Urinary Tract Infections (UTI)

The urinary tract includes the kidneys, bladder, and urethra, which is the small tube that connects the bladder to the outside of the body. Urinary tract infections (UTI) are when a part of this tract becomes infected. Although both men and women can get UTIs, these infections are about four times more likely in women.

UTIs can be painful and uncomfortable. Usually treatment with antibiotics is all that is required.

Symptoms

Most urinary tract infections begin at the urethra. Common symptoms include:

• Burning or pain during urination
• Feeling like you need to urinate more often than usual
• Feeling the urge to urinate but not being able to
• Leaking a little urine or discharge
• Cloudy, dark, smelly or bloody urine

Symptoms of kidney infection may include:

• Upper back and side pain
• High fever
• Shaking and chills
• Nausea
• Vomiting

Symptoms of infection in the bladder include:

• Pressure in the pelvic region
• Lower abdomen discomfort
• Frequent, painful urination
• Blood in urine

In a child, symptoms may include any of the symptoms listed above and may also include:

• Fever
• Diarrhea
• Vomiting
• Irritability or fussiness
• Fatigue or being less active
• Stomach pain
• Back pain
• Bathroom accidents, even though he or she is potty trained

Causes/Risk Factors

UTIs are caused by bacteria in the urinary tract. There are a number of ways bacteria can be introduced to this area including:

• Bacteria from the rectum – women and girls should wipe from front to back after using the bathroom.
• Sex – urinating after sex can help clear the area of bacteria.
• Using a diaphragm – diaphragms can push against the urethra and cause irritation and prevent the bladder from completely emptying.
• Spermicides – some can cause irritation, which may aid bacterial growth and infection.
• Douches, oral antibiotics, and menopause – all can change the healthy bacterial composition of the vaginal area, allowing the growth of harmful bacteria.

Women have about four times as many UTIs as men because bacteria can reach the bladder more easily in women through the shorter urethra.

Diagnosis

Your Erlanger urologist will perform a physical exam and take a medical history. Tests may include:

• Urinalysis – test for bacteria and blood in the urine.
• Blood tests – to rule out other problems.
• CT or MRI scans – provides a more detailed anatomy for patients with repeated infections.
• Cytoscope – using a tiny camera to look at the urinary tract, also for patients with repeat infections or complications.

Treatment

Drugs commonly recommended for simple UTIs include:

• Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)
• Fosfomycin (Monurol)
• Nitrofurantoin (Macrodantin, Macrobid)
• Ciprofloxacin (Cipro)
• Levofloxacin (Levaquin)
• Cephalexin (Keflex)
• Ceftriaxone (Rocephin)
• Azithromycin (Zithromax, Zmax)
• Doxycycline (Monodox, Vibramycin, others)

Often, symptoms clear up within one to three days of treatment. But patients should complete the course of antibiotics as directed.

Your doctor may also prescribe a pain medication that numbs the bladder and urethra to relieve burning while urinating.

If you have frequent UTIs, your treatment may include:

• Low dose antibiotics for a long period (6 months)
• Self-diagnosis and antibiotic refills
• A single dose of antibiotic after sexual intercourse
• Vaginal estrogen therapy for post-menopausal women

For a severe UTI, especially one that affects the kidneys, you may need treatment with intravenous antibiotics in a hospital.

For children with repeated infections, a doctor may want to check to see if an anatomical (physical) problem is causing the UTIs. If so, surgery may be needed.

Outcomes

Treatment is usually successful within one to three days. If a patient has repeated UTIs, doctors will do some more in-depth testing to find the cause. Left untreated, a urinary tract infection can have serious consequences, including kidney damage and sepsis (blood poisoning).

Prevention

Tips on preventing urinary tract infections include:

• Drink plenty of water to flush out bacteria.
• Drink cranberry juice, which has been shown to reduce bacterial infection in the urinary tract.
• Urinate when you feel the need. Remind children to go regularly and not wait.
• Wipe from front to back after bowel movements. Teach children to wipe correctly.
• Urinate after having sex.
• Use lubrication during sex to avoid vaginal irritation.
• If you use a diaphragm and get urinary tract infections often, you may want to change birth control methods.
• Avoid baths with scented soaps or oils.
• Avoid tight clothing.
• Avoid feminine sprays, douches, and powders.
• If you are uncircumcised, wash the foreskin regularly (teach young boys to do the same).
• Empty your bladder soon after intercourse. Also, drink a full glass of water to help flush bacteria.

Erlanger Resources

Erlanger is on the forefront of urological and urogynecological therapies for women. Our fellowship-trained experts excel in the evaluation and treatment of pelvic floor disorders including female urinary incontinence and pelvic organ prolapse.  We provide the highest quality medical and surgical care in a minimally invasive fashion, so that our patients return quickly to healthy, active and productive lives. The following resources are available for patients with these concerns.

Erlanger Urology

Erlanger Gynecological Services