Urinary Tract Infection

Definition

UTIs are caused by bacteria. The bacteria invade the urinary system and multiply. The infection can occur in any part of the urinary system, but usually starts in the urethra. The urethra is a tube that carries the urine out of the body.

The Urinary Tract

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Causes

In most cases, bacteria begins growing in the urethra. The bacteria comes most often from the digestive tract and rectal area. They cling to the opening of the urethra and begin to multiply. An infection only in the urethra is called urethritis . From there, bacteria move to the bladder, causing a bladder infection . If the infection is not treated right away, bacteria may then go up the ureters. Ureters are two tubes that carry urine from the kidneys to the bladder. From there the infection can continue into the kidneys ( pyelonephritis ).

Most infections are caused by one type of bacteria called E. coli . E. coli normally lives in the colon. In women, since the rectum and urethra are fairly close to each other, the bacteria can move into the urethra. This makes women more prone to UTIs than men.

UTIs can also be sexually transmitted. This type of infection usually does not spread past the urethra. Both partners need to be treated.

Risk Factors

These factors increase your chance of developing a UTI. Tell your doctor if you have any of these risk factors:

Symptoms

If you have any of these symptoms do not assume they are due to a UTI. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

  • Frequent and urgent need to urinate
  • Passing small amounts of urine
  • Pain in the abdomen or pelvic area
  • Burning sensation during urination
  • Cloudy, bad-smelling urine
  • Increased need to get up at night to urinate
  • Blood in the urine
  • Leaking urine
  • Low back pain or pain along the side of the ribs
  • Fever and chills
  • Nausea and poor appetite

Bloody urine, low back pain, high fever, and chills are all signs of a kidney infection . Call your doctor right away if you have these symptoms.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will also be done. A sample of your urine will also be tested for blood, pus, and bacteria.

Children and men who have UTIs may need more testing. There may be structural problems of the kidneys, bladder, or tubes that make them likely to have an infection.

Treatment

UTIs are treated with antibiotic drugs. Standard medical care for a UTI includes taking antibiotics for three days. You most likely will start to feel better after a day or two. However, it is important that you continue to take the entire course of medication.

You may be asked to have your urine checked after you finish taking the antibiotics. This is to make sure that the infection is truly gone.

If you still experience recurrent infections, you may be referred to a specialist.

Pyridium is a medicine that decreases pain and bladder spasm. It may turn your urine, and sometimes your sweat, an orange color.

In some cases, severe UTIs are treated with intravenous or intramuscular antibiotics. Researchers, though, found that oral antibiotics appear to be as effective in treating UTIs as other treatments.

Prevention

Here are some steps you can take to keep bacteria out of your urinary tract:

  • Drink plenty of liquids, especially water.
  • Include cranberry juice in your diet. Some studies support the use of cranberry juice to prevent UTIs.
  • Urinate when you feel the need and do not resist the urge.
  • Empty your bladder completely and drink a full glass of water after having sex.
  • Wash genitals daily.
  • If you are a woman, always wipe from the front to the back after having a bowel movement.
  • Avoid using douches and feminine hygiene sprays.

RESOURCES:

American Urological Association Foundation
http://www.urologyhealth.org/

National Kidney and Urologic Diseases Information Clearinghouse
http://kidney.niddk.nih.gov/

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org/

Women's Health Matters
http://www.womenshealthmatters.ca/

References:

Car J. Urinary tract infections in women: diagnosis and management in primary care. BMJ . 2006;14;332.

Cranberry. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/. Updated February 1, 2011. Accessed May 6, 2011.

DynaMed Editorial Team. Urinary tract infection (UTI) in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated May 3, 2011. Accessed May 6, 2011.

Jepson RG, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD001321.

Sheffield JS, Cunningham FG. Urinary tract infection in women. Obstet Gynecol . 2005;106:1085-1092.

Urinary tract infections in adults. American Urological Association Foundation website. http://www.urologyhealth.org/adult/index.cfm?cat=07&topic=147 . Accessed July 31, 2010.

Urinary tract infections in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/ . Published December 2005. Accessed July 31, 2010.

12/5/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Pohl A. Modes of administration of antibiotics for symptomatic severe urinary tract infections [review]. Cochrane Database of Systematic Reviews . 2007(4). DOI: 10.1002/14651858.CD003237.

5/6/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Barbosa-Cesnik C, Brown MB, Buxton M, Zhang L, DeBusscher J, Foxman B. Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial. Clin Infect Dis. 2011;52(1):23-30.



Last reviewed September 2010 by Adrienne Carmack, MD


Last updated Updated: 5/6/2011

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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