Urinary tract infection (UTI) is an infection in any part of your urinary system. The following article will review the essentials of it.
Urinary tract infections are the most common bacterial infection in women. They also affect men, but the proportion is 4:1. The most affected age group are young patients between 16 and 35 years old. Around 10% will get a UTI a year, and approximately 40%-60% will get one at some point in life. Recurrent UTIs are common, with half of the people getting a second infection in less than a year.
In this article, you will find everything you need to know about urinary tract infections, from what causes them and their symptoms to the treatment and how to prevent them. A trained doctor will explain everything, that will answer everything with simple words. So, keep reading, and you will find everything you need about this common condition.
What is a urinary tract infection?
Urinary tract infection (UTI) is a prevalent infectious disease. It is an infection that happens in any part of your urinary system. The main function of the urinary tract is to get the urine outside of your body. This system includes the following organs: the kidneys, the ureters, the bladder, and the urethra. Therefore, these organs have direct communication to the outer world. This makes it easy for different microorganisms to get inside your body and cause harm. Depending on which organ is affecting, urinary infections can be: upper urinary tract infection and lower urinary tract infection.
When the infection affects the kidneys (pyelonephritis), it’s considered an upper urinary tract infection. On the other side, when the UTI affects the bladder, it’s a lower urinary tract infection (cystitis).
Furthermore, urinary tract infections can be classified into complicated UTI and uncomplicated UTI. A complicated UTI occurs in a urinary tract that has a structural or functional abnormality. Conversely, an uncomplicated UTI occurs in a urinary tract with no abnormalities. This classification is essential to establish the treatment and prognosis (possible outcomes) of the UTI.
What causes a urinary tract infection?
The main cause of a urinary tract infection is the presence of harmful microorganisms in the urinary tract. UTI can be caused by bacteria, fungi, and even viruses (very rare). Bacterial UTI is the most common form of urinary infection. Usually, UTI is mainly caused by bacteria from the feces. These bacteria enter through your urethra (which is the tube that connects the bladder with the outside world) and can easily get to the bladder or the kidneys. The most common bacteria to cause UTIs is Escherichia coli, present in human feces.
Moreover, many risk factors make you prone to develop a urinary tract infection. You have a higher risk of urinary infections if you:
- Have a sexual activity or intercourse
- Don’t fully empty your bladder while peeing
- Being female: They have a shorter urethra than men, making it easier for bacteria to reach the urinary tract
- Have a urinary catheter: Any foreign object can cause infections
- Suffer from kidney stones or enlarged prostate: Any type of obstruction can cause a UTI
- Have a weakened immune system: Any condition that impairs your immune system makes you more likely to have infections
- Have other diseases, such as diabetes
- Suffer from recurrent urinary tract infections
What causes urinary tract infections, and are men at risk for getting them?
It is an infection of the urinary system, mostly causing bladder infection or kidney infection. A bacteria (Escherichia coli) causes the vast majority of the cases.
Yes, several risk factors are in association with an increase in urinary tract infection diagnosis such as sexual activity, female patients, not having a full empty of the bladder while urination, vaginal infections, placement of a urinary catheter, having surgery, older age, other diseases (as diabetes), and recurrent urinary tract infections. Even though most cases of urinary tract infection are from females, males can have it too, and often are complicated ones.
Why do women get urinary tract infections more often than men?
If you are a female, it is highly probable to get at least one UTI throughout your life. By the age of 32 years, half of the women report having at least one UTI. Also, among young and healthy women with UTI, the infection recurs in 30% of the cases within six months. There’s gotta be a cause.
In specific periods of life, an increase in UTI has been described, such as childhood, honeymoon, pregnancy, and elderly. It is multifactorial, indeed. Firstly, the canal where the urine emerges (the urethra) is way shorter in females than in males. An average male urethra length about 8 inches, while women just 1,5 inches. Therefore, it is more manageable for bacteria to ease the female urinary tract than for the male. This anatomical variance predisposes to other risk factors. The other two most important are hormonal changes and sexual habits.
Sexual intercourse with the use or not of spermicides, new sex partners, are important determinants. Also, in critical periods of female life, the hormonal changes (basically lower estrogen) predispose to exponential bacteria growth. The elderly population is even more vulnerable due to its deteriorating hormonal condition, which can cease with the right hormonal treatment.
How severe can this urinary infection be?
Depending on the location of the infection, the name and impact would vary. There are two significant definitions for this infection, cystitis (bladder infection) and pyelonephritis (kidney infection). The former is an infection of the lower urinary tract, including the urethra and bladder. In comparison, pyelonephritis involves the higher urinary tract as kidneys. The severity of the disease indeed varies upon the location, being the higher structures associated with a more severe infection.
The urinary tract infection classification also depends upon the severity and frequency. The names are complicated and uncomplicated urinary tract infections. Uncomplicated UTI mostly relies on urinary bladder infection in females with no severe symptoms. On the contrary, complicated UTI is extensive. Any male urinary tract infection, severe UTI symptoms, presence of another risk factor with the disease as an indwelling catheter, and more are considered complicated infections.
In terms of frequency, repetitive infection of the urinary tract is also named differently as a recurrent urinary infection. These classifications are important because they would take place later in the medical management and treatment of the disease.
All urinary infections are the same?
It is crucial to see that urinary tract infection is not always the same as having bacteria in the urine sample. The term for the latter situation is “asymptomatic bacteriuria.” this asseveration means that even though bacteria present in your urine samples, sometimes it is not enough to call it an infection. A minimum number of bacteria need to be present in some exams that would be explained further for accurate diagnosis of urinary disease, hence, receiving antibiotics. However, there is only one scenario where bacteria in the urine get treatment, which is in pregnant women to protect them from possible complications.
What are the symptoms of urinary tract infections?
A urinary tract infection can cause many different symptoms. It is not the same for everyone, and it can be different in upper and lower UTIs. The most common symptoms of urinary tract infections include:
- Dysuria: It’s the most common UTI symptom. It is a painful, stinging, or burning sensation that happens while you pee. It’s the most common symptom and a sign of lower UTI.
- Fever: usually with shivers.
- Sudden urgency to pee.
- Peeing more frequently than usual.
- Blood in your urine.
- Urine with a strong smell and more intense color.
- Feeling that you still have to pee, even if you just did it.
- Nocturia: Increased need to pee during the night while you are sleeping.
- Lower abdominal pain or back pain.
- Nausea and vomiting.
What is dysuria?
Dysuria or painful urination is a symptom mostly occurring in people with UTI, either male or female. It is a burning, tingling, or stinging of the urethra and meatus associated with urination. It is different from other forms of pain that typically increase with the bladder filling and decrease with urination (bladder emptying). A notable percentage of 3% of the adults older than 40 years have dysuria at least occasionally. Also, acute cystitis is the most common cause of dysuria in women accounting for nearly 9 million outpatient medical visits in 2007.
However, dysuria isn’t always present in patients with UTI. It would ultimately depend on the characteristics of the patient. But it is the most prevalent for sure.
What is the prognosis of a urinary tract infection?
In the big majority of cases, the prognosis or possible outcomes in UTIs are excellent. Most of the cases will improve with the proper medical treatment. In fact, most of your symptoms will disappear even after two days of treatment. However, like any other disease, it can lead to complications if left untreated. The most common complications of an untreated UTI include:
- Kidney damage: It can be permanent as a result of acute or chronic kidney infection.
- Recurrent infections: Considered when a patient suffers from two episodes of UTI in less than six months, or four within a year.
- Premature birth or low birth weight in pregnant women.
- Sepsis: If the infection gets to your blood, it can affect other organs and cause death.
You must know that complicated urinary tract infections have a higher risk of any of these complications. This is why most of these cases will need close medical surveillance to avoid bad outcomes.
On the other side, uncomplicated urinary tract infections are most likely to get better shortly after treatment.
What are other possible causes of painful urination?
UTI, specifically cystitis, is the most common cause of dysuria. But other infectious and non-infectious causes are also an option. The most common contagious causes include urethritis, sexually transmitted infections, and vaginitis. While the non-infectious would mostly have inflammatory conditions such as dermatologic diseases or foreign bodies within the tract.
Furthermore, non-infectious and non-inflammatory causes could also take place and be very common. The local trauma of the glans, particular medication use, and other rarer conditions as a variation of tract structure or bladder pain syndrome are other possible options.
How does urinary tract infection affect children?
UTI is ubiquitous and a challenge for children aging less than two years. It may represent the first step to recognize an underlying anomaly in the urinary tract formation (the most common is vesicoureteral reflux). If recurrent bacterial UTI occurs, it can lead to kidney damage and chronic kidney disease.
Early and correct diagnosis of febrile infants is core. Then, they could have a referral to a nephrologist that would perform an accurate kidney function assessment.
How does urinary tract infection affect the elderly?
Both UTI and the asymptomatic presence of bacteria in the urine are prevalent among the elderly and represent a significant economic and healthcare burden. UTI represents nearly a sixth of the hospitalizations in people over 65 years. It is also the cause for 6% of the deaths by infectious diseases.
The symptoms in the elderly could be mild or unnoted, for that it is often a difficult task to diagnose this infection in this particular population. The complete assessment is a priority, mostly in people carrying a urinary catheter or post-menopausal women.
When should people get medical care for a UTI?
People should always get medical care for UTI. It is vital that a doctor sees your symptoms and indicates the proper laboratory test for diagnosis. After an accurate diagnosis, a doctor is the only person that can indicate the right treatment for the infection. Even if you already know you have a UTI, let a doctor prescribe the ideal treatment for you. Under no circumstances should you recur to auto medication.
How is a UTI diagnosed?
If you think you have a UTI, you should go to the doctor. A trained physician will ask about the symptoms you have and your medical history. Then, they will perform a physical examination. The focus in the physical examination will be the abdomen and the back, looking for painful spots. After this, a doctor can suspect a urinary tract infection. However, to diagnose it, they will ask for some studies.
The most useful study for UTI diagnosis is a urinalysis or a simple urine sample. This lets doctors see if there are red or white blood cells and bacteria in the sample. The leukocyte esterase is also an important parameter to diagnose a UTI. There is a specific method in which you should take the sample to assure the right diagnosis.
Moreover, doctors may ask for a urine culture. With the urine specimen, doctors culture it and wait for it to grow bacteria. This helps the doctor identify the bacteria causing the infection and give you specific treatment. Some patients, especially the ones with frequent urinary tract infections, may need imaging studies. Doctors do this because sometimes, a structural abnormality is the cause of UTIs. The most helpful imaging studies are ultrasounds, CT scans, and MRIs. Sometimes, doctors may even use contrast to highlight the structures of the urinary tract.
What are the steps to provide a urine sample?
Recollecting a urine sample is simple, but there are a few details that you should keep an eye on:
- You will need a sterile, screw-top container. This will be identified with your personal information.
- You have to wash your hands before taking the sample to avoid contamination.
- You should clean your genitals with an antiseptic solution or antiseptic towel. Sometimes, this is not possible to do.
- You will start to pee for a few seconds and will collect a mid-stream urine sample. You will proceed to take the sample. This means that you won’t get any of the first or last parts of the urine in the container.
- You’ll close the container’s lid and rewash your hands.
You should hand out your urine sample within the first hour after taking it. If you can’t do this, then you should keep it in the fridge. This will prevent that other bacterium grow in the sample, giving you a mistaken diagnosis.
You must follow these steps carefully. It is the only way to ensure that the sample won’t be contaminated with bacteria from your hands or genitals.
How do health care professionals treat a urinary tract infection?
Once doctors have a definite diagnosis of UTI, they can decide on treatment. Most of the time and uncomplicated urinary tract infections can receive outpatient treatment. Since bacteria cause most UTIs, the first-line treatment is antibiotics. The decision of which antibiotic to use depends on the bacteria causing the infection. Also, it will depend on the specific conditions of the patient. For example, pregnant women may receive a different antibiotic than non-pregnant women. The most common antibiotics doctors use to treat UTIs are:
- Quinolones (like ciprofloxacin)
It is also vital that you know that the treatment is different in uncomplicated and complicated UTIs. Patients with complicated UTIs may need hospitalization for close medical surveillance and IV treatment.
Furthermore, the presence of bacteria in the urine sample is not always treated. This is what doctors call asymptomatic bacteriuria. This means that there are bacteria in the urine sample, but they are not causing symptoms. For healthy individuals, this will not require treatment. On the other side, pregnant women with asymptomatic bacteriuria will need to take antibiotic treatment.
What kinds of doctors treat urinary tract infections?
Almost any doctor can treat a urinary tract infection. Your family doctor or your primary care physician is more than qualified to treat this condition. However, if you suffer from frequent UTIs, you may have to be referred to another doctor.
Some doctors specialize in urinary disorders, called urologists. Besides, there are other doctors specialized in kidney disorders, the nephrologists. An evaluation from these, more specialized doctors can be useful in specific cases. For example, if you have kidney stones blocking your urinary tract, you can suffer from UTIs. But you may have to get surgery to remove them. This is when the urologist comes in. Also, urologists have more experience in detecting structural or functional abnormalities of the urinary tract. A patient who suffers from complicated UTIs will benefit more from a urologist than from a family doctor.
How long do you need to take antibiotics?
The duration of antibiotic treatment is variable. This depends on the patient’s condition, the bacteria causing the infection, and the antibiotic used. If you receive outpatient treatment, the duration of oral antibiotics can go anywhere from 5 to 14 days.
On the other side, you may receive more extended treatment periods if you have a complicated UTI. In fact, you may even have to receive IV treatment. This may also take from 7 days to two or three weeks, depending on the severity of the infection. Patients with IV treatment may also get two types of antibiotics at the same time to fight the infection.
You must know that you should continue the treatment for as long as your doctor indicated, even if you start feeling better after a couple of days. If you stop the treatment because you are already feeling better, you may experience a new UTI in a short time. Also, not completing antibiotic treatment can lead to bacterial resistance. This means that bacteria get stronger and don’t die with the same antibiotic as before.
How do you avoid getting urinary tract infections?
Hopefully, there are many tips you can put into practice to avoid getting UTIs. These are easy to follow and really help avoid this uncomfortable condition.
- Increase your liquid intake (especially water): This way, your urine will be more diluted, and you will pee more frequently. This will help flush potentially harmful bacteria out of your urinary tract, preventing infections.
- After peeing, wipe from front to back: Since women’s urethra is shorter than men’s, they need to be extra careful. When wiping from front to back, you prevent bacteria from your anus from getting to your urethra.
- Pee frequently: As we mentioned before, to help flush bacteria out of your urinary tract.
- Empty your bladder after intercourse: Sexual activity is a risk factor for UTIs. Try peeing right after you had sex to prevent this from happening.
- Drink cranberry juice or cranberry supplements: It is not confirmed yet, but several studies show that cranberry can prevent UTIs. This happens because it doesn’t let harmful bacteria stick to your urinary tract tissue.
What can be done for women that get repeated UTIs?
Like we mentioned before, women are much more likely to develop UTIs. This happens because their urethra is much shorter than men’s. This results in an easier a quicker way for bacteria to get to the urinary tract. Besides, women are much more likely to develop recurrent urinary tract infections. There are several ways to prevent this from happening, some more effective than others. Additional to the ones we mentioned before, women can prevent recurrent UTIs by:
- Avoiding irritating feminine products: Vaginal douches and powders can irritate the urethra and change the pH of your genital area. This results in a higher reproduction rate of the bacteria, promoting UTIs.
- Change birth control methods: Some methods like diaphragms and spermicide-treated condoms can increase bacterial growth.
- Medical treatment: Sometimes, your doctor can prescribe antibiotics with specific schemes to prevent recurrent UTIs. Sometimes you’ll need to take antibiotics two days apart after having intercourse or right when symptoms start to appear.
How do I know if I have the infection?
This tool is a Urinary Infection Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for the infection. Therefore, the tool will tell about the likelihood of your symptoms being because of a urinary infection.