Urinary Tract Infection (UTI)
What is a urinary tract
infection (UTI)?
A urinary tract infection (UTI) is an infection of your
urinary system. This type of infection can involve your:
Urethra (urethritis).
Kidneys (pyelonephritis).
Bladder (cystitis).
Urine (pee) is a byproduct of your blood-filtering system,
which your kidneys perform. Your kidneys create pee when they remove waste
products and excess water from your blood. Pee usually moves through your
urinary system without any contamination. However, bacteria can get into your urinarysystem, which can cause UTIs.
What is the urinary tract?
The urinary tract makes and stores pee. It includes your:
Kidneys. Kidneys are small, bean-shaped organs on the back
of your body, above your hips. Most people have two kidneys. They filter water
and waste products from your blood, which becomes pee. Common wastes include
urea and creatinine.
Ureters.
Your ureters are thin tubes that carry pee from your kidneys to your bladder.
Bladder.
Your bladder is a balloon-like organ that stores pee before it leaves your
body.
Urethra.
The urethra is a tube that carries pee from your bladder to the outside of your
body.
How common are urinary tract
infections?
UTIs are very common, especially in women and people
assigned female at birth (AFAB). About 20% of people AFAB will have a UTI at
some point during their lives. Men and people assigned male at birth (AMAB) can
also get UTIs, as well as children, though they only affect 1% to 2% of
children. Healthcare providers treat 8 million to 10 million people each year
for UTIs.
SYMPTOMS AND CAUSES
What
are the signs of a urinary tract infection?
A UTI causes inflammation in the lining of your urinary
tract. The inflammation may cause the following problems:
Pain in your flank, abdomen, pelvic area or lower back.
Pressure in the lower part of your pelvis.
Cloudy, foul-smelling pee.
Urinary incontinence.
Frequent urination.
Urge incontinence.
Pain when you pee (dysuria).
Blood in your pee (hematuria).
Other UTI-associated symptoms may include:
Pain in your penis.
Feeling extremely tired (fatigue).
Fever.
Chills.
Nausea and vomiting.
Mental changes or confusion.
How do you get a urinary tract infection?
Microorganisms — usually bacteria — cause urinary tract
infections. They typically enter through your urethra and may infect your
bladder. The infection can also travel up from your bladder through your
ureters and eventually infect your kidneys.
What is
the major cause of a urinary tract infection?
E. coli cause more than 90% of bladder infections. E. coli
typically exist in your lower intestines (large intestine).
Who is
at the greatest risk of getting a urinary tract infection?
Anyone can get a urinary tract infection, but you’re more
likely to get a UTI if you have a vagina. This is because the urethra in people
AFAB is shorter and closer to the anus, where E. coli bacteria are common.
Can you
get a UTI from fingers?
Yes, it’s possible to get a UTI from your fingers. Your
hands can pick up bacteria and other microorganisms whenever you touch a
surface. You can accidentally introduce bacteria to your urethra when you go to
the bathroom or during sexual acts, including masturbation or fingering.
It’s a good idea to wash your hands before and after going
to the bathroom or having sex.
DIAGNOSIS AND TESTS
How do
you know if you have a UTI?
If you have symptoms of a urinary tract infection, talk to a
healthcare provider. They’ll ask questions about your symptoms, review your
medical history and conduct a physical examination. They can also order tests
to help confirm a diagnosis.
What
tests will be done to diagnose a urinary tract infection?
A healthcare provider may order the following tests to
diagnose a UTI:
Urinalysis.
During this test, you’ll pee into a special cup. The provider will send the
sample to a laboratory, where technicians will examine it for signs of a UTI
using multiple variables such as nitrites, leukocyte esterase and white blood
cells.
Urine culture.
You’ll pee into a special cup, and lab technicians will test your sample to
grow and identify any bacteria that are present. Urine cultures are important
because they help your provider determine the most appropriate treatment.
If your infection doesn’t respond to treatment, a provider
may order the following tests to examine your urinary tract for a disease or
injury:
Ultrasound. An
ultrasound is an imaging test that helps your provider look at your internal
organs. An ultrasound is painless and doesn’t require any preparation.
Computed tomography
(CT) scan. A CT scan is another imaging test. It’s a type of X-ray that
takes cross-section images of your body — like slices — that create 3D images
of the inside of your body. A CT scan is more precise than a standard X-ray.
Cystoscopy. A
cystoscopy uses a cystoscope to look inside your bladder through your urethra.
A cystoscope is a thin instrument with a lens and a light at the end.
If you get UTIs frequently, a healthcare provider may
perform tests to check for other health issues — such as diabetes or an
abnormal urinary system — that may contribute to your infections.
MANAGEMENT AND TREATMENT
What is the best thing to do for a urinary tract infection?
The best thing to do for a urinary tract infection is to see
a healthcare provider. You need antibiotics to treat a UTI. Your provider will
select an antibiotic that works best against the bacteria responsible for your
infection.
Once you get a prescription for antibiotics, it’s very
important that you follow the directions for taking them. Be sure to take the
full course of antibiotics, even if your symptoms go away and you start feeling
better. If you don’t finish all your medicine, the infection can return and be
more challenging to treat.
If you get UTIs a lot, a provider may recommend that you
take antibiotics:
Every day.
Every other day.
After sex.
At the first sign of symptoms.
Talk to a provider about your best treatment option if you
have a history of frequent UTIs.
What specific antibiotics are used to treat a urinary tract
infection?
Healthcare providers commonly prescribe the following
antibiotics to treat UTIs:
Nitrofurantoin.
Sulfonamides (sulfa drugs), such as
sulfamethoxazole/trimethoprim.
Amoxicillin.
Cephalosporins, such as cephalexin.
Doxycycline.
Fosfomycin.
Quinolones, such as ciprofloxacin or levofloxacin.
If you get UTIs often, a healthcare provider may give you
low-dose antibiotics for a short time to prevent the infection from coming
back. The provider may recommend this cautious approach to treat frequent UTIs
because your body can develop resistance to the antibiotic, and you can get
other types of infections, including C. diff colitis. This practice isn’t very
common.
Can I
become immune to the antibiotics used to treat a UTI?
Yes. Every time you use antibiotics to treat a UTI, the
infection adapts and can become harder to fight (antibiotic resistance).
Therefore, antibiotics may not always be the best solution. As a result, a
healthcare provider may suggest alternative treatments if you get frequent
urinary tract infections. These may include:
Waiting. Your provider may suggest a “watch and wait”
approach to your symptoms. During this time, it’s a good idea to drink plenty
of fluids (especially water) to help flush out your system.
Intravenous (IV)
treatment. In some complicated cases, a UTI may be resistant to antibiotics,
or the infection may move to your kidneys. You may need treatment at a
hospital, where providers will give you medicine through a needle they insert
into a vein, usually in your arm (intravenously). Once you return home, you may
need to take oral antibiotics for a period to rid yourself of the infection
completely.
Does
cranberry juice prevent a urinary tract infection?
Cranberry juice that you can buy at the grocery store
doesn’t prevent a UTI. However, cranberry extract supplements (vitamin pills)
may decrease your chances of getting a UTI.
If you get UTIs often, methenamine hippurate is another
nonantibiotic alternative that helps prevent infections
PREVENTION
Can I
prevent a urinary tract infection?
The following lifestyle changes can help prevent urinary
tract infections:
Practice Good Hygiene
Practicing good hygiene is one of the best ways to help
prevent UTIs. This is especially important if you have a vagina because your
urethra is much shorter, and it’s easier for E. coli to move from your rectum
back into your body. Always wipe from front to back after a bowel movement
(pooping) to avoid this.
During your menstrual cycle, it’s also a good idea to
regularly change your period products, including pads and tampons. You should
also avoid using any deodorants on your vagina.
Drink plenty of
fluids
Drinking extra fluids — especially water — each day can help
flush out bacteria from your urinary tract. Healthcare providers recommend
drinking six to eight glasses of water daily.
Change your peeing
habits
Peeing can play a big role in getting rid of bacteria from
your body. Your pee is a waste product, and each time you empty your bladder,
you help remove that waste from your body.
Peeing frequently can reduce your risk of developing an
infection, especially if you get UTIs a lot.
You should also try to pee right before and right after
having sex. Sex can introduce bacteria to your urethra, and peeing before and
after sex helps flush it out. If you can’t pee, wash the area with warm water.
Change your birth
control
Some people have an increased risk of developing a UTI if
they use a diaphragm for birth control. Talk to a healthcare provider about
other birth control options.
Use a water-based
lubricant during sex
If you use lubricant during sex, make sure it’s water-based.
You should also avoid spermicide if you have frequent UTIs.
Change your clothing
Tight-fitting clothing can create a moist environment, which
promotes bacterial growth. You can try loose-fitting clothing and cotton
underwear to prevent moisture from accumulating around your urethra
