Urinary Tract Infection (UTI)

What is a urinary tract infection?

When bacteria get into the otherwise sterile parts of the body that form and excrete urine, this is called a UTI. The three most common types of urinary tract infections are:

  • Cystitis (infection of the bladder)
  • Urethritis (infection of urethra)
  • Pyelonephritis (infection of the kidneys)

What causes a urinary tract infection?

Cystitis and pyelonephritis usually are caused by bacteria that are normally found in the colon. These bacteria are spread from the rectum or vagina to the urethra and then to the bladder and kidneys. Urethritis, on the other hand, is caused by sexually transmitted infections such as gonorrhea or chlamydia.

Females are more likely than males to get UTI's because the urethra is located close to the vagina and rectum. Sexual intercourse may be a common cause of UTI's as bacteria can be forced into the urinary tract during intercourse.

What are the symptoms of a urinary tract infection?

  • Burning during urination
  • A frequent urge to urinate
  • Pain in the lower abdomen or pubic area
  • Blood in the urine
  • General malaise (not feeling well), often accompanied by a slight fever.

Pyelonephritis can cause the symptoms associated with cystitis, listed above, as well as pain in the back or side, high fever, chills, nausea and vomiting.

Sometimes a urinary tract infection may cause no symptoms. This is particularly true during pregnancy, when about 4% to 7% of pregnant women have urinary tract infections without symptoms. This is one of the reasons we test a pregnant woman’s urine for the presence of an infection. If present, the infection should be treated as soon as possible.

How is a urinary tract infection diagnosed?

We can often diagnose a UTI just on the basis of your symptoms and a simple test called a urinalysis. If the cause of your infection is not clear, a urine culture may be needed. The culture can tell what type of bacteria is responsible for the infection and which antibiotics will best treat it.

How is a urinary tract infection treated?

A number of very effective antibiotics are available to treat urinary tract infections that are due to bacteria. In some cases of urethritis and simple cystitis, just one dose of an antibiotic can cure the infection. For patients with more severe urinary tract infections, more days of antibiotic treatment may be necessary. Urethritis associated with sexually transmitted diseases or other vaginal infections may require more extensive treatment.

Pyelonephritis usually requires an extended course of antibiotics, or even hospitalization for IV antibiotics.

A hospital stay might also be required for women who are diabetic, pregnant, or who cannot tolerate oral antibiotics.

Is a urinary tract infection dangerous?

Cystitis usually is not dangerous, although it is very uncomfortable. It should be treated so that the bacteria will not spread to the kidneys and cause pyelonephritis. Urethritis must be treated to prevent spread of the disease. UTI during pregnancy is always of concern because it can progress to pyelonephritis or cause premature labor.

Are some women more likely to get a urinary tract infection?

It is estimated that between 10% and 20% of women will experience a UTI at some time in their lives and approximately 80% of women who have one infection will experience another one within a year.

After menopause, women may be more likely to get UTI's due to reduced levels of estrogen. The decrease in estrogen makes skin and tissues more delicate and this, in turn, may make the urinary tract easier for bacteria to infect.

How can I lower my risk of getting a urinary tract infection?

  • Drink plenty of fluids regularly to wash out the bladder. Cranberry juice is a good fluid, and may further help by changing the bacteria’s adhesion to the bladder. Cranberry tablets may also be helpful.
  • Urinate after sexual intercourse
  • Urinate regularly; do not suppress the urge
  • Use a water soluble lubricant during sexual intercourse if necessary for comfort.

Recurrent urinary tract infections

Some women tend to get UTI's repeatedly. If you have this problem, talk to us. Often, suppressive medications or dietary changes will be helpful. Occasionally, referral to a urologist may be necessary.