Urinary Tract Infection

A urinary tract infection (UTI) is an infection in the organs in your urinary tract, which includes the bladder and kidneys. Symptoms depend on the part of the urinary tract affected. A UTI is an infection from microbes. These are organisms that are too small to be seen without a microscope. Most UTIs are caused by bacteria, but some are caused by fungi and, in rare cases, by viruses. UTIs are among the most common infections in humans. Your urinary tract is made up of your:

• Kidneys
• Ureters
• Bladder
• Urethra

Most UTIs only involve the urethra and bladder, in the lower tract. But UTIs can involve the ureters and kidneys, in the upper tract. Although upper tract UTIs are rarer than lower tract UTIs, they’re also usually more severe.

What are the symptoms of UTI?

Symptoms of a UTI depend on what part of the urinary tract is infected.

Lower tract UTI symptoms

Lower tract UTIs affect the urethra and bladder. Symptoms of a lower tract UTI include:

• Burning with urination
• Increased frequency of urination without passing much urine
• Increased urgency of urination
• Bloody urine
• Cloudy urine
• Urine that looks like cola or tea
• Urine that has a strong odor
• Pelvic pain in women
• Rectal pain in men

Upper tract UTI symptoms

Upper tract UTIs affect the kidneys. These can be potentially life threatening if bacteria move from the infected kidney into the blood. This condition, called urosepsis, can cause dangerously low blood pressure, shock, and death. Symptoms of an upper tract UTI include:

• Pain and tenderness in the upper back and sides
• Chills
• Fever
• Nausea
• Vomiting

UTI symptoms in men

Symptoms of an upper tract urinary infection in men are similar to those in women. But men with a lower tract UTI may sometimes also experience rectal pain.

UTI symptoms in women

Women with a lower tract urinary infection may experience pelvic pain. This is in addition to the other common symptoms.

What are UTI causes and risk factors?

Anything that reduces your bladder emptying or irritates the urinary tract can lead to a UTI. There are also many factors that can put you at an increased risk of getting a UTI.

These risk factors include:

• Age (older adults are more likely to get UTIs)
• Reduced mobility after surgery or prolonged bed rest
• Kidney stones
• A previous UTI
• Urinary tract obstructions or blockages, like:
• Enlarged prostate
• Kidney stones
• Certain forms of cancer
• Prolonged use of urinary catheters, which may make it easier for bacteria to get into your bladder
• Diabetes
• Pregnancy
• Abnormally developed urinary structures from birth
• Weakened immune system
• Additional UTI risk factors for men

Most UTI risk factors for men are the same as those for women. But having an enlarged prostate can also increase UTI risk. While it’s widely believed that wiping from back to front after using the bathroom increases the risk of recurring UTIs, older research showed that this isn’t the case. But there are still some risk factors unique to female anatomy. This includes a shorter urethra and the proximity of the urethra to the anus. Penetrative sex may also contribute to UTI. Peeing after sex may help reduce the risk of infection.

Spermicides may increase UTI risk because they can disrupt the vaginal microbiome. Non-lubricated latex condoms may increase friction and irritate the skin during sexual intercourse. This may increase the risk of a UTI. Use a water based gel like ky gel to avoid such friction. After menopause, a decrease in estrogen level changes the normal bacteria in your vagina. This can increase the risk of a UTI.

How is a UTI diagnosed?

To confirm a diagnosis of a UTI, your doctor will need to test your urine for microbes. A urine sample is collected at the middle of your urinary stream, rather than at the beginning. This helps to avoid collecting bacteria or yeast from your skin, which can contaminate the sample. Your doctor will explain to you how to get a clean catch. Your doctor will also do a urine culture to test for bacteria or fungi. The culture can help identify the cause of the infection. It can also help your doctor choose a treatment.

Upper tract UTIs

If your doctor suspects that you have an upper tract UTI, they may also need to do a complete blood count (CBC) and blood cultures, in addition to the urine test. A blood culture can confirm that your infection hasn’t spread to your bloodstream.

Chronic UTIs

Most UTIs go away after treatment. But some people develop chronic UTIs. Chronic UTIs either don’t go away after treatment or keep recurring. Recurrent UTIs are common among women. If you have chronic UTIs, your doctor may want to check for any abnormalities or obstructions in your urinary tract. Here are some common tests:

• An ultrasound is where a device called a transducer is passed over your abdomen. The transducer uses ultrasound waves to create an image of your urinary tract organs that are displayed on a monitor.
• An intravenous pyelogram (IVP) involves injecting a dye into your body that travels through your urinary tract. Then, an X-ray of your abdomen is taken. The dye highlights your urinary tract on the X-ray image.
• A cystoscopy uses a small camera that’s inserted through your urethra and up into your bladder to see inside your bladder. During a cystoscopy, your doctor may remove a small piece of bladder tissue and test it to rule out bladder inflammation or cancer as a cause of your symptoms.
• A computerized tomography (CT) scan gets more detailed images of your urinary system.

UTIs during pregnancy

If you’re pregnant and have symptoms of a UTI, see your doctor right away. UTIs during pregnancy can cause high blood pressure and premature delivery. UTIs during pregnancy are also more likely to spread to the kidneys.

What are some tips to prevent UTI?

Everyone can take the following steps to help prevent UTIs:

• Always pee after sex
• Drink 6 to 8 glasses of water daily.
• Don’t hold urine in for long periods of time.

Talk with your doctor about managing any urinary incontinence or difficulties fully emptying your bladder.

What is the treatment for UTI?

Treatment of a UTI depends on whether it’s:

• Bacterial (most common)
• Viral
• Fungal

Your doctor will be able to determine which it is by looking at your test results. Bacterial UTIs are treated with antibiotics. Viral UTIs are treated with medications called antivirals. Often, the antiviral cidofovir is the choice to treat viral UTIs. Fungal UTIs are treated with medications called antifungals.