Urinary tract infections and neurologic events: identification, implications, treatment and prevention

Urinary tract infections and neurologic events: identification, implications, treatment and prevention

Content provided by Dr. Tarvinder P. Singh, neurohospitalist and medical director of neurology at Providence Regional Medical Center - Everett’s Providence Neuroscience Institute - Everett

Clinically reviewed by Darren Crout, PTA, TPI Cert.

What is a urinary tract infection (UTI)?

A urinary tract infection (UTI) is an infection of the urinary system (which includes the kidneys, ureters, bladder and urethra). The majority of UTIs are caused by an infection of the urethra and bladder (also called cystitis). Escherichia coli is the most frequent microbial cause of cystitis (70% to 80% of cases, according to this study).

Who is at risk for UTIs?

UTIs are most common in older adults and in those with a female anatomy. Bacteria that cause UTIs normally inhabit the tissues surrounding the urethral opening – while males do get UTIs, females are at a higher risk of infection due to the shorter distance from the anus to the urethral opening as well as between the urethral opening and the bladder.

Sexual activity, catheter use, diseases that impair the immune system (i.e. diabetes), blockages in the urinary tract (i.e. kidney stones), and recent medical procedures involving the urinary tract (i.e. surgery) are additional risk factors for developing a UTI.

What are the symptoms of a UTI?

Symptoms of a UTI can include pain in the lower abdomen, pelvic area, lower back or upper back; the feeling of needing to urinate urgently and frequently; burning pain while urinating; fever; and urine that appears cloudy and that has a foul smell, according to the Urology Care Foundation.

What is the relationship between UTIs and neurologic events?

Recent research has found that any infection, especially a UTI, may raise the risk of stroke in vulnerable individuals. Risk of suffering a stroke was found to be high in the weeks to months following any infection that required a trip to the hospital, with UTIs showing the strongest link. Patients were five times more likely to have an ischemic stroke in the week following a UTI than in the year preceding it. Risk of hemorrhagic strokes were also found to be increased in association with UTIs.

A UTI’s connection to stroke risk is attributed to the inflammation that infections cause throughout the body. Inflammation increases the risk of the spontaneous formation of blood clots which are the main cause of stroke occurrences. As such, the risk of experiencing a stroke rises after an infection. It is not clear why UTIs show the strongest association with strokes (when compared to respiratory and blood infections).

I think that I may have a UTI – what should I do?

Individuals who are concerned that they may have a UTI should seek care from a health care provider immediately – the earlier that a UTI is treated, the lower the probability is that the patient will experience serious complications. If one has recently been in the hospital for an infection, it is even more important to control stroke risk factors such as high blood pressure and diabetes. Studies have shown that the risk of stroke falls down gradually after the infection is treated.

How are UTIs treated?

Treatment for a UTI is individualized to each patient and is typically reserved for people with symptoms. Choice of treatment includes natural supplements as well as oral and intravenous antibiotics.

How can UTIs and their associated complications be prevented?

Stanford Medicine recommends strategies such as urinating every two to three hours, urinating before and after sexual activity, and drinking plenty of water to aid in UTI prevention.

Additionally, physical therapy treatment with the aim of improving pelvic floor health can greatly contribute to the prevention of a UTI from recurring – or happening in the first place.

Tarvinder P. Singh, M.D. is a neurohospitalist and the medical director of neurology at the Providence Neuroscience Institute - Everett of Providence Regional Medical Center - Everett. To learn more about the Providence Neuroscience Institute or to schedule an appointment with an associated provider, please contact 425.297.6400.

Click here to request an appointment with an IRG therapist specializing in pelvic floor rehabilitation — Washington is a direct access state that allows patients to self-refer to physical therapy. Call 425.316.8046 to learn more about starting the journey back to your best self.