A urinary tract infection (UTI) is an infection involving the urinary tract (the kidneys, ureters, bladder and/or urethra). UTIs are extremely common and are estimated to account for over 8.1 million physician visits annually.
Urine is normally sterile, meaning that it contains no bacteria. It is possible for bacteria to enter urine via the urethra and cause a bladder infection (cystitis) or a kidney infection (pyelonephritis). The body normally has defenses that prevent these infections, but sometimes, the defenses break down and an infection occurs.
What are Symptoms of UTI?
Common symptoms of a UTI are burning with urination, the urge to urinate frequently, bladder or lower abdominal pressure, and, in some cases, blood in the urine (hematuria). If the infection is severe or involves the kidneys, fevers and lower back pain may occur.
Who gets UTIs?
40% of women and 12% of men are estimated to have a symptomatic UTI in their lifetime. Some people are more prone to UTI than others.
Women who have gone through menopause are at increased risk because of the loss of the protective estrogen effects. Sexual intercourse has been shown to increase risk, as has diaphragm usage. Some women are genetically more prone to getting UTIs.
A history of diabetes or steroid usage can put one at risk of UTIs. A recent history of surgery on the urinary tract or instrumentation (a catheter or ureteral stent) also increases UTI risk. Some individuals have congenital urinary conditions that put them at risk, and men with kidney stones or BPH may become more prone to UTIs.
How are UTIs Diagnosed?
A urinalysis and urine culture are performed to determine if there are any specific types of bacteria or signs of infection (white blood cells). This testing is important because some of the symptoms of UTI can be due to other, possibly more serious, conditions. It is important that patients with hematuria have a complete urologic evaluation, especially if a UTI was not confirmed to be the cause of the hematuria.
How are UTIs Treated?
UTIs may require antibiotics to eradicate the bacteria that caused the infection. A usual course of antibiotics may only be for three to five days, but some complicated infections may require longer therapy. There are also some medications that can help relieve some of the symptoms of UTI. In rare cases, patients require hospitalization for severe infections.
Do I Need Special Testing Because I get UTIs?
A urologist will perform a detailed history and physical examination and review urinalyses and urine cultures. Some patients benefit from imaging studies to evaluate their upper urinary tract (kidneys and ureters) in more detail. This could include an ultrasound or CT scan. A cystoscopy may be recommended in special cases to more completely evaluate the lower urinary tract (bladder and urethra).