Urinary Tract Infections

What Causes a UTI?

A UTI occurs when bacteria, usually E. coli from the gastrointestinal tract, enters the urinary tract through the urethra (the hollow tube that carries urine out of the body from the bladder).

A UTI can affect any portion of the urinary tract. They most commonly involve the urethra and bladder (lower tract), but can sometimes affect the ureters and kidneys (upper tract). Though rarer, infections of the upper urinary tract tend to be more severe. Left untreated, a UTI can progress to a kidney infection or sepsis, a life-threatening condition.

Who Is at Risk for UTI?

Women are more prone to UTIs because of their anatomy. Women have a shorter urethra than men, and it is also in close proximity to the anus. This allows bacteria to travel more easily from around the anus to the urinary tract.

Additional risk factors for women include:

• Being sexually active or having a new sexual partner.
• The use of certain birth control methods such as diaphragms and spermicides.
• The decline in estrogen during menopause.
• Hormonal changes and pressure on the bladder during pregnancy.

Other risk factors include:

• Older age
• Kidney stones
• A previous UTI
• Urinary tract blockage or obstruction
• Use of urinary catheter
• Diabetes
• Weakened immune system

UTI Symptoms

Common symptoms of a urinary tract infection may include:

• Blood in urine
• Dark or cloudy urine
• Fatigue
• Fever
• Foul-smelling urine
• Frequent or painful urination
• Nausea or vomiting
• Pain in the belly, back or sides
• Pelvic pain (in women)
• Urge to urinate without passing much urine

Potential complications of a UTI can include:

• RecurrentUTIs (two or more in six months, or three within a year)
• Kidney damage from an untreated UTI
• Sepsis
• Early delivery or low birth weight if UTI occurs while pregnant

UTI Diagnosis and Treatment

A UTI is generally diagnosed with a urine sample that can be tested for the presence of bacteria or other contaminants. Tests include urinalysis, urine culture and urine DNA tests. These tests can determine the amount and type of bacteria, which will inform the treatment course.

Additional tests may be ordered for people with recurrent UTIs, to identify any abnormalities in the urinary tract. Tests include:

• Cystoscopy: A thin, flexible tube and viewing device is inserted through the urethra to examine the bladder and other parts of the urinary tract.
• Ultrasound of the bladder and kidneys.
• Computed tomography (CT) scan of the urinary tract.

UTIs are treated with antibiotics and pain medications may be used to manage any discomfort. Lifestyle changes that can help include increasing water intake and avoiding coffee, alcohol and spicy foods.

UTI Prevention Tips

While not all UTIs can be prevented, there are a number of ways you can reduce your risk of getting one. These include:

• Drink plenty of water throughout the day.
• Empty your bladder often.
• Wipe from back to front to avoid transferring bacteria to the urethra.
• Urinate after sex, and clean the genital area before and after sex.
• Avoid using feminine hygiene sprays or scented douches.
• Wear breathable, loose-fitting cotton underwear to keep the area around the urethra dry.