go often), or pain during or after urination. The urine may have a different smell and appearance, or even have blood in it.

If the UTI spreads to your kidneys, you may experience fevers, chills and flank or back pain. While serious consequences can occur, most kidney infections can usually be treated with antibiotics and good hydration successfully. UTI symptoms in older women may present with more insidious symptoms such as confusion, agitation or falling.

Some things to remember if you keep getting UTIs: If you’re a woman above the age of 35 and have persistent blood in your urine, go to see a urologist; often women are misdiagnosed with recurrent UTIs when there may be something else causing the blood in the urine (kidney stones, kidney or bladder tumors, etc.).

Sometimes structural problems within your urinary tract can cause recurrent infections and can be managed medically or surgically. If you’re postmenopausal, talk to your doctor — vaginal estrogen may help reduce UTI episodes.

And finally, make sure to hydrate well not just during episodes, but all the time! Urologists often say, “the solution to pollution is dilution.”