UTIs: Information and Treatment

A UTI is a urinary tract infection, which is an infection that impacts on any area of the urinary system such as the kidneys, bladder, urethra and ureter. The great majority of such infections affect the bladder and the urethra. UTIs are more common in women than men, and while infections that affect only the bladder can be annoying and painful, UTIs that spread to the kidneys can have far more serious consequences. Urinary tract infections are normally treated by doctors with antibiotics, but there are a number of things patients can do to cut down the likelihood of developing a UTI at all.

Symptoms

Symptoms and signs do not always manifest as a result of a urinary tract infection, but when they do they can include:

  • A persistent and strong desire to urinate
  • The frequent passing of small amounts of urine
  • Urine that appears bright pink, red or coloured like cola, which is an indication of blood in the urine
  • Pain in the pelvis for women, particularly in the pelvic centre and near the pubic bone area

 

In older adults urinary tract infections can often be mistaken for another condition, or even completely overlooked.

Urinary tract infections come in three different types, which can result in more specific symptoms and signs related to the particular condition. A UTI in the kidneys is called pyelonephritis, and can result in upper back and side pain, chills and shaking, fever, nausea and vomiting.

A bladder infection is called cystitis, and results in a feeling of pressure in the pelvis, frequent and painful urination, discomfort in the lower abdomen, and blood in the urine.

A UTI in the urethra is known as urethritis, symptoms of which include discharge and a burning sensation when urinating. If you have any symptoms or signs that you believe may be the result of urinary tract infection, then you should see a doctor.

Causes

Urinary tract infections take place after bacteria enter the urinary tract via the urethra, and start multiplying within the bladder. The urinary system is generally able to resist such small interlopers, but sometimes defences fail, allowing the bacteria to take hold and become a serious infection. Women are more frequently affected by UTIs, with the urethra and bladder being the primary areas affected by the infection.

A bladder infection is normally the result of the bacteria known as Escherichia coli, which is normally present in the gastrointestinal tract, though other bacteria can sometimes be responsible. Although cystitis can be caused by sexual intercourse, those who are not sexually active can still develop the infection. All women are at risk simply because of the female anatomy, in particular the distance from the urethra up to the anus and the bladder’s urethral opening. Infection of the urethra can be caused when bacteria spread to the urethra from the anus, although sexually transmitted infections such as chlamydia, gonorrhoea, herpes and mycoplasma can also result in the infection due to the proximity of the urethra to the vagina.

Risk factors

There are a number of risk factors that increase the possibility of developing a UTI. For women in particular these risk factors include:

  • Sexual activity, with a higher rate of UTIs among sexually active women, and the risk increasing with a new sexual partner
  • Menopause, which results in changes to the urinary tract because of a fall in circulating oestrogen that can result in a greater likelihood of infection
  • Some forms of birth control, particularly spermicidal agents and diaphragms

 

More general risk factors include:

  • Abnormalities in the urinary tract that result in urine backing up in the urethra, or otherwise not exiting the body normally
  • The immune system being suppressed by diseases such as diabetes
  • Recent urinary procedures
  • The urinary tract being blocked by an enlarged prostate or kidney stones
  • The use of a catheter

Treatment

Antibiotics for a UTI are the normal first course of treatment, with short courses of treatment normally recommended for uncomplicated cases. Those who suffer frequent infections may need low dose antibiotics for longer periods. Vaginal oestrogen therapy may be appropriate for women who are postmenopausal, while intravenous antibiotic treatment in a hospital may be required for those with a severe UTI infection.