Diagnosis & Treatment of Bladder Infection

Bladder infection (cystitis) results from bacteria, such as E. coli or Staphylococcus ("Staph"), entering the bladder from the urethra (the tube to the bladder). Typical symptoms include burning on urination, frequent and urgent need to urinate even when the bladder is empty, foul smelling urine, bed-wetting at night in children and bloody urine and pain in the lower abdomen.

Considerations

• Bladder infections are more common in females because the vagina and rectum are very close to the urethral opening, so vaginal or fecal bacteria can easily enter the urethra (especially during sexual intercourse). According to Brunner & Suddarth's Textbook of Medical-Surgical Nursing, the female urethra is only about 0.75 inches long in infants and 1.5 inches long in adults. The male urethra at birth is about 2.5 inches and 8 inches in adults and is less at risk for infection.

Diagnosis

• Your physician may diagnose your bladder infection based on symptoms alone but will usually do a urinalysis (urine test) to check for signs of pus, bacteria or blood in the urine. If you have had recurrent urinary infections or your infection does not respond to treatment, your physician may want to culture your urine to see what bacterial organisms grow in a special medium used in the laboratory. If bacteria grow, then the laboratory does sensitivity tests to determine which drugs kill the bacteria.

Urine Specimen

• When you provide a urine specimen, you must be very careful not to contaminate the urine from bacteria that might be on your skin. You will usually provide a "clean-catch mid-stream" urine. This means that you must clean the area about the urethra with an antiseptic wipe and then urinate for a second or two, stop the flow of urine, position the container below the urethral opening and then begin urinating again to fill the container. This flushes the urethra. In some cases, the doctor may insert a catheter (a plastic tube) into your bladder to get a urine specimen.

Medical Treatment

• According to Merck Manuals, the primary treatment for bladder infection is antibiotic therapy to kill the bacteria and prevent spread of the infection to the kidneys. You may receive a one-time treatment or take antibiotics for three days. However, there has been an increase in bacteria that are resistant to many current antibiotics, so your doctor may give you a stronger medication for up to 10 days, especially if you have had recurrent infections. The doctor may also give you additional medications to relieve bladder spasms (tolterodine) or pain from inflammation inside the bladder (phenazopyridine).

Other Measures

• Sitting in a warm bath can relieve the burning in and about the urethra. Cranberry juice (10 ounces daily) helps increase the acidity of your urine (making it less hospitable to bacteria) and prevents bacteria from attaching to the bladder. When you have a bladder infection, you should drink ample fluids (2 or more quarts daily) to increase urinary output, prevent kidney infection and help flush the bacteria from your bladder. Careful hygiene can help reduce risk of recurrence.