Your Guide to Urinary Tract Infections (UTIs)

What is a UTI, and how can it be treated? Get answers to your questions here.

A stinging, burning sensation when you urinate.

Feeling like you need to go again (right now!) even though you went just two minutes earlier. These are telltale signs of a urinary tract infection (UTI). And if you’ve had one before, you know just how painful they can be.

Urinary tract infections are the second most common type of infection in the body, causing about 8.1 million visits to the doctor each year, and can lead to dangerous complications if left untreated.

Thankfully, UTIs often respond well to antibiotics, and over-the-counter medicines can relieve symptoms in the meantime. Learn more about these common infections and what steps you can take to help prevent them in the first place.

What is a UTI?

A UTI is an infection in the urinary system, which includes the kidneys, bladder, ureters (the tubes that connect the kidneys to the bladder) and urethra (the tube that leads from the bladder to outside the body). UTIs develop when germs, typically bacteria, enter the urethra and spread to the bladder. Most of the time, the body is able to rid itself of these germs, but when it can’t, an infection can occur.

Most infections happen in the bladder, but they can also occur in the kidneys or urethra and, rarely, in the ureters. Depending on where the infection occurs in the urinary tract, it has different names. An infection of the bladder is called cystitis; an infection in one or both kidneys is called pyelonephritis; and an infection in the urethra is called urethritis.

More than half of all women will experience at least one UTI during her lifetime. Men can also get UTIs, but women get them much more often because their urethra is shorter, making it easier for bacteria to reach the bladder. Some people have an obstruction, such as a kidney stone or an enlarged prostate, which blocks the flow of urine. This increases their risk for developing a UTI.

What are UTI symptoms?

Symptoms of a UTI vary by age and gender. In younger women, symptoms include:

Pain, stinging or burning when urinating
Frequent urge to urinate, but without much urine coming out when you try to go
Cramps, pain or soreness in the lower abdomen or back
Urine that has a strong odor
Blood or pus in urine
Pain during sex

If the infection has spread to your kidneys, symptoms may include:

Fatigue
Chills and shaking or night sweats
Fever
Nausea or vomiting
Pain in the flank (side), back or groin

In older women and men, UTI symptoms more often include:

Mental confusion (in seniors, this may be the only or predominant sign)
Feeling tired, shaky and weak
Muscle aches
Abdominal pain
Dark or cloudy urine or urine that has a foul odor

If I think I have a UTI, what should I do?

If you have UTI symptoms, see your doctor at once. Getting prompt treatment can stop the infection from spreading to your kidneys, which can lead to permanent kidney damage. It’s especially critical for pregnant women to see their healthcare provider at the first sign of a UTI because these infections can increase a pregnant woman’s risk of preterm birth and of delivering a low birth weight baby. (UTIs are more common in pregnant women because the weight of the growing womb can impede drainage from the ureters.)

How is a UTI diagnosed?

At your appointment, your doctor will ask you for a urine sample. The sample will be sent for lab analysis to look for bacteria or white blood cells, which are produced by the body to fight off infections. Bacteria can be found in the urine of healthy people, though, so your doctor will diagnose you with a UTI only if you have symptoms of an infection and your urine sample comes back positive.

If you have recurrent UTIs, your doctor may do further testing to determine if your urinary tract is healthy. Your doctor may order an X-ray, ultrasound or CT scan to get a glimpse of your urinary tract, or your doctor may want to get a close-up view of your urethra and bladder through a cystoscopy. In this procedure, a small tube (cystoscope) is inserted into your urethra.

How can I reduce my risk for a UTI?

The bacterium E. coli causes the majority of urinary tract infections. E. coli lives in the bowel naturally and can make its way to the urethra from sexual activity or poor personal hygiene. For this reason, changes to some personal habits can help lessen your chance of getting a UTI, such as:

Don't "hold it." Urinate as soon as you feel the urge. Keeping urine in your bladder for a long time can cause bacteria to multiply.
Drink plenty of water. Drinking enough water can help flush germs from your body.
Empty your bladder after sex. Urinating helps gets rid of the bacteria that may have entered your body during sex.
Wipe from front to back after going to the bathroom. This helps prevent bacteria in your anus from entering the urethra and bladder.
Don’t use douches or scented feminine sprays.
If you get frequent UTIs and use spermicides, talk to your doctor about other birth control options.
Wear cotton underwear and avoid tight-fitting, synthetic underwear or pants because they can trap in moisture.
Take showers instead of baths.

People with diabetes or those with weakened immune systems are more susceptible to getting UTIs and should take extra care.

How are UTIs treated?

Your doctor will prescribe an antibiotic to clear up a UTI. You may only need to take medicine for a couple days, or you may need to take it for a week or more depending on your health status and the type of bacteria causing the infection. Your doctor may also give you pain medication, such as phenazopyridine (Uristat®), or recommend that you buy it over the counter to help get rid of the burning you feel during urination. Note that a common side effect of this type of medicine is orange- or red-colored urine.

Most UTIs go away after two to three days of treatment. However, the infection can last longer, especially if you’re pregnant, have a weakened immune system or have an abnormality in your urinary tract. For very severe UTIs, you may need treatment with intravenous (IV) medication in a hospital.

If you get frequent UTIs, your doctor may recommend long-term antibiotic treatment (that lasts for six months or longer). Or he or she may recommend you take a single dose of antibiotic after every time you have sex, a two- to three-day dose of antibiotics as soon as symptoms appear, or estrogen therapy if you’re going through menopause.

I have gotten multiple UTIs in a year. Is that common?

One in five young women with a first UTI will have another infection, and with each infection, the risk that a woman will have a recurrent infection increases, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Some women suffer three or more UTIs a year. However, this frequency of infection usually lasts for a period of one or two years only, after which recurrent infections stop. Very few women will have recurrent infections throughout their lives.

If you have diabetes or a problem that makes it hard to urinate, you are more likely to have repeat infections. Researchers are currently looking into why some people are more prone to recurrent UTIs than others.

What causes UTIs in men?

UTIs in men most often occur due to an obstruction, such as an enlarged prostate or kidney stone, or as a side effect of using a catheter. Diagnosis and treatment for UTIs in men is the same as in women.

Can drinking cranberry juice help prevent UTIs?

There is some scientific evidence that shows cranberries may help prevent UTIs, especially in women who are prone to these types of infections.

“Cranberry may decrease the incidence of recurrent UTIs because they make the urine more acidic and less likely to allow certain bacteria to grow in the bladder,” says Roseline Dauphin-Baptiste, MD, an ob-gyn practicing in Burbank, California, with more than 35 years of experience.

Research shows that components found in cranberries may prevent bacteria, including E. coli, from clinging to the walls of the urinary tract and causing an infection. However, it is not known how much and how often you’d need to drink cranberry juice to have an effect and whether a similar benefit can be gained from taking cranberry extract pills.

Jennifer Hanes, DO, an emergency and integrative medicine physician in Austin, Texas, tells her patients to drink cranberry juice but cautions against taking cranberry pills. Unlike medications, she notes that the U.S. Food and Drug Administration (FDA) does not test supplements. “There have been bottles of cranberry supplements with absolutely zero of the compound they claim to have,” says Hanes.

The American College of Obstetrics and Gynecology says that drinking cranberry juice may help ease symptoms of existing UTIs. However, cranberries won’t actually treat the infection—you still need to see a doctor for antibiotics.

Both Dauphin-Baptiste and Hanes recommend drinking pure, unsweetened cranberry juice, and avoiding cranberry cocktail, as it contains little cranberry and lots of added sugar.

Jenilee Matz is a medical writer, health educator and triathlete based in Charlotte, NC.

Reviewed by Elaine Brown, MD on January 10, 2014

Sources

https://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/

https://www.mayoclinic.com/health/urinary-tract-infection/DS00286

https://womenshealth.gov/publications/our-publications/fact-sheet/urinary-tract-infection.cfm

https://www.umm.edu/altmed/articles/urinary-tract-000169.htm

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001549/

https://nccam.nih.gov/health/cranberry

https://www.ncbi.nlm.nih.gov/pubmed/18253990

https://www.americanpregnancy.org/pregnancycomplications/utiduringpreg.html

Dauphin-Bautiste, Roseline, MD. OB/GYN, Southern California Women’s Medical Group.