Urinary Tract Infections: Prevention and Treatment
Burning, pain, and that seemingly endless urge to go... Sound familiar? Urinary tract infections (UTIs) are the most common infection in humans. Read on to learn more about how they occur, how they are treated, and how you can work to prevent them from happening in the first place.
What Is the Urinary Tract?
In a woman, the urinary tract is made up of two main parts: the lower urinary tract, including the urethra and the bladder, and the upper urinary tract, including the kidneys and ureters.
Most urinary tract infections occur in in the lower urinary tract. That’s because there is normally bacteria around the vagina and anus, and it’s a shorter path for bacteria to reach the lower part of the urinary tract.
When bacteria moves to the bladder and causes an infection, it is called cystitis, a bladder infection. It’s also possible to get an infection in the kidneys, called pyelonephritis. An infection in the upper portion of the tract is less common, but potentially more serious.
What Causes a UTI?
When bacteria 9sually E. Coli) near the vagina or anus enter the urinary tract, it can cause a UTI. While less common, blockages can also cause UTIs. Blockages happen when something prevents urine from leaving the body; for example, they can occur when a stone in the kidney blocks the ureter, or simply when there is a narrow area in the urethra or ureter.
There are also some cases of UTI associated with certain medical procedures, like a cystoscopy (looking at the bladder via camera) or even having a urinary catheter. Your doctor or practitioner will talk to you about the need for potential treatment to prevent a UTI if you're having one of these procedures.
Who Is at Risk of Getting a UTI?
In general, women get more UTIs than men because of the shorter length of the female urethra. If you have had one UTI, you may be more prone to getting them in the future.
Does Sex Play a Role in Getting a UTI?
Sexual activity does play a role in getting UTIs. The urethra is near the opening of the vagina. Because the bacteria is on the vagina and anus, it can be transmitted to the urethra via the penis, fingers, and even objects used during sexual play like vibrators or dildos.
Sometimes, the use of spermicides can irritate the area and make a UTI more likely to occur. You may also notice that having a new sexual partner, or having sex more frequently (defined as more than three times per week), increases the frequency of UTIs.
What Are the Signs of a UTI?
Two of the most common signs you have a UTI in the lower urinary tract are needing to urinate urgently and/or frequently or experience pain when urinating — this is called dysuria.
Your urine may also have signs of a UTI. It may look cloudy or have a strong odor. Sometimes your urine may have a tinge of blood — however, this can also happen with other problems, so a medical provider should make the diagnosis.
Once the infection reaches the ureters or kidneys, the symptoms can worsen. They can include flu-like symptoms: back pain, fever, chills, and nausea with or without vomiting. When an infection reaches this area, the condition becomes much more serious.
Some have also reported that recurrent UTIs may pose a later risk of bladder cancer. However, the most recent studies indicate that there isn't enough strong data to support that.
How Is a UTI Diagnosed?
Your practitioner will ask you to provide a clean urine sample. In women, this involves washing your vulva and then providing a urine sample.
You may also be asked to provide a midstream sample. This is where you start the flow of urine, stop, wipe off with a special cloth, then collect the sample in a sterilized cup. This sample will be tested for bacteria and blood cells. The presence of these indicates that you have a UTI.
How Is a UTI Treated?
Antibiotics are used to treat UTIs. Which antibiotic you use will depend on what type of UTI you have, how long you’ve had it, how often you get UTIs, and your medical history. A course of oral antibiotics will be used for most UTIs. The antibiotics usually have you feeling better within a matter of days, but it's important to finish your prescription completely, even if you're feeling better before finishing all of the pills.
If the infection is in your kidneys, you may need to have Intravenous (IV) antibiotics. This may also require a hospital stay depending on the severity of the infection. Your kidneys filter your blood, and when they are infected, it can be very problematic.
If your UTI isn’t responding to the antibiotics or you have frequent UTIs, your practitioner may decide to run a culture test on your urine sample to see which specific bacteria is growing. This can help them choose an exact match for the antibiotic for the best treatment.
What If I Get Frequent UTIs?
Most people do not have UTIs frequently, but if you have more than two a year, you’re considered to have recurring infections. After the course of antibiotics, your urine may be tested again just to be sure that all of the bacteria is gone.
You and your practitioner may also try to figure out the cause of the recurrence. Sometimes something as simple as switching methods of birth control is helpful in preventing another infection.
UTIs During Pregnancy
A UTI in pregnancy needs immediate treatment. Leaving it untreated can cause preterm labor or having a baby who is small for gestational age (SGA), which can lead to premature birth and other complications for you and your baby. Be sure to call your doctor right away if you think you have a UTI in pregnancy.
Can UTIs Be Prevented?
The good news is there are multiple things that you can do to help reduce your chances of getting a UTI:
Stay well hydrated and drink plenty of water. This will help your urinary tract system flush bacteria out. Be sure to empty your bladder as soon as you feel full.
Always wiping from front to back after using the bathroom to prevent the spread of bacteria.
Wash your hands prior to touching yourself and washing the genital area, including your anus.
Yes, it’s true: Emptying your bladder after sex can help you avoid a UTI.
Don’t use deodorant sprays, douches, or powders in the genital area. These can cause you to get a UTI.
Wearing cotton underwear can also help alleviate the risk of a UTI.
You may have heard that using some form of cranberry can help treat or prevent a UTI. While studies are ongoing, unsweetened cranberry juice and some cranberry pills may help fight infections. What we don’t yet know is what type and how much it takes to work.
The bottom line is that using good hygiene and being mindful of symptoms can help you identify an infection early. This can help you feel better sooner by getting the proper treatment. This is particularly important if you are pregnant or have a kidney infection.
Common Questions About Recurrent Urinary Tract Infections in Women. Arnold JJ, Hehn LE, Klein DA. Am Fam Physician. 2016 Apr 1;93(7):560-9.