Urinary Tract Infections (UTIs)

A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder, and urethra. Most infections involve the lower urinary tract — the bladder and the urethra.

Women are at greater risk of developing a UTI than are men. Infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a UTI spreads to your kidneys.

Doctors typically treat urinary tract infections with antibiotics. But you can take steps to reduce your chances of getting a UTI in the first place.

Symptoms of Urinary Tract Infections

The symptoms of a UTI can include:

  • A burning feeling when you pee
  • A frequent or intense urge to pee, even though little comes out when you do
  • Cloudy, dark, bloody, or strange-smelling pee
  • Feeling tired or shaky
  • Fever or chills (a sign that the infection may have reached your kidneys)
  • Pain or pressure in your back or lower abdomen

Types of Urinary Tract Infections

An infection can happen in different parts of your urinary tract. Each type has a different name, based on where it is.

  • Cystitis (bladder) – You might feel like you need to pee a lot, or it might hurt when you pee. You might also have lower belly pain and cloudy or bloody urine.
  • Pyelonephritis (kidneys) – This can cause fever, chills, nausea, vomiting, and pain in your upper back or side.
  • Urethritis (urethra) – This can cause a discharge and burning when you pee.

Chronic Urinary Tract Infection

If a man gets a UTI, they’re likely to get another. About 1 in 5 women have a second urinary tract infection, and some have them again and again. In most cases, each infection is brought on by a different type or strain of bacteria. But some bacteria can invade your body’s cells and multiply, creating a colony of antibiotic-resistant bacteria. They then travel out of the cells and re-invade your urinary tract.

Chronic Urinary Tract Infection Treatment

If you have three or more UTIs a year, ask your doctor to recommend a treatment plan. Some options include taking:

  • A low dose of an antibiotic over a longer period to help prevent repeat infections
  • A single dose of an antibiotic after sex, which is a common infection trigger
  • Antibiotics for 1 or 2 days every time symptoms appear
  • A non-antibiotic prophylaxis treatment

At-home urine tests, which you can get without a prescription, can help you decide whether you need to call your doctor. If you’re taking antibiotics for a UTI, you can test to see whether they’ve cured the infection (although you still need to finish your prescription).

Causes

Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, these defenses sometimes fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract.

The most common UTIs occur mainly in women and affect the bladder and urethra.

  • Infection of the bladder (cystitis) – This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible. Sexual intercourse may lead to cystitis, but you don’t have to be sexually active to develop it. All women are at risk of cystitis because of their anatomy — specifically, the short distance from the urethra to the anus and the urethral opening to the bladder.
  • Infection of the urethra (urethritis) – This type of UTI can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea, chlamydia and mycoplasma, can cause urethritis.

UTI Tests and Diagnosis

If you suspect that you have a urinary tract infection, go to the doctor. You’ll give a urine sample to test for UTI-causing bacteria.

If you get frequent UTIs and your doctor suspects a problem in your urinary tract, they might take a closer look with an ultrasound, a CT scan, or an MRI scan. They might also use a long, flexible tube called a cystoscope to look inside your urethra and bladder.

Treatments for UTIs

If your physician thinks you need them, antibiotics are the most common treatment for urinary tract infections. As always, be sure to take all of your prescribed medicine, even after you start to feel better. Drink lots of water to help flush the bacteria from your body. Your doctor may also give you medication to soothe the pain. You might find a heating pad helpful.

Cranberry juice is often promoted to prevent or treat UTIs. The red berry contains a tannin that might prevent E. coli bacteria — the most common cause of urinary tract infections — from sticking to the walls of your bladder, where they can cause an infection. But research hasn’t found that it does much to reduce infections.

Experts are also looking at new ways to treat and prevent UTIs, including vaccines and things that boost your immune system.

Prevention

You can take these steps to reduce your risk of urinary tract infections:

  • Drink plenty of liquids, especially water – Drinking water helps dilute your urine and ensures that you’ll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin.
  • Drink cranberry juice – Although studies are not conclusive that cranberry juice prevents UTIs, it is most likely not harmful.
  • Wipe from front to back – Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
  • Empty your bladder soon after intercourse – Also, drink a full glass of water to help flush bacteria.
  • Avoid potentially irritating feminine products – Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.
  • Change your birth control method – Diaphragms, or unlubricated or spermicide-treated condoms, can all contribute to bacterial growth.

How to Prevent UTI Re-Infection

Following some tips can help you avoid getting another UTI:

  • Empty your bladder often as soon as you feel the need to pee; don’t rush, and be sure you’ve emptied your bladder completely.
  • Wipe from front to back after you use the toilet.
  • Drink lots of water.
  • Choose showers over baths.
  • Stay away from feminine hygiene sprays, scented douches, and scented bath products; they’ll only increase the irritation.
  • Cleanse your genital area before sex.
  • Pee after sex to flush out any bacteria that may have entered your urethra.
  • If you use a diaphragm, unlubricated condoms, or spermicidal jelly for birth control, you may want to switch to another method. Diaphragms can increase bacteria growth, while unlubricated condoms and spermicides can irritate your urinary tract. All can make UTI symptoms more likely.
  • Keep your genital area dry by wearing cotton underwear and loose-fitting clothes. Don’t wear tight jeans and nylon underwear; they can trap moisture, creating the perfect environment for bacteria growth.

Risk factors

Urinary tract infections are common in women, and many women experience more than one infection during their lifetime. Risk factors specific to women for UTIs include:

  • Female anatomy – A woman has a shorter urethra than a man does, which shortens the distance that bacteria must travel to reach the bladder.
  • Sexual activity – Sexually active women tend to have more UTIs than do women who aren’t sexually active. Having a new sexual partner also increases your risk.
  • Certain types of birth control – Women who use diaphragms for birth control may be at higher risk, as well as women who use spermicidal agents.
  • Menopause – After menopause, a decline in circulating estrogen causes changes in the urinary tract that make you more vulnerable to infection.

Other risk factors for UTIs include:

  • Urinary tract abnormalities – Babies born with urinary tract abnormalities that don’t allow urine to leave the body normally or cause urine to back up in the urethra have an increased risk of UTIs.
  • Blockages in the urinary tract – Kidney stones or an enlarged prostate can trap urine in the bladder and increase the risk of UTIs.
  • A suppressed immune system – Diabetes and other diseases that impair the immune system — the body’s defense against germs — can increase the risk of UTIs.
  • Catheter use – People who can’t urinate on their own and use a tube (catheter) to urinate have an increased risk of UTIs. This may include people who are hospitalized, people with neurological problems that make it difficult to control their ability to urinate and people who are paralyzed.
  • A recent urinary procedure – Urinary surgery or an exam of your urinary tract that involves medical instruments can both increase your risk of developing a urinary tract infection.

Complications

When treated promptly and properly, lower urinary tract infections rarely lead to complications. But left untreated, a urinary tract infection can have serious consequences.

Complications of a UTI may include:

  • Recurrent infections, especially in women who experience two or more UTIs in a six-month period or four or more within a year.
  • Permanent kidney damage from an acute or chronic kidney infection (pyelonephritis) due to an untreated UTI.
  • Increased risk in pregnant women of delivering low birth weight or premature infants.
  • Urethral narrowing (stricture) in men from recurrent urethritis, previously seen with gonococcal urethritis.
  • Sepsis, a potentially life-threatening complication of an infection, especially if the infection works its way up your urinary tract to your kidneys.

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