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Urinary Tract Infection (UTI) Symptons and Treatment

 

Urinary Tract Infection (UTI) is the name given to an infection in any part of the urinary system, usually by bacteria. Bacteria enter the urinary system through the urethra, or more rarely, through the bloodstream.

Symptoms of urinary tract infections

The symptoms of urinary infection are often termed cystitis or urthritis, although this terminology more accurately refers to inflammation of the bladder or urethra which may be caused by diseases other than those of bacterial origin.

The symptoms of UTI can vary, depending on whether the infection affects the lower (bladder and urethra) or upper (kidneys and ureters) parts of the urinary tract.

Lower urinary tract infection symptoms

  • Burning sensation on passing urine.
  • Need to pass urine more frequently than normal.
  • Need to hurry to the toilet to pass urine.
  • Urine can be cloudy with an offensive odour.

Upper urinary tract infection symptoms

People with upper urinary tract infection are likely to experience the symptoms above, plus:

  • Feeling unwell.
  • Having a high temperature and chills.
  • Loin (kidney) pain.
  • Patient is likely to be ill and could require hospital admission.

 

Types of urinary tract infections

Urinary tract infections may be simple or complicated:

Uncomplicated (simple) UTI

No structural or functional abnormality within urinary tract or underlying disease known to increase the risks of acquiring infection or failing therapy

Complicated UTI

Structural or functional abnormality of the urinary tract or the presence of an underlying disease which increases the risk of acquiring an infection or failing therapy

 

How common are urinary tract infections?

UTIs are more common in women than in men. Approximately 50 per cent of women will need treatment for at least one UTI during their lifetime, resulting in over 7 million consultations each year in the United Kingdom.

  • UTIs occur rarely in men and all such episodes warrant investigation.
  • UTIs in children can cause kidney damage, so prompt treatment is important.
  • Treating UTIs in pregnant women is also vital as, left untreated, a UTI can cause low birth weight or premature birth.

 

How is a urinary tract infection diagnosed?

Your doctor can undertake a simple test placing a plastic strip into a sample of fresh urine, giving a result within a minute or two. In many cases, however, it will be necessary to send a sample of urine to a laboratory for culture testing. This will confirm that infection is present, identify the kind of bacteria causing the infection and check that the antibiotic prescribed by the doctor is appropriate for the type of infection.

In women, no further investigations would usually be required, unless the UTI was a recurring problem. In men and children, additional investigations may be carried out to identify any underlying cause. These examinations may include an ultrasound scan of the bladder and kidneys and/or cystourethroscopy (examination of the inside of the bladder using a flexible telescope inserted into the bladder via the urethra).

 

What causes a urinary tract infection?

The bacteria which cause a UTI are usually present within an individual’s body and pass into the urinary system. A number of factors increase the risk of developing UTI:

Being female

The female urethra is shorter than the male’s and this means women’s bladders are more vulnerable to bacteria than men’s. Colonisation of vagina and urethra by more aggressive bacteria is allowed by oestrogen deficiency in older women and spermicidal jelly in sexually active women.

Failure to completely empty the bladder

This is likely to be obstruction caused by prostate enlargement in older men or neurological diseases in either men or women

Being pregnant

Being diabetic

Abnormal structure of the bladder

‘Vesico-ureteric reflux’

A condition that some children are born with, which causes urine to flow back into the ureters or kidney during urination.

Stones in the urinary tract

‘Foreign body’ in the urinary tract

Urinary catheters, nephrostomy tubes (a tube inserted into the kidney to drain urine) and ureteric stents (a wire tube fitted in the urethra to keep the passage open) all increase the likelihood of infection.

 

Treatment of urinary tract infections

Urinary tract infections are normally treated effectively with an antibiotic and symptoms usually start to improve within 24 hours of starting antibiotics.

Sometimes the culture test result may mean a different antibiotic is needed.

People who are prone to recurrent UTIs usually find drinking sufficient fluids, to regularly flush their urinary system, is helpful. Washing and passing urine after sexual intercourse can also be helpful. Self-start antibiotic therapy is used to prevent early infections from gaining hold. Short antibiotic course prevent bacterial resistance to antibiotics from developing. Occasionally patients with recurrent or difficult UTIs need to take continuous low doses of antibiotics.

Post menopausal women may benefit from short courses of vaginal oestrogens to help improve the protective lining of the vagina. There is some evidence to support the use of cranberry to prevent bacterial adhesion to the lining of the urethra and bladder. Lactobacilli yoghurts may also help prevent colonisation of the vagina by aggressive bacteria.

Surgery is sometimes needed to correct an abnormality of the urinary tract that increases the likelihood of an individual having an infection. Children with vesico-ureteric reflux may require preventative antibiotics for a period of time, but the condition usually improves without surgery as they grow older. If UTI is caused by the presence of renal stones, these will need to be removed. This is commonly undertaken using lithotripsy, an external shock wave therapy that breaks the stones into small pieces which are then passed out of the body within the urine.

However, urinary tract infections are normally very simple to treat and respond well to a course of antibiotics.

 

The information contained within this website has been provided as a general guide and should not be treated as a substitute for the medical advice of your own GP or any other health professional.