Urinary Tract Infection (UTI)
How common are urinary tract infections (UTIs)?
Urinary tract infections (UTIs) are common infections. Many women get them at some point in their lives. Some women have repeat infections and may have them often. But most UTIs are not serious. These infections can be treated with antibiotics, and symptoms can usually be relieved quickly.
What is the urinary tract?
The urinary tract has a lower part and an upper part. The upper urinary tract is made up of the ureters and kidneys. The lower tract is made up of the urethra and the bladder. The organs work together in the following ways:
- The two kidneys produce urine.
- The two tubes called ureters carry urine from the kidneys to the bladder.
- The bladder stores urine.
- The urethra carries urine from the bladder out of the body.
Where do UTIs start?
Most UTIs start in the lower urinary tract. Bacteria enter through the urethra and spread upward to the bladder. This can cause cystitis, a bladder infection. In some cases, an infection of the urethra called urethritis can develop at the same time.
How does a kidney infection start?
Bacteria that have infected the bladder may travel up the ureters to the kidneys. This can cause pyelonephritis, a kidney infection. An infection in the upper tract may cause a more severe illness than infection in the lower tract.
What can cause UTIs?
It’s normal for bacteria from the bowel to live on the skin near the anus or in the vagina. Sometimes these bacteria spread to the area around the urethra. If they move up the urethra, they may cause infections in the bladder and, sometimes, in other parts of the urinary tract.
Do women get UTIs more often than men?
Yes, research shows that women are more likely than men to get UTIs. This is because the urethra is shorter and closer to the anus in a woman than in a man. This means bacteria can reach the bladder more easily.
Can I get a UTI from sex?
The anatomy of women makes them prone to getting UTIs after having sex. The opening of the urethra is in front of the vagina. During sex, bacteria near the vagina can get into the urethra from contact with the penis, fingers, or sex toys.
UTIs tend to occur when you first start having sex or start having it more often. Using spermicide or a diaphragm for birth control can also cause more frequent UTIs.
What else can cause UTIs?
Infections can also develop when the bladder does not empty completely. This may be caused by the following
- A stone in the ureters, kidneys, or bladder that blocks the flow of urine through the urinary tract. Stones develop when minerals in urine stick together and there is not enough fluid to flush them out.
- A narrowed tube in the urinary tract that slows the flow of urine.
- A problem with the nerves or muscles of the pelvis.
What other factors increase the risk of getting a UTI?
You are more likely to get an infection if you
- Have had a UTI before
- Have had several children
- Have diabetes mellitus
- Are going through menopause
- Are pregnant
If you are pregnant and think you may have a UTI, call your obstetrician–gynecologist (ob-gyn) right away. Severe infections can cause problems for both you and your fetus, so it’s important to treat UTIs early.
What are the symptoms of a UTI?
Symptoms of UTIs can come on quickly. One sign is a strong urge to urinate that cannot be delayed (urgency). As urine flows, a sharp pain or burning may be felt in the urethra. The urge to urinate then returns minutes later (frequency). There may be soreness in the lower abdomen, in the back, or in the sides.
How does an infection affect my urine?
If you have a UTI, your urine may
- Have a strong odor
- Look cloudy
- Be tinged with blood
Blood in the urine may be caused by a UTI, but it may also be caused by other conditions. Call your ob-gyn right away if you see blood in your urine.
What are the symptoms of a kidney infection?
If the bacteria enter the ureters and spread to the kidneys, symptoms may include
- Back pain
If you have any of these symptoms, call your ob-gyn right away. Kidney infections are serious. They need to be treated promptly.
Could my symptoms be something else?
Pain when urinating can be caused by other conditions, such as infection of the vagina or vulva. Tests may be needed to confirm the diagnosis of a UTI. Talk with your ob-gyn in detail about your symptoms.
How are UTIs diagnosed?
The diagnosis of a UTI is often made based on symptoms, including pain with urination or frequent urination.
A simple test called urinalysis may show if you have a UTI. For this test, you are asked to provide a urine sample. This sample is studied in a lab to look for white blood cells, red blood cells, and bacteria. The urine sample may also be grown in a culture (a substance that promotes the growth of bacteria) to see which bacteria are present.
What are the steps to provide a urine sample?
For urinalysis, it’s important to provide a clean sample of urine. Your ob-gyn or a nurse should give you a sterile cup and a special wipe. Follow these steps:
- Open the cup and place it at easy reach. Place the cap nearby with the inside lid up.
- Separate the labia with one hand. With the other hand, clean your genital area with the wipe. Wipe from front to back and do not touch or wipe your anus.
- While still holding the labia open, pick up the opened container with your other hand, pass a little bit of urine into the toilet, and catch the rest in the cup. Place the cap back on the cup.
Do not touch the inside of the lid or the inside of the cup at any time. This helps keep the sample from picking up bacteria from your hands.
Why would I need more testing?
You and your ob-gyn may discuss testing to look at your urinary tract if
- Your infection does not clear up with treatment
- You have had several UTIs in a short time
- You have pain, fever, and chills
Your ob-gyn may recommend an ultrasound exam or computed tomography (CT) of the upper urinary tract.
Treatment and Prevention
How are UTIs treated?
Antibiotics are used to treat UTIs. The type, dose, and length of antibiotic treatment depend on the type of bacteria causing the infection and your medical history. A simple UTI rarely leads to infection of the upper urinary tract.
How long do I need to take antibiotics?
In most cases, treatment lasts a few days and is very effective. Most symptoms go away in 1 to 2 days. It’s very important to finish medication prescribed for a UTI, even after your symptoms go away.
What if I have a more severe infection?
For more severe infections, such as a kidney infection, you may need to stay in the hospital. Severe infections take longer to treat, and you may need medication given through an intravenous (IV) line.
What can I do to prevent UTIs?
There are several ways to prevent UTIs:
- Wash the skin around the anus and the genital area.
- Drink plenty of fluids (including water) to flush bacteria out of your urinary system.
- Empty your bladder as soon as you feel the urge or about every 2 to 3 hours.
Should I drink cranberry juice to stop a UTI?
Unsweetened cranberry juice and cranberry pills may decrease the risk of getting a UTI. The exact amount of juice or pills needed and how long you need to take them to prevent infection are being studied.
What does it mean if I get UTIs often?
If you have three or more UTIs in a year or two or more UTIs in 6 months, it is called a recurrent infection. The first step in treatment is finding the cause. Factors that increase the risk of recurrent infection are
- Frequent sex
- Long-term spermicide use
- Diaphragm use
- A new sexual partner
- Young age at first uti
- A history of utis
How are recurrent UTIs treated?
Recurrent infections are treated with antibiotics. A week or two after you finish treatment, a urine test may be done to see if the infection is gone.
How can recurrent UTIs be prevented?
- Changing your birth control method may be recommended.
- A single daily dose of antibiotic may be recommended for 6 to 12 months.
- If you often get UTIs from sexual activity, your ob-gyn may recommend you take a single dose of antibiotic after each time you have sex.
- If you are past menopause, your ob-gyn may recommend vaginal estrogen. This medication is a cream, tablet, or ring that is inserted into the vagina.