The urinary tract is the body’s drainage system for removing urine, which is made up of wastes and extra fluid. For normal urination to occur, all body parts in the urinary tract need to work together, and in the correct order. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys and ureter make up the upper urinary tract while the bladder and urethra make up the lower urinary tract. The urine produced by the kidneys enters the two ureters on each side which acts like a pipe that drains into the bladder. Urine from the bladder is passed out through the urethra during urination. A urinary tract infection (UTI) occurs when any part of the urinary tract is invaded by microorganisms, causing disease.
According to the WHO, UTI is the leading cause of morbidity and healthcare expenditures in persons of all ages. It occurs more in women than men and an estimated 50% of women report having had a UTI at some point in their lives. It can also occur in children and in the elderly. About 8.3 million office visits and more than 1million hospitalizations, are due to UTI and it accounts for an overall annual health cost of greater than $1 billion.
What causes Urinary Tract Infection (UTI)?
UTIs are usually caused by microorganisms, mostly bacteria that enter the urethra and bladder, causing inflammation and infection. The commonest source of the bacteria causing UTI is often from the feces in the anus. Other organisms like fungus, viruses and protozoa can also cause UTI in less common cases. The bacteria usually reach the urethra from the anus where they cause infection. They easily migrate up to the bladder to cause infection (Cystitis). In more serious cases, they can reach the ureters, and kidneys and cause more serious infections (Pyelonephritis). Women are more predisposed to UTI because they have a shorter urethra than men. Children also have a relatively short urethra and are also susceptible to UTI. Occasionally, the offending organism can reach the urinary system through the blood when there is generalized infection (sepsis).
What are the symptoms of Urinary Tract Infection (UTI)?
A urinary tract infection may not show symptoms but when they do, they cause complaints such as:
- A sudden, strong, persistent urge to urinate
- A burning sensation or pain when urinating (dysuria).
- Needing to urinate more often than usual, including at night.
- Cloudy urine
- Strong of foul smelling urine
- Blood in urine appearing as red, pink, or dark cola colored urine
- Pelvic pain in women
- Fever, chills and irritability, especially in children.
What are the complications of UTI?
Complications of UTI occur when a UTI is untreated or poorly treated. These complications include: recurrent UTIs, bladder dysfunction from the repetitive scarring of the bladder tissue from recurrent UTI, narrowing of the urethra which can cause stricture, especially in men; risk of preterm birth in pregnancy; overwhelming infection (Urosepsis) in children and elderly people, and Kidney failure which may be acute and temporary or become chronic (permanent).
What are the risk factors for Urinary Tract Infection (UTI)?
Some conditions or behaviors make it more likely for microorganisms like bacteria a person more likely to have a UTI. These factors include:
- Being female due to the short urethra
- Being sexually active as bacteria can easily be swept forwards into the female urethra during sex
- Not keeping the genital area clean and dry after defecation
- Being pregnant
- Having conditions that block the free flow of urine in the urinary tract like kidney stones
- Structural issues in the urinary system that impede urine flow or make it flow backwards like the vesicoureteral reflux
- conditions that make emptying the bladder difficult like an enlarged prostate in men and constipation in children.
- Having foreign bodies like urinary catheters in the bladder
- having a weak immune system – for example, people with diabetes, people on chemotherapy, people on medications that suppress immunity like kidney transplant patients,
- some diseases like sickle cell disease, nervous system disorders that make it difficult to empty the bladder effectively.
What are thongs?
Thongs are type of underwear mostly worn by females. When seen from the front, the thong typically resembles a bikini bottom, but at the back the material is reduced to a minimum. Thongs are almost always designed to cover the genitals, anus and perineum and leave part or most of the buttocks uncovered. The back of the garment typically consists of a thin waistband and a thin strip of material, designed to be worn between the buttocks, that connects the middle of the waistband with the bottom front of the garment.
Why do people wear thongs?
Thongs are usually worn to avoid showing of panty lines which is associated with the conventional underwear when one wears body-fitting pants, skirts, or gowns.
It also allows the wearer greater freedom of movement, especially when squatting, bending, jumping.
Also because the buttock/thigh interface is free while wearing thongs, so there is no pinching, no riding-up, and no chafing in that area during movements.
Thongs also have a sex appeal and can be worn to feel sexy, or to please or attract a sexual partner.
Many women report discomfort when they start wearing thongs initially, but this reduces and disappears when one gets used to it.
Do thongs cause UTI?
Based on the above discussion about UTI, it is apparent that thongs in themselves do not cause a UTI. However, some factors associated with thongs can serve as a risk factor for UTI. Women, who are the main people that wear thongs are already predisposed to UTI by reason of their gender because of the anatomy of their genital area. The female urethra lies just about 4.5cm (about 2 inches) front of the anus. This means that the female urethra and anus are in very close proximity. Thongs act in the same way as tight underwear to compress these genital tissues and trap bacteria, making it easier for bacteria from the anus to travel a shorter distance to the urethra, causing a UTI.
If you wear thongs, it is advisable that you keep your genital area clean always by cleaning up very well after defecation with clean tissue, wipes, and you may also want to wash the area after doing your business; Also wipe from front to back after defecation and not the opposite to avoid pushing bacteria into the urethra; try to wash up after sex or at least within 30 minutes after sex; and change your pads regularly during your period. These actions reduce your chances of having a UTI whether you wear thongs or not.
What to do when you have a Urinary Tract Infection (UTI)
When you think you have a UTI, do consult your doctor as it can be very distressing. Antibiotics taken properly easily cures a UTI. Some UTIs may go on their own but it is usually advised to seek professional help from a doctor to prevent complications from occurring.