Urology Center of Englewood

Urinary Tract Infections in Adults

Overview

The urinary tract includes the kidneys, the ureters, the bladder, and the urethra. The kidneys create urine by filtering the blood and removing waste and excess water. From the kidneys, urine travels to the bladder through small tubes called ureters. Urine is then stored in the bladder until it is passed to the outside of the body through the urethra. The opening of the urethra is at the end of the penis in men, and just in front of the vagina in women.

Urinary tract infections (UTIs) are very common. A majority of the infections are caused by bacteria that enter the urinary tract through the urethra and then travel upwards. An infection of the urethra is called urethritis, an infection of the bladder is called cystitis, and an infection of the kidney is called pyelonephritis.

Who Gets UTIs?

Anyone can get a urinary tract infection, but certain groups of people are at higher risk than others. For example, UTIs tend to be more common in women than in men. Women have a shorter urethra than men, making it easier for bacteria to reach the bladder. The opening of a woman’s urethra is also close to the opening of the vagina and the anus, which can be sources of bacteria.[1] Factors that can further increase a woman’s risk of UTI include menopause and certain types of contraceptives, such as diaphragms, spermicides, and condoms.

Other groups at increased risk of UTI include people with spinal cord injuries or other nerve problems that affect the bladder, health conditions that interfere with urine flow, diabetes, or a suppressed immune system. Catheters (tubes inserted through the urethra to drain urine) also make a UTI more likely.

What Are the Symptoms of a UTI?

UTI symptoms can vary, but may include a frequent or intense need to urinate and a burning feeling during urination. Urine may also smell and look different (urine may be dark, cloudy, or bloody). If a fever is present, it may mean that the infection has reached the kidneys; infections confined to the lower urinary tract (the bladder and urethra) usually do not cause a fever. Pain in the back or side may also indicate a kidney infection.

How is a UTI Diagnosed?

A diagnosis of UTI is based on your symptoms as well as the results of urine tests. Urine tests check for signs of infection in the urine, such as bacteria and white blood cells. If you have had recurrent urinary tract infections, additional tests may be performed in order to check for an underlying problem with the urinary tract.

Management of a UTI

Seeking prompt, effective treatment of a UTI is important. For a simple, uncomplicated case of UTI, treatment commonly involved a short course of oral antibiotics. It’s important to finish the entire prescription even if you quickly begin to feel better.

If you have a more complicated case, such as one that involves underlying urinary tract problems or an infection with bacteria that are resistant to treatment,  you may need a much longer course of antibiotics, some of which may be administered intravenously (into a vein).

Understanding Kidney Infections

A kidney infection—also referred to as pyelonephritis—is a UTI that has reached one or both kidneys. It is less common than infections of the bladder and urethra, but can also be much more serious. A severe or untreated kidney infection can cause kidney damage and other serious problems. Factors that increase the likelihood of a kidney infection include pregnancy, diabetes, and kidney stones or other causes of urinary obstruction.

Symptoms of a kidney infection include pain in the back, side, or groin; fever; nausea and vomiting; discomfort during urination; urinary frequency or urgency; and blood or pus in the urine. Treatment of a kidney infection involves antibiotics, some of which may need to be administered in the hospital.

UTIs During Pregnancy

UTIs during pregnancy can pose risks to both the mother and the baby, making detection and treatment very important. Pregnant women are more likely than other women to have a UTI reach the kidneys.

UTI Prevention

Although you can never eliminate your risk of getting a UTI, there are several steps that you can take to make an infection less likely:

  • Drink plenty of fluids (if you have a kidney problem or other health condition, talk with your doctor about what’s safe).
  • Urinate whenever the urge arises.
  • Urinate shortly after sex.
  • Wear underwear that is made of cotton or another natural fiber.
  • Avoid tight clothing.
  • For women: after using the toilet, wipe from front to back.
  • Also for women: if you have a problem with UTIs and use certain types of birth control (such as spermicide or a diaphragm), talk with your doctor about whether it would be advisable to try a different form of birth control.

References:


[1] National Kidney and Urologic Diseases Information Clearinghouse. Urinary Tract Infections in Adults. NIH Publication No. 12-2097. November, 2011.