Diagnostics

Urinary Infection

Urinary tract infection (UTI) is often uncomplicated and straightforward to treat. It can, however, sometimes turn into acute cystitis and have more severe health consequences.

DESCRIPTION AND PREVALENCE

UTI is deemed uncomplicated when it occurs acutely or sporadically in a healthy person. Acute cystitis is defined by at least three episodes of urinary tract infection during 12 consecutive months. It can be complicated in pregnant women, men with benign prostatic hyperplasia and urinary voiding problems, or a person who regularly catheterizes.

However, 20 to 30 per cent of women who have had acute cystitis have a recurrence. Among them, 25 per cent will have recurrent urinary tract infections, that’s to say more than three episodes per year. In most cases, this is a new urinary tract infection called reinfection. It may recur quickly, two to four weeks after the initial treatment. In this case, it may be a persistent infection due to bacterial resistance, inadequate treatment or an anatomical or functional abnormality of the urinary tract.

Asymptomatic bacteriuria refers to bacteria in the urine in the absence of symptoms or clinical signs.

What are the signs and symptoms of urinary infection?

Diagnosis is based on a combination of symptoms, which may include:

Burning sensation or pain when urinating
Pollakiuria, frequent daytime urination
Dysuria, difficulty urinating
Hematuria, blood in the urine
Pelvic pain
Cloudy or foul-smelling urine (this symptom is non-specific if it’s the only one)

It’s essential to distinguish bacterial cystitis from pyelonephritis, vaginitis and prostate or testicular pain.

What are the possible causes of urinary infection?

Use of urinary catheters
Malformations of the genitourinary system
Kidney stones
Dehydration
Constipation
Urinary voiding problems
Sexual activity
Menopause

What diagnostic exams are available at Les Cliniques Marois?

Complete anamnesis, covering lifestyle and medical history.
Physical examination.
Urinalysis, an exam that detects various substances in the urine, such as white or red blood cells, proteins, glucose and ketones. This exam is not specific to UTIs.
Urine culture, a test in which bacteria from a urine sample are monitored in a laboratory. This exam is specific for a UTI diagnosis.
Cystoscopy or urodynamic assessment if factors complicate the initial profile.

What treatments are available for cystitis?

- For fewer than 12 episodes per year, cystitis is treated with short-term antibiotic treatments.
- Beyond 12 episodes per year, prophylactic treatment with long-acting, low-dose antibiotics is recommended.
- Lifestyle modifications can help prevent recurrences of urinary tract infections when no contributing cause is found and treated:

Urinate regularly during the day and avoid “holding it”
Drink 1.5 litres of water per day
Wipe from front to back after a bowel movement
Practice healthy eating habits that enable regular bowel movements
Clean externally once a day

In the case of recurrent post-coital cystitis, make a habit of urinating after sexual intercourse.
The right dose of cranberry juice is effective against recurrent E. coli cystitis. Cranberries contain proanthocyanidins (PACs) that prevent the attachment of E. coli to the bladder’s walls. The dosage must be 36 mg of PAC per day for at least three months to be effective.
After menopause, local hormone therapies like estrogen can prevent recurrent UTIs.
No treatment is recommended for asymptomatic bacteriuria.

References

https://www.inspq.qc.ca/pdf/publications/1932_Prevention_Infections_Urinaires_Catheters.pdf
https://www.inesss.qc.ca/fileadmin/doc/CDM/UsageOptimal/Guides-serieI/Guide_InfectionUrinaire.pdf
www.cua.org: Urinary tract infections and uncomplicated urinary tract infections in women: an AUA, 'AUC, and SUFU practice guide, 2019.

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Dr. Marois is a urologist who is not a member of the Régie d’Assurance Maladie du Québec (RAMQ). As such, the clinic can not claim the RAMQ for the payment of his services. If you consult Dr Marois, you must pay for the services rendered.

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To ensure the smooth running of the clinic and a minimum of courtesy towards other patients and our staff, we ask you to notify us 48 hours in advance for the cancellation of a consultation, 5 working days in advance for a surgery at the office and 21 working days in advance for a major surgery. If these deadlines are not respected, a cancellation fee of 50% of the service will be charged.

Change of appointment:

We understand that events occur, so we ask you to provide us with at least a 24-hour notice for any change in their appointment; we will be happy to accommodate you, the best we can. However, if you fail to inform us within this timeframe or do not show up, we will charge a $ 100 fee.

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Dr. Marois is a urologist who is not a member of the Régie de l’Assurance Maladie du Québec (RAMQ). As such, if you require his professional services, you will have to pay directly the Cliniques Marois for the services rendered.

Cancellation Policy:

To ensure the smooth running of the clinics aa well as a minimum of courtesy towards other patients and staff members, we ask you to notify us 48 hours in advance for cancelling an appointment, 5 working days for cancelling a minor surgery in the office and 21 working days for major surgery at the CMC. If these deadlines are not respected, a cancellation fee of 50% of the service will be charged.

Change of appointment:

We understand that events occur and schedules change, so we ask patients to give us at least a 24-hour notice for any changes of appointment. We will be happy to reschedule another one for you. Failure to provide such notice within this timeframe will result in a $ 100 fee.

Thank you for your understanding.

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