Urinary Tract Infection (UTI)

Urinary tract infections can be diagnosed and treated by the Urology Division at Premier Medical Group.

What is a urinary tract infection?

A urinary tract infection (UTI) is an infection of the urinary system. A UTI occurs when bacteria grow excessively within any portion of the urinary system (kidneys, ureters, bladder, urethra). The most common type of UTI involves the bladder and is known as acute cystitis. Infections within the kidney (the upper urinary tract) cause greater systemic symptoms and are called pyelonephritis. These infections commonly cause frequent, painful, and/or foul-smelling urination, but they can also other general symptoms such as fever, nausea, fatigue, and even mental confusion.

What are the Risk Factors for a UTI?

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Most UTI’s occur in adult women, who are more prone to the condition than men due to their shorter urethra and its closer proximity to fecal contamination. As a result, women are more likely to get an infection after sexual activity or perhaps when using a diaphragm for birth control. Menopause also increases the risk of a UTI.

UTI’s are very uncommon in children younger than 5 years old, and even more uncommon in boys at any age. Uncircumcised males are more likely to develop UTI than circumcised males. Children with a congenital anomaly of the urinary tract are more likely to develop UTI.

What causes a urinary tract infection?

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Urinary tract infections are caused by germs, typically bacteria that enter the urethra and travel to the bladder. If these bacteria are able to survive and grow, they can cause an infection. Many lower urinary tract infections (cystitis) can be cleared by increased fluid intake and by the body’s own immune system. UTI’s may be more likely to occur in the presence of upper urinary tract obstruction, kidney stone, incomplete bladder emptying, and hormonal change (menopause). Lower UTI’s can sometimes be caused by a viral infection, which is more common in immunocompromised patients.

Other factors that can increase your chances of developing a UTI include:

  • Diabetes
  • Advanced age (people in nursing homes are more susceptible)
  • Trouble emptying your bladder, perhaps due to a neurologic condition
  • Anything that blocks the flow of urine, such as an enlarged prostate or narrowed urethra
  • Kidney stones
  • A urinary catheter
  • Bowel incontinence

What are the symptoms of a urinary tract infection?

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Common symptoms of UTI’s include:

  • Frequent and urgent urination
  • Painful or difficult urination
  • Discomfort above the pubic bone
  • Blood in the urine
  • Cloudy or foul smelling urine
  • Nausea and/or vomiting
  • Fever above 101° Fahrenheit
  • Chills and shaking or night sweats
  • Small amount of urine, even though you have urge to go
  • Side, back or groin pain (sometimes severe abdominal pain)
  • Fatigue and general ill feeling
  • Flushed, warm, or reddened skin
  • Mental status changes or confusion (particularly in the elderly)

How is a urinary tract infection diagnosed?

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The fastest way to diagnose a urinary tract infection is via urinalysis, which includes use of a dipstick and microscopic analysis by trained personnel. Confirming a diagnosis of UTI is often done with a urine culture, which also helps ensure that the appropriate antibiotic is selected.

Your doctor may order the following tests to diagnose any structural causes in the urinary system that can predispose you to repeat UTI’s:

  • CT scan of the abdomen
  • Intravenous pyelogram (IVP) Kidney scan
  • Kidney ultrasound
  • Voiding cystourethrogram

What are the types of urinary tract infections?

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The different types of UTI’s are determined by where the infection occurs in the urinary tract:

  • Urethritis: This is an infection of the urethra, which is the hollow tube that drains urine from the bladder to the outside of the body.
  • Cystitis: This type is a bacterial infection in the bladder.
  • Pyelonephritis: This is an infection of the kidneys. Usually this is the result of an infection that has spread up the urinary tract, or possibly from an obstruction in the urinary tract. When an obstruction in the urinary tract occurs, this can cause urine to back flow into the ureters and kidneys.

How are urinary tract infections treated?

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The treatment for UTI’s is usually a simple, short course of antibiotics. With complications or when left untreated for too long, these infections can spread to the upper urinary tract and result in significant illness. In addition to appropriate antibiotic treatment, your physician will discuss other interventions to minimize your chances of developing another infection. First, your doctor must decide if you have an infection, and whether your infection is more serious.

First, your doctor must decide if you have an infection, or whether your infection is more serious.

Urinary tract infections are often treated with antibacterial drugs. The type of drug used and the duration of treatment depend on the type of bacteria. Most UTIs are treated with trimethoprim-sulfamethoxazole (e.g., Bactrim®, Cotrim®, Septra®), amoxicillin (e.g., Amoxil®, Trimox®), or fluoroquinolones (e.g., Levaquin®, Cipro®). Your UTI may get better within a couple of days, but 1 to 2 weeks of medication may be prescribed to treat a kidney infection.

Over-the-counter pain relievers (such as Tylenol® and Advil®), along with a heating pad, will help relieve discomfort. You should drink plenty of water to help cleanse bacteria out of the urinary tract. You should avoid alcohol, caffeine, and smoking.

Natural Remedies

The most popular natural remedy is cranberry juice. Make sure it’s pure cranberry juice and not “juiced cocktail”, which contains increased sugar. Cranberry juice seems to work by inhibiting the growth of bacteria and making it harder for the bacteria to cling to urinary tract walls. Watermelon, celery, and parsley may also provide UTI relief because they act as a diuretic, which helps to flush out the bladder.

How are urinary tract infections prevented?

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Here are things we recommend to prevent urinary tract infections:

  • Drink plenty of fluids
  • Avoid vaginal douching
  • Wipe anus from front to back
  • Do not routinely resist the urge to urinate
  • Wear underwear with cotton crotch
  • Keep the groin clean and dry
  • Avoid bubble bath, scented feminine products
  • Cleanse the genital area before sexual intercourse.
  • Take showers instead of baths.
  • Urinate after sexual intercourse.
  • Do not smoke