Urinary Tract Infections

Urinary tract infections or UTIs are infections in any part of the urinary tract. They are a common health problem that affects millions of people each year. Women are especially prone to UTIs.

A UTI may affect any part of the urinary tract causing:

• Urethritis. This is an infection of the urethra, the hollow tube that carries urine from the bladder to the outside of the body.
• Cystitis. This is an infection in the bladder from germs that have moved up from the urethra.
• Pyelonephritis. This infection of the kidneys is most often a result of an infection that has spread up the urinary tract, or from a blockage in the urinary tract. A blockage causes urine to back up into the ureters and kidneys.
• Abscess. A collection of pus along the course of the urinary tract is called an abscess.

What causes urinary tract infections?

Normal urine is sterile and contains fluids, salts, and waste products. It does not contain bacteria, viruses, or fungi. A UTI occurs when germs, most often bacteria from the digestive tract, get into the opening of the urethra and start to multiply.

Most UTIs are caused by E. coli bacteria, which normally live in the colon.

What are the symptoms of a urinary tract infection?

These are the most common symptoms of a UTI:

• Frequent urination
• Pain or burning when passing urine
• Fever
• Urine looks dark, cloudy, or reddish in color (blood may be present in the urine)
• Urine smells bad
• Feeling pain even when not urinating
• Tiredness
• Pain in the back or side, below the ribs
• Nausea and/or vomiting
• Despite an strong urge to urinate, only a small amount of urine is passed
• Women may feel an uncomfortable pressure above the pubic bone

The symptoms of UTI may look like other conditions or medical problems. Always see a health care provider for a diagnosis.

How are urinary tract infections diagnosed?

Your doctor will review your medical history and do a physical exam. Other tests may include:

• Urinalysis. Lab testing of urine is done to check for various cells and chemicals, such as red and white blood cells, germs (like bacteria), or a lot of protein.

If UTIs become a repeated problem, other tests may be used to see if the urinary tract is normal. These tests may include:

• Intravenous pyelogram (IVP). This is a series of X-rays of the kidney, ureters (the two tubes that connect the kidneys to the bladder), and bladder. It uses a contrast dye injected into a vein. This can be used to find tumors, structural abnormalities, kidney stones, or blockages. It also checks blood flow in the kidneys.
• Cystoscopy. In this test, a thin, flexible tube and viewing device is put in through the urethra to examine the bladder and other parts of the urinary tract. Structural changes or blockages, such as tumors or stones can be found.
• Kidney and bladder ultrasound. This imaging test uses high-frequency sound waves to make images of the bladder and the kidneys on a computer screen. The test is used to determine the size and shape of the bladder and the kidneys, and check for a mass, kidney stone(s), cysts, or other blockages or abnormalities.

How are urinary tract infections treated?

Your health care provider will figure out the best treatment based on:

• How old you are
• Your overall health and medical history
• How sick you are
• How well you can handle specific medications, procedures, or therapies
• How long the condition is expected to last
• Your opinion or preference

Treatment for UTIs may include:

• Antibiotics
• Other medications to ease pain
• Heat (such as heating pad) to ease pain

You may also need to make lifestyle changes such as:

• Drinking plenty of water to help wash bacteria out of the urinary tract
• Avoiding coffee, alcohol, and spicy foods
• Quitting smoking

Can urinary tract infections be prevented?

These steps may help reduce the chance of getting UTIs:

• Drink plenty of water every day.
• Drink cranberry juice. Large amounts of vitamin C limit the growth of some bacteria by acidifying the urine. Vitamin C supplements have the same effect.
• Urinate when you feel the need. Do not wait.
• Females, wipe from front to back to keep bacteria around the anus from going in the vagina or urethra.
• Take showers instead of tub baths.
• Clean the genital area before and after sex, and urinate shortly after sex.
• Women should not use feminine hygiene sprays or scented douches.
• Cotton underwear and loose fitting clothes help keep the area around the urethra dry. Tight clothes and nylon underwear trap moisture. This can help bacteria grow.
• Repeated bouts of urinary tract infections can be treated with small doses of regular antibiotics.

Please consult your health care provider with any questions or concerns you may have about UTIs.

Key points about urinary tract infections

• Urinary tract infections (UTIs) are a common health problem that affects millions of people each year. These infections can affect any part of the urinary tract.
• Most UTIs are caused by E. coli bacteria, which normally live in the colon.
• The most common symptoms of UTIs include changes in urination such as frequency, pain, or burning; urine looks dark, cloudy, or red and smells bad; back or side pain; nausea/vomiting; and fever.
• Antibiotics are used to treat UTIs. Other treatments may include pain relievers, and drinking plenty of water to help wash bacteria out of the urinary tract.
• Other things that can be done may help reduce the likelihood of developing UTIs.

Next steps

Tips to help you get the most from a visit to your health care provider:

• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.