What are urinary tract infections?

Urinary tract infections or UTIs are infections in any part of the urinary tract. They are a common health problem that affects millions of people each year. Women are especially prone to UTIs.

A UTI may affect any part of the urinary tract causing:

• Urethritis. This is an infection of the urethra. This is the hollow tube that carries urine from the bladder to the outside of the body.

• Cystitis. This is a bladder infection caused by germs that have moved up from the urethra.

• Pyelonephritis. This kidney infection is most often caused by an infection that has spread up the urinary tract, or by a blockage in the urinary tract. A blockage causes urine to back up into the ureters and kidneys. The ureters are the hollow tubes that drain urine from the kidneys into the bladder.

• Abscess. A collection of pus along the course of the urinary tract.

What causes urinary tract infections?

Normal urine is sterile and contains fluids, salts, and waste products. It does not contain bacteria, viruses, or fungi. A UTI happens when germs, most often bacteria from the digestive tract, get into the opening of the urethra and start to multiply.

Most UTIs are caused by E. coli bacteria, which normally live in the colon.

What are the symptoms of a urinary tract infection?

These are the most common symptoms of a UTI:

• Frequent urination

• Pain or burning when passing urine

• Fever

• Urine looks dark, cloudy, or reddish in color. (Blood may be present in the urine.)

• Urine smells bad

• Feeling pain even when not urinating

• Tiredness

• Pain in the belly (abdomen) area below the bellybutton, or in the back or side, below the ribs

• Nausea or vomiting

• Have a strong urge to urinate, but only a small amount of urine is passed

• Women may feel an uncomfortable pressure above the pubic bone

• Older adults can have a change in their mental state, such as confusion or severe lethargy

The symptoms of a UTI may look like other conditions or health problems. Always see a healthcare provider for a diagnosis.

How are urinary tract infections diagnosed?

Your healthcare provider will review your health history and do a physical exam. Other tests may include:

• Urinalysis. Lab testing of urine is done to check for various cells and chemicals. These include red and white blood cells, germs (such as bacteria), or protein.

• Urine culture. This is a lab test to grow possible bacteria found in the urine. It can also determine which antibiotics are best for treatment.

• Urine DNA tests. This is a lab test to isolate the DNA of bacteria living in the urine and find out which antibiotics will kill the bacteria.

If UTIs become a repeated problem, other tests may be used to see if the urinary tract is normal. These tests may include:

• Cystoscopy. In this test, a thin, flexible tube and viewing device is put in through the urethra to examine the bladder and other parts of the urinary tract. Structural changes or blockages such as tumors or stones can be found.

• Kidney and bladder ultrasound. This imaging test uses high-frequency sound waves to make images of the bladder and the kidneys on a computer screen. The test is used to determine the size and shape of the bladder and the kidneys, and check for a mass, kidney stone, cysts, or other blockages or abnormalities.

• CT scan. This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs.

How are urinary tract infections treated?

Treatment for UTIs may include:

• Antibiotics

• Other medicines to ease pain

You may also need to make lifestyle changes such as:

• Drinking plenty of water to help wash bacteria out of the urinary tract

• Not having coffee, alcohol, or spicy foods

• Quitting smoking

Can urinary tract infections be prevented?

These steps may help reduce the chance of getting UTIs:

• Drink plenty of water every day.

• Urinate when you feel the need. Don't wait.

• Females, wipe from front to back to keep bacteria around the anus from going in the vagina or urethra.

• Take showers instead of tub baths.

• Clean the genital area before and after sex, and urinate shortly after sex.

• Women should not use feminine hygiene sprays or scented douches.

• Cotton underwear and loose fitting clothes help keep the area around the urethra dry. Tight clothes and nylon underwear trap moisture. This can help bacteria grow.

• Repeated UTIs can be treated with small doses of regular antibiotics.

Talk with your healthcare provider if you have any questions or concerns about UTIs.

Key points about urinary tract infections

• Urinary tract infections (UTIs) are a common health problem that affects millions of people each year. These infections can affect any part of the urinary tract.

• Most UTIs are caused by E. coli bacteria, which normally live in the colon.

• The most common symptoms of UTIs include changes in urination such as frequency, pain, or burning.

• Lab tests may be done for diagnosis. Imaging tests may be needed to see if the urinary tract is normal.

• Antibiotics are used to treat UTIs. Other treatments may include pain relievers, and drinking plenty of water to help wash bacteria out of the urinary tract.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.