Health reports have confirmed that urinary tract infections are chronic diseases that cause kidney damage, according to the World Health Organization, which indicated that these infections are among the biggest medical causes of blindness in the world, affecting about 450 million people, making them one of the biggest global diseases affecting public health and quality of life.

A recent medical conference indicated that over 150 million people worldwide suffer from urinary tract infections annually. These infections are among the most common types of infections, affecting men and women of all ages. Half of all women will experience a urinary tract infection at some point in their lives. The risk increases during pregnancy and after menopause, and is also higher in individuals with spinal cord injuries, diabetes, and multiple sclerosis. The elderly are more susceptible due to underlying health problems and chronic diseases, which directly or indirectly weaken their bodies' ability to fight infections. According to scientific health reports, some cases are treated with antibiotics, which the patient takes for a specific duration determined by the doctor. Some patients respond to antibiotics, while others do not, leading to chronic conditions that require hospitalization.

1000 beneficiaries in the Eastern Province

In Saudi Arabia, urinary tract infections are common and require appropriate medical care to prevent complications. Urologists in the Eastern Province provided specialized services to over 1,000 patients and performed surgeries on more than 288 patients during 2022. Meanwhile, the Al-Ahsa Health Cluster announced that the number of patients benefiting from the urology unit at King Fahd Hospital in Hofuf reached 1,040. Among them were 82 cases of dynamic bladder mapping, 173 cases of minor surgeries, and 785 received other services in the unit. The urology unit performs simple operations to remove ureteral stents and cystoscopies, conducts dynamic bladder mapping studies, bladder neurostimulation sessions, as well as bladder treatment sessions for tissue inflammation syndrome, catheter changes, and self-catheterization instruction. The neuro-bladder surgery and pelvic reconstruction clinic has contributed to reducing the percentage of referrals outside Al-Ahsa in the subspecialty of neuro-surgical reconstruction by 66%, as it has provided its services since its opening in 2022 to 582 patients who were previously referred to specialized hospitals outside Al-Ahsa.

More common in women

Dr. Ayman Al-Sulaimani, Consultant and Head of the Urology Department at King Fahd General Hospital in Jeddah, said: Urinary tract infections are among the most common diseases worldwide. They are infections that affect the urinary system, which includes the kidneys, ureters, bladder, and urethra. They often occur as a result of bacteria, especially Escherichia coli, entering the urinary tract from the digestive system. The bladder and urethra are more susceptible to infection, and they are more common among women due to anatomical and hormonal factors. Poor personal hygiene, urinary retention, sexual activity, and some chronic diseases such as diabetes may increase the risk of their occurrence.

Symptoms include pain or burning during urination, frequent urge to urinate with small amounts of urine passed, and changes in urine color, which may become dark or contain blood. There may also be foul-smelling urine and, in more severe cases, lower abdominal or pelvic pain, especially if the infection spreads to the kidneys. Fever and chills, pain in the sides or lower back, nausea or vomiting, and general fatigue may also be symptoms.

Drink excessive amounts of water

Dr. Al-Sulaimani, Head of the Urology Department at King Fahd General Hospital, explained that prevention involves drinking sufficient amounts of water to cleanse the urinary tract and flush out bacteria, and urinating regularly without delay. He advised urinating after sexual intercourse to cleanse the urinary tract of any potential bacteria, wearing cotton underwear to reduce moisture, and avoiding the use of irritating products such as harsh soaps.

Dr. Al-Sulaimani, a consultant urologist, warned against neglecting treatment for urinary tract infections (UTIs). He stated that if the infection is not treated properly, it can spread to the kidneys, causing acute glomerulonephritis, which can lead to permanent kidney tissue damage. The infection can also progress to sepsis, a life-threatening condition. In pregnant women, untreated UTIs can cause premature birth or low birth weight. Recurrent infections can lead to chronic bladder inflammation, weakened bladder muscles, or urinary problems. Furthermore, the misuse of antibiotics can lead to the development of antibiotic-resistant bacteria. He explained that UTIs affect both sexes at all ages, but are more common in women and less common in men due to factors such as an enlarged prostate or urinary tract obstruction. He also noted that children are susceptible, especially if they have congenital urinary tract problems or poor hygiene. Symptoms in children may be less obvious and include fever or irritability in infants, while in older children they are more pronounced, such as pain during urination or frequent urination.

Warning for patients with diabetes and high blood pressure

Dr. Al-Sulaimani, Head of the Urology Department at King Fahd General Hospital, pointed out that patients with chronic diseases such as diabetes and hypertension are more susceptible to urinary tract infections. Diabetes, for example, weakens the immune system and increases sugar levels in the urine, creating an ideal environment for bacterial growth. Furthermore, some diabetic patients may suffer from neuropathy, which impairs the sensation of needing to urinate, leading to urinary retention and an increased risk of infection. Patients with hypertension may also have kidney problems or use diuretics, which alter the body's natural balance and increase their risk of infection. Therefore, this group requires close monitoring and additional preventative measures.

Dr. Al-Sulaimani, a consultant urologist, added that urinary catheters are a major cause of urinary tract infections (UTIs), as they allow bacteria direct access to the bladder. The longer the catheter is used, the greater the risk of infection. To minimize this risk, doctors ensure thorough sterilization during catheter insertion and use it only when necessary. Therefore, it is preferable to remove the catheter as soon as it is no longer needed, while monitoring the patient's condition regularly. If any signs of infection appear, such as fever or a change in urine color, the catheter may be replaced, and appropriate treatment, such as antibiotics, may be prescribed.

When does the doctor intervene?

Dr. Ayman Al-Sulaimani, Consultant and Head of the Urology Department at King Fahd General Hospital in Jeddah, urged immediate medical attention if severe symptoms appear, such as sharp pain during urination, blood in the urine, fever or chills, and pain in the sides or lower back. If symptoms persist without improvement after two days despite drinking water or using home remedies, medical intervention is necessary, especially for those with recurrent infections or chronic conditions like diabetes or weakened immune systems. This also applies to pregnant women to avoid complications for both mother and fetus. He revealed that delirium or increasing confusion are serious symptoms that can affect patients with urinary tract infections, particularly the elderly. This occurs when the infection spreads to the bloodstream or reaches the kidneys, leading to a condition known as sepsis. When the body enters this state, a severe inflammatory response occurs, affecting brain function and causing impaired concentration and cognition, especially in the elderly. The nervous system may be more sensitive to any disruption in bodily functions, even if the infection is confined to the bladder. Confusion and delirium in this case are early warning signs indicating the need for immediate medical intervention to prevent the infection from worsening and causing complications. Therefore, patients and their families should be vigilant for these symptoms and seek urgent medical attention if they appear.

1.5 liters of liquid is sufficient

Dr. Ahmed Tawfiq, a consultant urologist, explained that the causes of urinary tract infections vary depending on the patient's age. In children, congenital defects such as ureteral reflux or urinary tract obstruction are among the main causes, while in women, vaginal infections are the most common.

In men, sexually transmitted infections, prostate enlargement, and stones are among the main causes. Often, the infections are not serious and are limited to the lower urinary tract, except in certain cases where we consider them to be infections of double risk.

Dr. Tawfiq, a consultant urologist, explained that dangerous cases include infections in pregnant women, infections associated with immunodeficiency diseases (and uncontrolled diabetes), and infections accompanied by a high fever and chills, which means that the infections have reached the kidney area.

Drinking plenty of fluids is a cornerstone of treating and preventing infections. Consuming 1.5 liters of fluids daily helps dilute the concentration of microbes and reduce their impact on the body.

And in patients who suffer from recurrent infections (without fever) more than 3 times a year.

Who are the most vulnerable?

Dr. Tawfiq, a consultant urologist, notes that older men and women are more susceptible to urinary tract infections (UTIs) due to hormonal changes in women, prostate enlargement in men, and other age-related conditions such as diabetes. Kidney stones are also a contributing factor to UTIs, and the pain associated with them can sometimes mimic that of a UTI. Differentiation between the two is crucial and can be achieved through urinalysis and ultrasound, especially if the infection is accompanied by pain on one side. Risk factors, or what are known as complicated UTIs, include pregnancy, immunodeficiency, and ureteral obstruction due to congenital defects or stones. These cases sometimes require hospitalization, intravenous antibiotics, or, in certain instances, endoscopic surgery. Dr. Tawfiq adds that there is a category of UTIs called recurrent UTIs, which refers to four or more episodes of infection per year. Causes of recurrent UTIs include urinary tract obstruction and bladder dysfunction. Or stones, immunodeficiency and diabetes irregularity, and sometimes recurrent infections occur without a clear cause, especially in middle-aged women, as some women may suffer from recurrent infections. There are some theories that have tried to explain the increased susceptibility to infections in certain bodies and people, but they have not been confirmed in all patients. It is possible to benefit from treating these infections by consuming cranberries, (but it should be noted that they help in preventing infections or as an adjunct during treatment, but they should not be relied upon alone as a treatment).