Definition

A urinary tract infection (UTI) is an infection in any part of the urinary system. Most UTIs start in the lower urinary tract in the bladder or urethra. The urethra is the tube that carries urine out of the body. A UTI can also include an infection in the upper urinary system, including the kidneys.

There are different names for infections in different parts of the urinary system, including:

• Urethritis—an infection in the urethra
• Cystitis—bladder infection
• Pyelonephritis—kidney infection

The infection may also occur in the tube connecting the bladder to the kidney. All of these infections are considered to be UTIs.

The Urinary Tract

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Causes

UTIs are caused by bacteria that most often come from the digestive tract or rectal area. The bacteria cling to the opening of the urethra and begin to multiply. If the infection is not treated right away, bacteria may move up the urinary system to the kidneys.

Most infections are caused by a type of bacteria called E. coli. E. coli normally lives in the colon. The bacteria may move from the rectal area to the urethra.

UTIs can also be sexually transmitted. This type of infection usually does not spread past the urethra. Both partners need to be treated.

Risk Factors

Factors that may increase your risk of developing a UTI include:

• Sex: female—the rectum and urethra are fairly close to each other in women, making infection more likely
• Being sexually active
• Using a diaphragm for birth control
• Menopause
• Diabetes
• Kidney stones
• Enlarged prostate
• Weak immune system
• Abnormalities of the urinary system, such as vesicoureteral reflux or polycystic kidneys
• Paraplegia or quadriplegia
• Sickle-cell anemia
• History of kidney transplant
• Bladder catheter in place, or recent device inserted into the urinary system
• Pregnancy

Symptoms

If you have any of these symptoms, do not assume they are due to a UTI. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

• Frequent and urgent need to urinate
• Passing small amounts of urine
• Pain in the abdomen or pelvic area
• Burning sensation during urination
• Cloudy, bad-smelling urine
• Increased need to get up at night to urinate
• Leaking urine
• Fever and chills
• Nausea and poor appetite

An infection in the kidney can be more serious. Call your doctor right away if you have symptoms of a kidney infection, such as:

• Bloody urine
• Low back pain or pain along the side of the ribs
• High fever and chills

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will also be done. A sample of your urine will be tested for blood, pus, and bacteria.

In general, children and men are less likely to get UTIs. Their infections are more likely to be caused by structural problems of the kidneys, bladder, or tubes. As a result, children and men may need more testing to determine the cause of a UTI.

Treatment

UTIs are treated with antibiotic drugs. Standard medical care for a UTI includes taking antibiotics for three days. You will probably start to feel better after a day or two. It is important that you continue to take the entire course of medication, even if you feel better.

You may have your urine checked after you finish taking the antibiotics. This is to make sure that the infection is truly gone. If you have recurrent infections, you may be referred to a specialist.

The infection may cause pain and spasms in the bladder. Your doctor may recommend a medication called Pyridium. It may turn your urine, and sometimes your sweat, an orange color.

Severe UTIs may need a strong initial dose of antibiotics. You may be given antibiotics through an IV or an injection.

Prevention

Here are some steps you can take to keep bacteria out of your urinary tract:

• Drink plenty of liquids, especially water.
• Include cranberry juice in your diet. Some studies suggest cranberry juice may help prevent UTIs.
• Urinate when you feel the need and do not resist the urge.
• Empty your bladder completely and drink a full glass of water after having sex.
• Wash genitals daily.
• If you are a woman, always wipe from the front to the back after having a bowel movement.
• Avoid using douches and feminine hygiene sprays.