Urinary tract infection

What is a urinary tract infection (UTI)?

A urinary tract infection (UTI) is a common infection of parts of the urinary tract. This infection causes pain, burning on passing urine and the urge to pass urine frequently. Such infections occur when the normally sterile and germ-free urine becomes infected with bacteria or other microorganisms. The most common bacteria causing a UTI is called E.coli, though other bacteria such as Staphylococcus and Chlamydia can also cause infection.  These bacteria or organisms enter the urethra – the tiny tube that links the genitals to the bladder – and cause irritation (urethritis). The infection can then spread back to the bladder causing cystitis (inflammation of the bladder). If a UTI is left untreated the infection can track even further back to the kidneys, via two small tubes called the ureters (one connects between each kidney and the bladder). This kidney infection is called pyelonephritis and can be a serious health problem.

With the right treatment, a UTI can be cleared quickly – in just one or two days. Even if your symptoms quickly go away, always finish any antibiotic course given by your doctor  - this will ensure the infection does not return  in a stronger or different form.

UTIs are much more common in women than men because their urethra is very close to the vagina and anus, so bacteria can spread easily. Women also have a shorter urethra than men which means bacteria can travel to the bladder quicker. Sexual intercourse can also irritate the urethra in a woman and increase the incidence of a UTI, and after the menopause UTIs can also become more common in women because of changes in the urethra, bladder and vagina due to hormonal changes. In men, UTIs can indicate  prostrate problems, kidney stones or a sexually transmitted disease, and in the elderly UTIs can cause confusion and falls.

What are the signs and symptoms of a UTI?

Burning and pain on urination

An urge to pass urine regularly

A feeling you need to urinate again even when you have just passed urine

Passing only small amounts of urine

Tiredness

The urine may be cloudy and strong smelling, and can have blood in it.

Are any tests required?

Although a UTI is usually obvious from the clinical symptoms, a doctor may order a urine test called a `mid-stream’ urine test where urine is collected part way through passing urine, which prevents bacteria from the genital region contaminating the sample. This test will determine the which antibiotic is needed to fight the infection and will also discover if there is pus or red blood cells in the urine.

Recurrent urinary tract infection or UTI’s that fail to respond to treatment may mean the doctor will order additional tests such as an ultrasound or other tests to see if there is a deeper problem in the urinary system.

Once treatment is complete, your doctor may order a follow-up urine test to ensure the infection has properly cleared

For recurrent UTIs caused by sexual intercourse, a single dose antibiotic following sex might be prescribed

A UTI caused by bacteria such as Chlamydia or Mycoplasma may be sexually transmitted, meaning both partners will need to be treated to prevent re-infection.

What can I do to prevent urinary tract infections occurring?

Drink plenty of water every day.

Don’t delay urination – when you have the urge to pass urine do it.

Urinate soon after sex and ensure the genital area is clean before sex.

Always wipe from the front to the back after you have used the toilet to stop bacteria spreading from the anus into the urethra.

Avoid sprays and douches that may irritate the urethra.

Avoid coffee, alcohol, spicy and sugary foods when fighting a UTI.

Shower instead of taking a bath.

Stop smoking – smoking can cause bladder problems, and is also a major cause of bladder cancer.

If you're a woman, using a diaphragm for contraception can increase the risk of getting a UTI because the diaphragm may press on your bladder and prevent it from emptying completely when you urinate. If you use a diaphragm and have recurring UTIs, consider changing to another method of contraception.

If you get recurring UTIs and you use condoms, try using condoms that don’t have a spermicidal lubricant on them – it will say whether it does on the packet. Spermicidal lubricant can cause irritation and make it more likely that you’ll get a UTI. There are lots of condoms that have non-spermicidal lubricant, so use these instead.