UTIs: Uro or Gynae?
What is a UTI?
A Urinary Tract Infection or UTI refers to the infection of any part of your urinary system. This system comprises the kidneys, ureters, bladder and urethra. If you have UTIs in the kidney, it will be called Pyelonephritis. If you have UTI in the bladder, it will be known as Cystitis. UTI originating in the urethra will then be known as Urethritis.
UTIs can also be further classified into two categories:
- Uncomplicated UTI
Uncomplicated UTIs are more likely to occur in women. These women are usually young, sexually active and have no structural abnormalities in their genitourinary tract.
Usually, uncomplicated UTIs go away without treatment and are confined to the lower urinary tract.
- Complicated UTI
Complicated UTIs commonly refer to UTIs that:
- Happen two or more times in six months or three or more times in a year
- Occur with a structural abnormality in the genitourinary tract
- Lead to more severe outcomes than patients without any identified risk factors
- Cannot be cured with a single course of antibiotics
- Occur in a person who has conditions which affect the immune system (e.g. HIV)
Symptoms of UTIs generally are the same across all UTI types and categories. These include:
- Urinating more frequently, even when there are only a few drops of urine
- A burning sensation when peeing
- The sensation of a full bladder, even after urinating
- Abdominal pain
- Cloudy, bloody urine
- Urine that smells very fishy
When should I see a doctor for my UTI?
Generally, UTIs go away on their own. The real issue starts if and when untreated UTI spreads to other parts of the urinary tract. For example, if UTI spreads to the kidneys, immediate medical attention is needed before kidney failure occurs. Apart from the symptoms mentioned above, you may experience:
- Abdominal pain
- Back pain
UTI in the kidney can be dangerous as the infection can permanently damage your kidneys or spread to the bloodstream (sepsis). Complications of sepsis include excessive blood clotting, which can rupture blood vessels or cause tissue death in essential organs.
Hence, it is paramount to get immediate medical care if you experience the symptoms above.
How do UTIs happen?
UTI is caused by a bacterial infection, the most common being Escherichia coli (E. Coli)
Usually, the bacteria is transferred from the anus to the urethra when one wipes from back to front.
Other bacteria which may cause UTIs include mycoplasma and chlamydia. These bacterial infections are sexually transmitted, so when the infection is detected in either partner, both need to undergo medical treatment to avoid recurrent UTIs.
If you are a woman who has reached menopause, your risk of getting a UTI is also higher as the hormonal imbalances in your body may affect the balance of bacteria in your urinary tract, causing UTI.
Can children get UTIs?
For children, UTIs usually signify more serious conditions such as urinary reflux. Urinary reflux refers to the backflow of urine to the kidneys due to a dysfunctional bladder valve. This increases the risk of a kidney infection in the child, which can be fatal.
Since urinary reflux runs in families, it is important to screen children early if a close relative has the same condition.
Can UTIs go away on their own?
Most uncomplicated UTIs can go away on their own in about a week. However, the recovery rate greatly depends on the individual, where some might never recover from UTIs unless they receive medical treatment.
These cases of long-term UTIs are dangerous, as the infection may spread to the kidneys to cause pyelonephritis or sepsis.
Since one cannot tell which kind of UTI is affecting the individual, it would be advisable to seek treatment immediately when you see signs of a UTI. If it is an uncomplicated UTI, medical treatment will help you recover quicker than without it.
So which doctor do I consult?
First, we should ask ourselves a few questions:
- Do I have a frequent urge to pee?
- Do I experience pelvic pain?
- Does my urine smell weird,
- or do I have any of the UTI symptoms mentioned above?
If you experience only these symptoms, it may be ideal to visit a Urologist.
However, you may also experience additional symptoms such as:
- Frothy, bright yellow, pink, brown coloured, cheese-curd-like, or fishy-smelling vaginal discharge
- Excessive or unexpected vaginal bleeding
- Vaginal itching
If so, then a Gynaecologist would be ideal.
Urologist vs. Gynaecologist
A Gynaecologist is a doctor who specialises in female reproductive health and disease which affects the female reproductive system. Organs of the female reproductive system include:
To diagnose gynaecological conditions, Gynaecologists will need to know what symptoms you have experienced and conduct a series of diagnostic tests. These tests may include hysteroscopy, Pap smears, mammograms and bone density tests.
Some examples of gynaecological conditions include:
- Cervical Dysplasia
- Menstrual Disorders
- Polycystic Ovarian Syndrome
- Vaginal Prolapse
After arriving at a diagnosis, your Gynaecologist will work out an appropriate treatment plan for you based on your condition.
A Urologist treats both males and females when they face issues in the genitourinary tract. This system comprises the kidneys, ureters, bladder and urethra. Symptoms of urological conditions are generally pee-related and can sometimes extend to pelvic pain.
If your Urologist suspects you have a urological condition, they will first need to run some tests to diagnose you. These tests include:
- Urine cultures
- Imaging scans
If your urologist confirms that you have a UTI, the treatments which you could be given include:
- Hormonal medication
- Intravesical therapy
- Surgical procedures
Of course, urological conditions are not just limited to UTIs. Bladder cancer, kidney and ureteral stones are all conditions that a Urologist can diagnose and treat. To do so, your Urologist might need to run further diagnostic tests like blood tests or do a biopsy.
It can be tough to know when to see a Gynaecologist or Urologist, as symptoms of gynecologic conditions can overlap with those of a UTI. In these situations, the key to choosing the right specialist involves considering any other symptoms present and undergoing more tests.
If you are unsure about where and how to find a doctor for your UTI, try Beyond Medical Assistance! This platform was built to assist in your medical enquiries and help you book appointments with the right doctor. Our knowledgeable healthcare management team has more than 40 years of combined medical experience and would be glad to assist you in your healthcare journey.
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