- Signs You Have Bladder Infection: Symptoms, Diagnosis, & Treatment
- Urinary tract infection: Causes, symptoms, and prevention
- Risk factors
- Recurrent infections in women
- Bladder infection: Causes, treatments, and remedies
- Cranberry juice
- Bladder Infection Treatment, Causes & Symptoms During Pregnancy
- Bladder Infections: UTI Causes, Symptoms, Treatments
Signs You Have Bladder Infection: Symptoms, Diagnosis, & Treatment
- Diagnosis and Treatment
By your 10th trip to the bathroom in 2 hours, you might wonder if you have a bladder infection. And you may be right, especially if it hurts, burns, or stings when you pee.
Bladder infections are the most common type of urinary tract infection (UTI). They’re caused by bacteria and lead to problems pain in your lower belly and having to pee way more often than usual.
Your doctor can do some simple tests to find out if you have one, and they’re usually easy to treat. If you get bladder infections often, your doctor may want to do more some advanced tests to find the cause.
Your doctor will first do a physical exam and talk to you about your symptoms. That may be enough to find out whether you have one.
If not, you’ll get a urine analysis. This is a test that checks for bacteria, blood, or pus in a sample of your pee. Your doctor may also run a urine culture to find out which bacteria are causing your infection.
Getting a bladder infection once in a while may be a bother, but it’s not usually a serious health concern. Sometimes, though, it’s important to know the cause of the infection, because medicine alone may not be enough to treat it.
You may get more advanced tests if you belong to one of these groups:
- Men (Because they tend not to get bladder infections, it could be a sign of something else.)
- People who have kidney damage
- Women who get three or more bladder infections in a year or have blood in their urine
To find the cause of a bladder infection, your doctor can use:
- Cystoscopy. Your doctor inserts a cystoscope – a thin tube with a camera — into your urethra to look for problems or to get a tissue sample for more testing (biopsy).
- Imaging. An ultrasound, CT scan, and MRI can show tumors, kidney stones, and other issues.
- Intravenous urogram (IVU). This is an X-ray that uses contrast dye to take images of the kidneys, ureters, and bladder.
- Voiding cystourethrography. Your doctor puts a dye into your bladder to see if any urine flows backward from the bladder toward the kidneys.
- Retrograde urethrography. This test uses contrast dye to find problems in the urethra.
A mild bladder infection may go away on its own within a few days. If it doesn’t, it’s usually treated with antibiotics. You usually start to feel better in a day or so, but be sure take all the medicine as directed.
Women with a basic infection usually take antibiotics for 3 to 7 days, though some doctors may give you an antibiotic you can take just once. For stronger infections, or if you get them often, you may take antibiotics for 7 to 10 days. And, if you have another health condition, such as diabetes, you may get a stronger antibiotic to take over a longer time.
For women past menopause, your doctor may also suggest a vaginal cream with estrogen, if it’s safe for you.
For men who have a bladder infection caused by a prostate infection, you may be on antibiotics for several weeks.
Your doctor may also give you medicine to help with symptoms such as pain or the constant urge to pee.
Here are some things you can do at home to get relief:
- Avoid having sex.
- Drink lots of water, but avoid alcohol, caffeine, and spicy foods. They can all make your symptoms worse.
- Take a pain reliever.
- Try a 15- to 20-minute soak in a warm bath.
- Use a heating pad on your lower belly.
National Health Service (U.K.): “Cystitis.”
Victoria State Government (Australia), Better Health Channel: “Cystitis.”
KidsHealth: “Urinary Tract Infections.”
Merck Manual: “Bladder Infection (Cystitis).”
Mayo Clinic: “Cystitis.”
© 2019 WebMD, LLC. All rights reserved. Prevention
Urinary tract infection: Causes, symptoms, and prevention
If you buy something through a link on this page, we may earn a small commission. How this works.
Urinary tract infections are caused by microbes such as bacteria overcoming the body’s defenses in the urinary tract. They can affect the kidneys, bladder, and the tubes that run between them.
They are one of the most common types of infection and account for around 8.1 million visits to a doctor every year.
The urinary tract can be divided into the upper urinary tract and the lower urinary tract. The upper urinary tract consists of the kidneys and the ureters, and the lower urinary tract consists of the bladder and the urethra.
- Women have a lifetime risk of over 50 percent of developing a urinary tract infection (UTI).
- Common symptoms include a strong, frequent urge to urinate and a painful and burning sensation when urinating.
- A UTI is usually diagnosed symptoms and testing of a urine sample.
- UTIs can be cured with 2 to 3 days of treatment.
- Cranberry extracts do not treat UTIs but may help reduce the risk of recurrent UTI.
Share on PinterestMany people will experience UTIs in their lifetime.
The vast majority of urinary tract infections (UTIs) are caused by the bacterium Escherichia coli (E. coli), usually found in the digestive system. Chlamydia and mycoplasma bacteria can infect the urethra but not the bladder.
UTIs are given different names depending on where they occur. For example:
- A bladder infection is called cystitis.
- A urethra infection is called urethritis.
- A kidney infection is called pyelonephritis.
The ureters are very rarely the site of infection.
Over 50 percent of all women will experience at least one UTI during their lifetime, with 20 to 30 percent experiencing recurrent UTIs.
Pregnant women are not more ly to develop a UTI than other women, but if one does occur, it is more ly to travel up to the kidneys. This is because changes in the body during pregnancy that affect the urinary tract.
As a UTI in pregnancy can prove dangerous for both maternal and infant health, most pregnant women are tested for the presence of bacteria in their urine, even if there are no symptoms, and treated with antibiotics to prevent spread.
People of any age and sex can develop a UTI. However, some people are more at risk than others. The following factors can increase the lihood of developing a UTI:
- sexual intercourse, especially if more frequent, intense, and with multiple or new partners
- poor personal hygiene
- problems emptying the bladder completely
- having a urinary catheter
- bowel incontinence
- blocked flow of urine
- kidney stones
- some forms of contraception
- procedures involving the urinary tract
- suppressed immune system
- immobility for a long period
- use of spermicides and tampons
- heavy use of antibiotics, which can disrupt the natural flora of the bowel and urinary tract
The symptoms of a UTI can depend on age, gender, the presence of a catheter, and what part of the urinary tract has been infected.
Common symptoms of a UTI include:
- strong and frequent urge to urinate
- cloudy, bloody, or strong-smelling urine
- pain or a burning sensation when urinating
- nausea and vomiting
- muscle aches and abdominal pains
People with catheters may only experience fever as a symptom, making diagnosis more difficult.
Acute pyelonephritis is a sudden and severe kidney infection. If an individual develops this condition they could also experience upper back and side pain, high fever, shaking, chills, fatigue, and mental changes. It is considered an emergency and should be evaluated by a doctor immediately if suspected.
If a person has a bladder infection, they could also experience low fever, and pressure and cramping in the abdomen and lower back.
Most UTIs are not serious, but some can lead to serious problems, particularly with upper UTIs.
Recurrent or long-lasting kidney infections can cause permanent damage, and some sudden kidney infections can be life-threatening, particularly if bacteria enter the bloodstream in a condition known as septicemia.
They can also increase the risk of women delivering infants that are premature or have a low birth weight.
Share on PinterestTaking showers instead of baths can help prevent UTIs.
There are several measures that can be taken to reduce the risk of developing a UTI:
- Drink lots of water and urinate frequently.
- Avoid fluids such as alcohol and caffeine that can irritate the bladder.
- Urinate shortly after sex.
- Wipe from front to back after urinating and bowel movement.
- Keep the genital area clean.
- Showers are preferred to baths and avoid using oils.
- Sanitary pads or menstrual cups are preferred to tampons. If you want to buy menstrual cups, then there is an excellent selection on Amazon with thousands of customer reviews.
- Avoid using a diaphragm or spermicide for birth control.
- Avoid using any perfumed products in the genital area.
- Wear cotton underwear and loose-fitting clothing to keep the area around the urethra dry.
Individuals are advised to contact a doctor if they develop the symptoms of a UTI, especially if they have developed the symptoms of a potential kidney infection.
Diagnosis will usually be made after asking about the symptoms and testing a urine sample to assess the presence of white blood cells, red blood cells, and bacteria.
A method of collecting urine called “clean catch” is used. This requires that a person wash their genital area before providing a urine sample mid-flow. This helps to prevent bacteria from around the genital area getting caught in the sample.
If a person has recurrent UTIs, a doctor may request further diagnostic testing to determine if anatomical issues or functional issues are to blame. Such tests may include:
- Diagnostic imaging: This involves assessing the urinary tract using ultrasound, CT and MRI scanning, radiation tracking, or X-rays.
- Urodynamics: This procedure determines how well the urinary tract is storing and releasing urine.
- Cystoscopy: This diagnostic exam allows the doctor to see inside the bladder and urethra with a camera lens, which inserted through the urethra through a long thin tube.
UTIs in men are rare. The incidence for men under the age of 50 years is between 5 and 8 men in every 10,000. The risk of infection increases with age.
When men contract a UTI, it will infect the same organs and areas as a UTI would in a woman. For men, however, the prostate is also at risk of infection.
A man with a circumcised penis is less ly to get a UTI that a man who has not undergone circumcision.
Treatment methods would be similar to those used to treat UTIs in women.
Share on PinterestDrinking plenty of water helps flush out UTIs and lowers the risk of future infection.
As UTIs are normally caused by bacteria, they are most commonly treated with antibiotics or antimicrobials.
The type of medication and length of treatment will depend on the symptoms and medical history of the individual.
The full course of treatment should always be completed for UTIs to make sure that the infection is fully clear, and to reduce the risk of antibiotic resistance. UTI symptoms can disappear before the infection has completely gone.
Drinking lots of fluids and frequently urinating are always recommended for people who have UTIs as this helps to flush out the bacteria. A variety of pain relief medications may be prescribed to alleviate pain. Applying a heating pad to the back or abdomen can also help.
An uncomplicated UTI is one that occurs in an otherwise healthy person with a normal clear urinary tract. These can usually be cured with 2 to 3 days of treatment.
A complicated UTI is one that occurs in a person who is weakened by another condition, such as pregnancy or heart transplant. Complicated UTIs tend to require longer periods of antibiotics, usually between 7 to 14 days.
To cure a UTI that is caused by problems within the urinary system, the underlying issue needs to be found and corrected. If left untreated, these infections can lead to kidney damage.
If the person is seriously ill, they may need to be admitted to a hospital to ensure that they take in sufficient fluids and receive the right medication. People may also need to go to the hospital if they are one of the following:
- pregnant and are otherwise ill
- older adults
- people with cancer, diabetes, multiple sclerosis, spinal cord injury, or other medical problems
- individuals with kidney stones or other changes in their urinary tract
- recovering from recent urinary tract surgery
Recurrent infections in women
Women who have recurrent bladder infections may be advised to:
- Take a single dose of an antibiotic after sexual contact
- Take a single, daily dose of an antibiotic for at least 6 months
- Take a 2-to-3-day course of an antibiotic if symptoms reappear
- Undergo vaginal estrogen therapy if they have already had menopause
There are a number of suggested remedies that people with a UTI can try at home.
Drinking fluids and urinating frequently can help flush bacteria from the body, and using a heated pad for short periods can help to relieve discomfort.
It is also often said that cranberries and their extracts could treat UTI.
Cranberry extracts do not help treat existing UTIs but may help prevent their development.
This is because cranberries contain compounds called proanthocyanidins that prevent E. coli from sticking to the walls of the digestive and urinary tracts.
In a large meta-analysis, researchers found that women with recurrent UTIs who took cranberry over 12 months had a 35 percent reduction in infections.
Another large clinical trial found that 500 milligrams (mg) of cranberry extract taken daily for 6 months reduced the rate of UTI to the same extent as 100 mg of trimethoprim, an antibiotic, without posing a risk of antimicrobial resistance or super-infection in women with recurrent UTIs.
Cranberry extract tablets appear to be twice as effective as cranberry juice for preventing UTIs, which may be due in part to the sugar content of cranberry juice. Cranberry extracts also contain anthocyanins and salicylic acid. This may have a painkilling and anti-inflammatory effect that can help alleviate UTI symptoms.
The Society of Obstetricians and Gynaecologists of Canada recommend cranberry products to prevent recurrent UTIs, but not for use in active UTIs.
Cranberry extract tablets are available to purchase online. Speaking to a doctor is recommended, to determine the suitability of these tablets.
Changes in the bacterial balance of the genitourinary tract can increase the lihood of colonization by organisms such as E. coli. Regular use of probiotics may help reduce the risk of UTIs, especially after a course of antibiotics.
Probiotics are available online as food products, such as yogurts, and supplements.
In particular, Bifidobacterium longum has shown an ability to prevent undesirable bacteria sticking to the walls of the intestinal tract, in addition to enhancing production of natural antibacterial chemicals and organic acids, thereby reducing the lihood of UTI.
Read the article in Spanish
Bladder infection: Causes, treatments, and remedies
If you buy something through a link on this page, we may earn a small commission. How this works.
A bladder infection is a bacterial infection of the bladder. It is also sometimes known as a urinary tract infection because the urinary tract includes the bladder, urethra, ureters, and kidneys.
Bladder infections are much more common in women than in men. It is estimated that more than 50 percent of women will experience a bladder infection at least once in their lifetime. Most are uncomplicated infections typically caused by the Escherichia coli (E. coli) bacterium.
The term “uncomplicated” is used to describe infections that occur in healthy women as opposed to “complicated” bladder infections that happen to people with other conditions, such as catheters, urinary stents, diabetes, pregnancy, or other causes.
Although an uncomplicated bladder infection is often easily treated with a short course of antibiotics, it can be considerably uncomfortable for the person who has it.
Bladder infections often occur when bacteria get into the urethra, the tube that carries urine the body, and then move into the bladder.
Share on PinterestA bladder infection may be caused by frequent sexual intercourse and not urinating immediately after sexual intercourse.
Once in the bladder, the bacteria can stick to the lining of the bladder, causing it to become inflamed, a condition known as cystitis. The bacteria can also move from the bladder into the kidneys, resulting in a kidney infection.
There are a number of factors that can increase the risk of getting a bladder infection, including:
- frequent sexual intercourse
- having sexual intercourse with a new partner
- using a diaphragm and a spermicide for birth control
- not urinating immediately after sexual intercourse
- having diabetes
- having a bladder or kidney infection within the past 12 months
- changes in the urinary system
The symptoms of a bladder infection can include:
- pain or burning when urinating
- urgent and frequent need to urinate, often passing small quantities of urine
- discomfort in the lower abdomen
- offensive-smelling urine
- cloudy urine
- blood in the urine
People with kidney infections have similar symptoms, but they may also have:
- back pain or pain in the side or groin
- nausea or vomiting
A doctor can usually diagnose a bladder infection after discussing the symptoms a person is experiencing and doing a urinalysis. This is a urine test that looks for the presence of white blood cells in the urine, and signs of inflammation, which indicates an infection.
If a kidney infection is suspected, the doctor may recommend a urine culture. A urine culture is a laboratory test used to identify the different bacteria that may be present in a urine sample.
Urine cultures are often recommended if the person:
- experiences symptoms that are not typical of a bladder infection
- gets frequent bladder infections
- has “resistant” bladder infections that do not improve with antibiotics
- does not begin to feel better within 24-48 hours after starting antibiotics
- is pregnant
People with uncomplicated bladder infections are usually treated with a short course of antibiotics. Treatment options vary, but the following are the most common prescriptions for uncomplicated cystitis:
Share on PinterestUncomplicated bladder infections may be treated by a course of antibiotics.
- trimethoprim-sulfamethoxazole (Bactrim) – 160-800 milligrams (mg) twice daily for 3 days
- nitrofurantoin monohydrate – 100 mg twice daily for 5 – 7 days
- fosfomycin trometamol – 3 grams (g) in a single dose
A 3-day course of treatment has been found to be as efficient as a 7-day course of treatment and people experienced fewer side effects. Side effects usually stem from the overgrowth of yeast, which can cause a rash and yeast vaginitis. The 3-day course is also more cost efficient than the 7-day regime.
A single-dose treatment is also available, but it generally results in lower cure rates and more frequent recurrence.
Most people find that their symptoms begin to improve the day after beginning the treatment. Even if someone feels better, it is important that they take the full course of antibiotics in order to completely eliminate the infection. If they do not finish the whole dose, the infection may return, and it can be harder to treat the second time around.
If symptoms persist for more than 2 or 3 days after starting treatment, people should contact their doctor.
People with more complicated bladder infections will usually need to take antibiotics for 7-14 days. Complicated infections include those that occur during pregnancy, or in people who have diabetes or a mild kidney infection. It is also recommended that men with acute urinary infections take antibiotics for 7-14 days as well.
Less commonly, fluoroquinolones and beta-lactam antibiotics are used to treat more invasive infections. These antibiotics are effective, but they are not recommended for initial treatment because of concerns about bacterial resistance.
Given the worrying problem of antibiotic-resistant bacteria, doctors try to encourage women who experience regular bladder infections to use prevention strategies when possible. These strategies may include:
- Changing their method of birth control: Bladder infections appear to be more common in women who use spermicides and a diaphragm.
- Staying hydrated and urinating directly after sexual intercourse: This may help to wash out any bacteria that enter the bladder.
- Topically applying estradiol cream if postmenopausal: Postmenopausal women may benefit from using vaginal estrogen to reduce risk of infection. Estradiol cream is available to purchase online.
- Using a preventive antibiotic: This may be recommended if someone repeatedly develops bladder infections and has not responded to other preventive measures.
People can also help prevent bladder infections by including unsweetened cranberry juice, D-mannose, apple cider vinegar, ascorbic acid (vitamin C), and probiotics into their diets. Of these remedies, cranberry products and D-mannose appear to be the most popular.
Share on PinterestStaying hydrated helps to flush out the bacteria that may cause a bladder infection.
Drinking unsweetened cranberry juice or taking cranberry supplements is often promoted as one way to help prevent frequent bladder infections.
Compounds known as proanthocyanidins found in cranberries are thought to prevent bacteria from sticking to the walls of the urethra and bladder, reducing the risk of infection.
The recommended dose is 3 glasses of unsweetened cranberry juice daily, or 2 tablets daily, until the infection subsides.
Cranberry juice is available for purchase online.
D-mannose is a naturally occurring sugar found in certain fruits, such as cranberries and blueberries. A new study suggests that D-mannose is just as effective as antibiotics in preventing recurrent urinary tract infections in women.
The sugar attaches to any E. coli bacteria present and prevents them from sticking to the walls of the urinary tract or bladder. The bacteria are then flushed out on urination.
D-mannose is available in powder or capsule form. The recommended dose is 500 mg taken every 2 hours for 5 days. People who experience recurrent bladder infections could take a lower daily dose of D-mannose as a preventive measure.
Uncomplicated bladder infections are mainly treated with a short course of antibiotics. This treatment is highly effective, inexpensive, and most people tolerate it well. Typically, symptoms start to improve after 48 hours and are often resolved within 72 hours.
For people whose infection has spread to the kidneys, antibiotics are usually administered for 10-14 days. After this time, most infections get better without any further complications.
Bladder Infection Treatment, Causes & Symptoms During Pregnancy
A urinalysis (UA) is the initial evaluation for a bladder infection. In most cases, health care professionals use a voided urine specimen, however, there is a risk of contamination by skin bacteria.
A “clean catch” voided urine specimen involves voiding and collecting a urine sample “mid-stream” as opposed to at the very start or end of voiding.
A catheterized urine sample is more accurate, but has the risk of introducing bacteria into the bladder and may be uncomfortable in children. In infants, medical professionals can perform a suprapubic aspiration.
The method of collecting a voided urine sample differs between men and women, as well as between circumcised men and uncircumcised men. In circumcised men, there is no special preparation. However, uncircumcised men should retract the foreskin.
If the source of the infection is unclear, three separate urine samples may be collected: the first void (the first 10 ml of urination) reflects whether or not bacteria are in the urethra; and the second sample is a midstream void (that which occurs after the first 10 ml) and reflects whether bacteria are in the bladder.
If there is a concern for bacteria in the prostate, a medical professional performs a rectal examination and massages the prostate to express fluid from the prostate into the urethra, and the third urine sample is obtained after the prostate massage. In both males and females, the voided urine should be collected midstream.
It is unclear if washing the penis or perineum with gauze or an antibiotic wipe is more effective in preventing contamination from the skin. In children who are not toilet-trained, a catheterized specimen is more accurate than placing a collection bag over the urethra.
In infants, a health care professional can perform a suprapubic aspiration (placing a small needle through the lower abdomen into the bladder and withdrawing a urine sample). In toilet-trained children, a health care professional may obtain a voided urine sample.
A quick office-based urinalysis, called a urine dipstick, is unable to detect if bacteria are present. However, health care professionals use it to detect the presence of nitrite in the urine and leukocyte esterase.
Nitrite is a chemical that forms when bacteria in the urine break down a chemical called nitrate, which is normally present in the urine. The nitrite test is not positive for all bacterial infections of the bladder, as not all bacteria can break down nitrate to nitrite.
In addition, the urine dipstick is unable to determine the number of white blood cells (infection cells) present in the urine but assesses whether or not white blood cells are present by measuring leukocyte esterase activity. Leukocyte esterase is a chemical produced by white blood cells.
The presence of both nitrites and an elevated leukocyte esterase are very suggestive of a urinary tract infection.
A formal urinalysis with examination of the urine under the microscope is able to identify whether or not bacteria are present in the urine as well as determine the number of white blood cells present in the urine. Examination of the urine under the microscope can also determine if yeast are present in the urine. Viruses cannot be seen under the routine microscope and require special tests to identify.
The definitive test to determine if there is a bladder infection is the urine culture. The urine culture identifies the number of and type of bacteria in the urine as well as determine the sensitivity of the bacteria to a number of different antibiotics.
The usual cutoff for a urinary tract infection is the presence of greater than 100,000 bacteria, however, in the presence of symptoms, a positive leukocyte esterase or > 10 white blood cells on urinalysis, even fewer bacteria in the urine is supportive of a urinary tract infection.
A recent publication in the Infectious Disease Clinics of North America highlights the importance of differentiating between asymptomatic bacteriuria, possible, probable, and definite urinary tract infection.
Localizing symptoms and signs (pain with urination, urinary frequency, suprapubic/bladder pain, bloody urine, pain in the flank, new or worsening urgency or urinary incontinence), pyuria (white blood cells in the urine), or positive leukocyte esterase on urinalysis are the most important predictors of a urinary tract infection.
They note that the diagnosis of a urinary tract infection requires three components: (1) clinical symptoms of infection localizing to the urinary tract or nonspecific symptoms of infection (fever, chills, change in mental status) in the absence of symptoms suggesting an infection in another part of the body, (2) the presence of white blood cells in the urine and bacteria in the urine, and (3) absence of another infection or noninfectious process accounting for the symptoms and signs.
If symptoms of an upper urinary tract infection (pyelonephritis), fever, flank pain, nausea or vomiting are present, health care professionals will obtain a blood test (a complete blood cell count [CBC]).
If there is a concern for a severe infection, a medical professionals will culture a sample of blood to see if there are bacteria in the bloodstream.
Radiologic studies are not routinely obtained in the case of cystitis, however, if there are signs of a kidney infection (pyelonephritis) such as flank pain, fevers/chills, or there is a failure to respond to antibiotics (with persistent or worsening symptoms), then radiologic testing (renal ultrasound, CT scan, or MRI) can be performed to rule out an abscess or other abnormalities. If a physician suspects constipation, a plain X-ray of the abdomen may be obtained to assess the severity of the constipation.
Bladder Infections: UTI Causes, Symptoms, Treatments
A urinary tract infection (UTI) occurs when one or more parts of the urinary system (kidneys, ureters, bladder, or urethra) become infected with a pathogen (most frequently, bacteria). UTIs most commonly occur in females; about 50% of all females get a UTI during their lifetime. Many UTIs are not serious but if infection reaches the kidneys, serious illness, and even death, can occur.
Bladder infections are the most common type of UTI. Some individuals may have few or no symptoms; however, the usual symptoms include dysuria (pain or burning during urination), low abdominal pain, and/or urine that is cloudy or smells bad or unusual.
Some bladder infections do not resolve and get worse with the pathogens moving up (retrograde) the ureters to the kidneys. Symptoms may include those listed for bladder infections on the pervious slide, but often include other symptoms such as pain in the lower back (flank pain on one or both sides), fever, chills, and nausea and/or vomiting.
Although a bladder infection is not a medical emergency, the following individuals have a higher risk for UTI complications such as infection spread to the kidneys or elsewhere in the body:
- Pregnant women
- People who have diabetes
- Individuals with kidney problems such as kidney stones or blockages
- Elderly individuals
- Immunocompromised patients
- Men with enlarged prostates
- People with urinary retention and/or indwelling catheters
UTI symptoms described in previous slides may also be symptoms of other fairly common types of infections, sexually transmitted diseases (STDs).
These diseases include gonorrhea (and sometimes syphilis along with gonorrhea), chlamydia, and trichomoniasis. Lab tests are readily available to diagnose and differentiate a UTI from an STD.
Discharge of pus or fluid from the penis or vagina is a symptom often present in STDs but not usually present in UTIs.
Honeymoon cystitis is the term for a UTI that often occurs after sexual activity. A few women get a UTI frequently after sexual activity (honeymoon or not). Sexual activity can push infecting bacteria into the urethra resulting in an infection. Women with a diaphragm placed for birth control are at a higher risk for UTIs.
UTIs without symptoms are not unusual; urine tests can show that bacteria are present in the urine and the condition is termed asymptomatic bacteriuria. Usually this condition is not treated, but in some patients it is better to treat them with antibiotics (for example, pregnant women, some children, and kidney transplant patients).
There are two major complications of UTIs. The first is infection spread to one or both kidneys. If the infection continues, kidney function can be damaged and result in kidney failure or complete loss of kidney function. The second complication is that the infecting organisms occasionally enter the bloodstream and may infect other organs or, rarely, cause sepsis and death.
The vast majority of UTIs start when pathogens (usually bacteria E. coli ) reach the urethra and then travel up (retrograde) the urethra to the bladder. Urine is usually sterile until it reaches the distal urethra. Women have short urethras compared to men and most clinicians think the shorter urethra is the major reason women have more UTIs than men.
Risk factors for UTIs were presented previously, but besides being a woman who is sexually active or someone who is elderly or immunocompromised, there are other risk factors:
- Not drinking enough fluids (slows the wash of pathogens the body)
- Taking frequent baths (soaking in fluid that may promote retrograde infections)
- Waiting to urinate (promotes retrograde bacterial movement)
- Kidney stones (causes slowing or partial blockage of urine flow)
Adult men have infrequent UTIs; if they get a UTI there usually is an underlying cause (for example, having an enlarged prostate or kidney stone or being an elderly person with a catheter).
Urinalysis is usually the first diagnostic test done after a patient presents their medical history and has a physical exam. The test provides information about the presence of bacteria, white and red blood cells, and chemical abnormalities.
It can indicate that other studies such as urine culture and bacterial drug sensitivity tests should be done. Simple tests the urine dipstick test or even home tests of urine can be done but they are not 100% accurate.
It is best to have your doctor evaluate your symptoms and test results.
Although severe kidney infections are often treated in the hospital with IV antibiotics, most UTIs (and many mild-to-moderate kidney infections) are treated with oral antibiotics.
However, many clinicians are sending urine samples to identify the infecting organisms and determine their antimicrobial resistance. It is not unusual for a doctor to call a patient and switch antibiotics because of antibiotic resistance.
In addition, the doctor will usually recommend that the patient take in plenty of fluids (water) and encourage frequent urination to flush bacteria the urinary tract.
Recurrent UTIs are not unusual; you should ask your primary care physician (PCP) for a referral to a urologist if you have three or more UTIs per year to see if there may be an underlying urinary tract problem that may be the cause. Your PCP may also suggest taking taking an oral antibiotic after sex, or taking an oral antibiotic as needed when UTI symptoms appear.
People who have diabetes are at higher risk for UTIs because the high sugar (glucose) levels in the blood can result in high sugar levels in the urine and result in a good growth environment for bacteria.
People who have diabetes often have an immune system that does not respond as well to infections.
Diabetes can damage nerves that result in incomplete bladder emptying thus encouraging bacterial survival and retrograde infections.
Pregnancy increases the risk of UTIs; hormonal changes may alter normal urinary tract function and the expanding uterus may put pressure on both the bladder and ureters.
The effect is to slow urine output and cause pregnant women to “hold or delay urination.” This results in favorable growth conditions for bacteria.
UTIs may play a role in preterm labor so your doctor(s) should be informed if you suspect you have a UTI when pregnant.
During menopause, estrogen levels drop. Because estrogen provides some level of protection against UTIs, its reduction during menopause may make some women more susceptible to UTIs.
During a hospital stay, many patients cannot get up to go to the bathroom and require a catheter (a tube put through the urethra into the bladder to allow urine to flow). Bacteria can enter the bladder through and around the catheter in some individuals. This problem is more frequent in people who have long hospital stays or are in long-term care facilities such as nursing homes.
UTIs in the elderly are common in both men and women. Although they may have symptoms commonly associated with UTIs, often UTI symptoms in elderly individuals are different. They may show only symptoms of agitation, delirium, confusion and/or behavioral changes. The elderly are at higher risk of developing complications such as kidney infections or sepsis from UTIs.
Changing a wet and/or soiled diaper is a good way to help prevent UTIs in children. In addition, wiping from front to back in both males and females also reduces the chances of developing UTIs.
the elderly, infants and young children may develop classic UTI symptoms but are unable to communicate them to anyone.
However, signs of UTI in children may include fever, odd-smelling urine, decreased food intake, vomiting, abdominal discomfort, and fussy behavior. Early treatment of UTIs in children helps prevent kidney damage.
About 1% of boys and 3% of girls have UTIs before puberty. Some of these children have structural problems in their urinary tracts that allow retrograde flow to easily occur thus giving bacteria an easy route to the kidneys.
A pediatric urologist is usually consulted for evaluation and treatment. Other children may delay urination and some may not relax their muscles enough to completely empty their bladder.
These children may be helped by increased fluid intake and encouraging more bathroom trips.
Potty training can be difficult for the child (and the adults). However, accidents are part of this training, so adults should expect them to happen and the child should be taught that accidents can happen and to not be upset if they do. Some children rebel (scream and cry) when potty training.
Reassurance is useful, but not all children can be potty trained at one particular age. Some children may not be at the developmental stage for training while others are. Children often imitate other children's behavior. Seeing a closely-aged sibling or day-care friend use the potty and be praised for it has worked well for many children.
A child's rejection of potty training is not usually considered a sign of a UTI.
Prevention methods for UTIs have been presented in several preceding slides; here is a short summary of common and easy ways to prevent UTIs:
- Drink a lot of water daily
- Don't “put off” going to the restroom (don't delay urination)
- Wipe from front to back
- Don't use feminine hygiene sprays
- Take showers instead of baths
Some studies suggest cranberry juice may help prevent UTIs because there is some evidence cranberry juice interferes with E.coli attaching to the bladder wall. Cranberry tablets or capsules may also accomplish this.
However, there is no good evidence that indicates cranberries, in any form, can cure a UTI.
People with a history of kidney stones should check with their doctor(s) before trying cranberry preparations as a preventive measure against UTIs.
IMAGES PROVIDED BY:
- David M. Phillips / Photo Researchers, Eye of Science / Photo Researchers, 3D4Medical.com
- Thierry Dosogne/Photographer's Choice
- Tetra Images
- Tom Merton/OJO Images
- Peter Dazeley/Photographer's Choice
- Eye of Science / Photo Researchers, 3D4Medical.com
- Darcy G. Varney/Flickr
- David Sacks/The Image Bank
- Radius Images
- Dorling Kindserley/Agency Collection
- Bounce/Uppercut Images
- Bambu Productions/Taxi
- Nicole Hill/Rubberball
- Matt Carey/Flickr
- Safia Fatimi/Photographer's Choice
- Laurence Monneret/Stock Image
- Rosemary Calvert/Photographer's Choice RF
- Medscape: “Urinary Tract Infections: A Primer for Clinicians”