Urinary tract infections

A urinary tract infection (UTI) is a bacterial infection in any part of your urinary system, which consists of the kidneys, ureters, bladder and urethra. Most UTIs happen in the bladder and urethra.

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Causes and types of UTIs

Most urinary tract infections are caused from bacteria that enter the urinary tract through the urethra and multiply in the bladder, growing into an infection in the urinary tract. Left untreated, a UTI can lead to complications such as a kidney infection (pyelonephritis), which can be serious.

The most common UTIs happen in women and affect the bladder and urethra:

  • Infection of the bladder (cystitis). Usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract.
  • Infection of the urethra (urethritis). Usually occurs when GI bacteria spreads from the anus to the urethra, but this can also be caused by sexually transmitted diseases (STDs) like herpes, gonorrhea, chlamydia and mycoplasma.

Men can get a UTI – usually cystitis – but not as often as women.

Women are at a higher risk due to several factors, especially their anatomy—the short distance from the urethra to the anus and the urethral opening to the bladder.

Urinary tract infections are not contagious, but the bacteria that causes them can be spread during sexual intercourse.

Signs and symptoms of urinary tract infections

(and when to see your primary care provider)

In rare cases, a UTI causes no symptoms. However, in most cases common symptoms can include:

  • Burning feeling when urinating.
  • Strong, persistent urge to urinate.
  • Frequent, small amounts of urine.
  • Urine that appears cloudy.
  • Urine that appears red, bright pink or brownish.
  • Strong-smelling urine.
  • Pelvic pain in women, especially in the center of the pelvis and around the area of the pubic bone.

You should see your primary care provider right away if you have any of these symptoms. Your provider can determine if you have a UTI with a medical history, physical exam and a urine test.

Based on the type of UTI you have and your symptoms, your provider will personalize the best treatment plan for you.

How women get UTIs

In addition to a woman’s anatomy and shorter urethra, there are several other risk factors for women and UTIs:

  • Diabetes. Can lower your immune system and cause nerve damage, making it hard to completely empty your bladder.
  • Kidney stones. They can block the flow of urine between your kidneys and bladder.
  • Menopause. Loss of estrogen causes changes in vaginal tissue, making bacterial growth easier.
  • Pregnancy. Pregnancy hormones can change bacteria in the urinary tract, and many pregnant women have trouble completely emptying the bladder, leaving behind bacteria.
  • Sexual activity. Can spread bacteria that cause UTIs around the genital area.
  • Spermicides with or without a diaphragm. Can kill good bacteria that protect you from UTIs.

Treating a UTI

Your provider’s personalized treatment plan for you will guide you through at-home remedies to help alleviate symptoms, and may also include prescription antibiotics to get rid of the bacteria causing the type of UTI you have.

Your plan might include:

  • Antibiotics. These are often the first line of treatment for simple UTIs. For a complicated UTI, your provider may prescribe a fluoroquinolone medicine.
  • Heating pad on your back or abdomen that may help you manage pain.
  • Hydration. Drinking a lot of liquids will help you urinate often to speed healing. Water is best.
  • Over-the-counter (OTC) pain relievers.

For frequent UTIs

If you experience frequent UTIs, your provider may adjust your treatment plan by prescribing:

  • Low-dose antibiotics. Initially for 6 months but sometimes longer.
  • A single dose of antibiotic after sexual intercourse, if your infections are related to sexual activity.
  • Vaginal estrogen therapy if you are postmenopausal.

Preventing a UTI

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

  • Avoid potentially irritating feminine products. Using anything in the genital area can irritate the urethra.
  • Change your birth control method. Diaphragms, unlubricated or spermicide-treated condoms can all contribute to bacterial growth.
  • Drink cranberry juice. Plus lots of other liquids too, especially water, to help flush out your bladder frequently.
  • Urinate shortly after intercourse. Also, drink a full glass of water to help flush bacteria.
  • Wear loose-fitting clothing when possible. Air can keep the area around your urethra dry.
  • Women and girls should wipe from front to back. This helps prevent bacteria in the anal region from spreading to the vagina and urethra.

A UTI is not likely to damage your urinary tract if you treat it. However, if left untreated, the infection can spread to your kidneys and beyond. Your primary care provider is ready to help you with any treatment you might need to keep a UTI from interfering in your life anymore.

References

Center for Disease Control and Prevention (CDC). Urinary Tract Infection (https://www.cdc.gov/antibiotic-use/uti.html)

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Bladder Infection (Urinary Tract Infection—UTI) in Adults (https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-infection-uti-in-adults)

MedlinePlus: National Library of Medicine. Urinary Tract Infections (https://medlineplus.gov/urinarytractinfections.html)