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Everything You Need To Know About Urinary Tract Infections (UTIs)

What is a UTI?

urinary tract infection (UTI) is an infection caused by microbes such as bacteria that cause inflammation and infection in any part of your urinary system. It commonly occurs in the bladder and urethra, but if left untreated, the bacteria can climb to the ureters and kidneys and this becomes life-threatening. Although upper tract UTIs are rarer than lower tract UTIs, they’re also usually more severe.

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Who gets a UTI?

UTIs are very common, affecting 150 million people per year globally. One in five women will have at least one UTI in their lifetime. Women get UTIs up to 30 times more often than men do. Also, as many as 4 in 10 women who get a UTI will get at least one more within six months.

Women get UTIs more often because a woman’s urethra (the tube from the bladder to where the urine comes out of the body) is shorter than a man’s. This makes it easier for bacteria to get into the bladder. A woman’s urethral opening is also closer to both the vagina and the anus, the main source of germs such as Escherichia coli (E. coli) that cause UTIs. 90% of UTIs are caused by a bacteria called E. coli, which is commonly found in the gastrointestinal tract. 

You may be at greater risk for a UTI if you:

  • Are sexually active. Sexual activity can move germs that cause UTIs from other areas, such as the vagina, to the urethra.
  • Use a diaphragm for birth control or use spermicides (creams that kill sperm) with a diaphragm or with condoms. Spermicides can kill good bacteria that protect you from UTIs.
  • Are pregnant. Pregnancy hormones can change the bacteria in the urinary tract, making UTIs more likely. Also, many pregnant women have trouble completely emptying the bladder, because the uterus (womb) with the developing baby sits on top of the bladder during pregnancy. Leftover urine with bacteria in it can cause a UTI.
  • Have gone through menopause. After menopause, loss of the hormone estrogen causes vaginal tissue to become thin and dry. This can make it easier for harmful bacteria to grow and cause a UTI.
  • Have diabetes, which can lower your immune (defense) system and cause nerve damage that makes it hard to completely empty your bladder
  • Have any condition, like a kidney stone, that may block the flow of urine between your kidneys and bladder

Causes

Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, these defenses sometimes fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract.

  • Infection of the bladder (cystitis). This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible. Sexual intercourse may lead to cystitis, but you don’t have to be sexually active to develop it. All women are at risk of cystitis because of their anatomy — specifically, the short distance from the urethra to the anus and the urethral opening to the bladder.
  • Infection of the urethra (urethritis). This type of UTI can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea, chlamydia and mycoplasma, can cause urethritis.

Signs & Symptoms

  • Pain or burning when urinating
  • An urge to urinate often, but not much comes out when you go
  • Pressure in your lower abdomen
  • Urine that smells bad or looks milky or cloudy
  • Blood in the urine. This is more common in younger women. If you see blood in your urine, tell a doctor or nurse right away.
  • Feeling tired, shaky, confused, or weak. This is more common in older women.
  • Having a fever, which may mean the infection has reached your kidneys.

Diagnosis & Treatment

To find out whether you have a UTI, your doctor or nurse will test a clean sample of your urine. This means you will first wipe your genital area with a special wipe. Then you will collect your urine in midstream in a cup. Your doctor or nurse may then test your urine for bacteria to see whether you have a UTI, which can take a few days.

UTIs are treated with antibiotics prescribed by your doctor. You may feel better in one or two days. Make sure to finish taking all of the antibiotics as prescribed, even if you feel better after a day or two.

What can happen if a UTI is not treated?

If treated right away, a UTI is not likely to damage your urinary tract. But if your UTI is not treated, the infection can spread to the kidneys and other parts of your body. The most common symptoms of kidney infection are fever and pain in the back where the kidneys are located. Antibiotics can also treat kidney infections.

When treated promptly and properly, lower urinary tract infections rarely lead to complications. But left untreated, a urinary tract infection can have serious consequences. Sometimes the infection can get in the bloodstream. This is rare but life-threatening.

Complications of a UTI may include:

  • Recurrent infections, especially in women who experience two or more UTIs in a six-month period or four or more within a year.
  • Permanent kidney damage from an acute or chronic kidney infection (pyelonephritis) due to an untreated UTI.
  • Increased risk in pregnant women of delivering low birth weight or premature infants.
  • Sepsis, a potentially life-threatening complication of an infection, especially if the infection works its way up your urinary tract to your kidneys.

Prevention

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

  • Drink plenty of liquids, especially water. Drinking water helps dilute your urine and ensures that you’ll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin.
  • Urinate when you need to. Don’t go without urinating for longer than three or four hours. The longer urine stays in the bladder, the more time bacteria have to grow.
  • Drink cranberry juice. Although studies are not conclusive that cranberry juice prevents UTIs, it is likely not harmful.
  • Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
  • Empty your bladder soon after intercourse. Also, drink a full glass of water to help flush bacteria.
  • Avoid potentially irritating feminine products. Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.
  • Change your birth control method. Diaphragms, or unlubricated or spermicide-treated condoms, can all contribute to bacterial growth.

References

Everything you need to know about urinary tract infections (UTI). UTI Stings. (n.d.). Retrieved December 5, 2021, from https://utistings.com/blogs/news/urinary-tract-infections-uti.

Lights, V. (2021, October 14). Urinary tract infection: Symptoms, diagnosis & treatment. Healthline. Retrieved December 5, 2021, from https://www.healthline.com/health/urinary-tract-infection-adults#risks-for-women.

Mayo Foundation for Medical Education and Research. (2021, April 23). Urinary tract infection (UTI). Mayo Clinic. Retrieved December 5, 2021, from https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447.

Top 10 things to know about urinary tract infections. National Kidney Foundation. (2014, August 12). Retrieved December 5, 2021, from https://www.kidney.org/transplantation/transaction/TC/winter11/TCwinter11_UTI#:~:text=%20Top%2010%20Things%20to%20Know%20About%20Urinary,also%20include%20diabetics%20and%20men%20with…%20More%20.

Urinary tract infections. Urinary tract infections | Office on Women’s Health. (n.d.). Retrieved December 5, 2021, from https://www.womenshealth.gov/a-z-topics/urinary-tract-infections.